APPENDIX 1: Zone Charts

Acupuncture Zones in Zhu’s Acupuncture.

APPENDIX 1, continued: Zone Charts

Acupuncture Zones Based on Motor/Sensory, Speech/Hearing, and Other Divisions
(not used in Zhu’s acupuncture system).

Appendix 2: Dr. Zhu’s Work in America

Dr. Qingming Zhu opened his neurology clinic for scalp acupuncture therapy in Santa Cruz, California in October, 1997, after offering his services for 6 years in San Francisco.Santa Cruz is a small beach town about 85 miles south of San Francisco that supports an acupuncture college-the Five Branches Institute. The neurology clinic shares space in the same building as the college, serving also as a training center for acupuncture students.Another acupuncture clinic is also in the same building, staffed by several experienced Western practitioners, and provides the more standard variety of acupuncture therapy. Although Zhu has learned English, his work is aided by a translator who can speed up and clarify the communications. Still, many of his house calls are made without this help.

While Zhu’s work has gotten some favorable press, his efforts at helping those with neurological problems remains an uphill battle.In California, medical insurance generally covers the cost of acupuncture, but insurers have repeatedly refused to pay for other medical expenses associated with Zhu’s work, such as special exercise equipment developed for those with paralysis, herbal treatments, and extended physical therapy.The main hospital in neighboring San Jose, after initially letting him work on in-patients, has since refused to continue such permission, viewing his techniques unfavorably, despite the overwhelming support of those receiving the treatments.Medical doctors have scoffed at his claims to be able to help quadriplegics by scalp acupuncture.

His clinic is a small facility with one main room, having a dozen chairs for patients to sit on while receiving scalp acupuncture, and a pair of curtained-off segments of the room for beds so that patients can receive acupuncture while lying down.There is a small office, which often turns into a treatment room, and one small private treatment room off the office.At this facility, about 20 patients visit each day, staying for 2-3 hours: after the needles are inserted, Zhu stimulates the needles from time to time.The room becomes quite crowded as most of the patients come with helpers.The clinic is usually open only 4-5 hours a day; much of the rest of Zhu’s long and grueling work day is spent making home visits to those who are so severely impaired that they can’t travel to the clinic.He also teaches at the college.

His treatment technique relies almost exclusively on scalp acupuncture, sometimes using a dozen or more needles in the scalp at one time for the more severely debilitated patients.Although the needling is sometimes painful, he has adapted the treatment so that even babies and young children accept it.Zhu rarely prescribes herbs, but primarily relies on frequent scalp acupuncture therapy (daily or every other day).He has a few patent remedies available at his clinic and has access to crude herbs for making decoctions, or preparing topical applications, from the college pharmacy.

Zhu treats a wide range of neurological problems, including cerebral palsy, epilepsy, injury-induced paraplegia, multiple sclerosis, and post-stroke syndrome, as well as disorders that seem to fall beyond the ability of neurologists to pin them down with a name.The results of Zhu’s work are somewhat difficult to elucidate.With the absence of support from the community of neurologists who could provide detailed monitoring, and the limited assistance available during patient treatment (which doesn’t permit careful documentation of the cases), the extent and nature of the responses are not well established. At Zhu’s clinic, patients report notable improvements compared to their earlier conditions.?In a few cases of quadriplegia, Dr. Zhu is using a video camera to illustrate the extent of changes in patient capabilities.For more information on Dr. Zhu and his clinic, write: Zhu's Acupuncture Medical & Neurology Center, 100 O'Connor Drive, Suite 20, San Jose, CA 95128, or call Five Branches Institute (831-476-9424).

APPENDIX 3:Scalp Acupuncture Protocol for Multiple Sclerosis

The following protocol was developed by Dr. Edythe Vickers, based on the teachings of Dr. Mingqing Zhu, and is being used at the Institute for Traditional Medicine.

1.If the primary lesions are in the brain, insert needle in Eding Zone 1, needling along the GV line towards the face.This is intended to improve vision (e.g., to relieve optic neuritis) and increase mental clarity.If the primary lesions are in the neck, then insert the needle in Dingzhen Zone 1, which governs the neck.

2.Insert needle from Eding Zone 3 to Eding Zone 4, needling along the GV line towards the back of the head.This is intended to tonify the kidney/liver system that is weak in nearly all persons with multiple sclerosis.If the patient is suffering from a bladder disorder (typically, there is inability to completely empty the bladder, and there may also be incontinence; many individuals rely on a catheter), then needle only within Eding Zone 4.This latter treatment is the same as selected by Chen and Chen (4) for treatment of enuresis.

3.Use two additional needles to complete the treatment.For persons who are not highly symptomatic, the two needles may be placed parallel to the needle in Eding Zones 3 and 4, about 1/4 inch on either side of the central needle.This will enhance the tonification of the liver/kidney system and strengthen the legs, bladder, and abdominal organs.For persons who have weakness, tingling sensation, or other disorders affecting the arms and hands, needle instead Dingnie Zone 2, with the needle aiming towards the face (towards ST-8).If the problem affects one side of the body, needle the opposite side of the scalp, but if it affects both sides, needle both sides of the scalp.For persons with weakness and numbness in the legs, use Dingnie Zone 1, with the needle towards the GV-21.For persons with aching and numbness in the shoulders, needle the DingjieZone.Again, needle either one side or both sides, as appropriate.

Use the thrusting technique (jinqi) in most cases, as this will tonify the deficiency.The manipulation should be carried out until the patient notices a change in their condition.When treating the arm or leg scalp zones, have the patient attempt movement of the body part while the needle is manipulated.For bladder disorders, have the patient breathe deeply (to the lower abdomen, Dan Tian), which should focus attention on the area being treated and help to produce a warming sensation.When treating Eding 1 (for the eyes), have the patient gently rub their palms over the eyes.

If an effect is not noted (clarifying of vision, change in sensation or strength in affected limbs) within about 3 minutes of manipulation time, check that the needling location and needle placement are correct; if correct, it may be necessary to try the lifting method (chouqi) instead, especially if there is pain. It may also be valuable to treat body points, such as ST-36 and GB-34 for the legs and LI-4 and LI-11 for the arms.Once a response is noted, the needle manipulation can be ceased.Patients with leg weakness should attempt to walk for a few minutes.After about 15 minutes (from the previous manipulation), the needles should be manipulated again.At the end of the third manipulation, the patient will be instructed to retain the needles for a period of several hours, up to two days, and then remove the needles themselves or with the aid of someone who can assist them.The needles used for body acupuncture are removed at the end of the in-clinic treatment session.

Appendix 4: Treatment Method at Vitality Center

Holly Gahn, L.Ac., O.M.D., has been using scalp acupuncture for several years and currently practices at Vitality Center in Lake Forest, California.She described her basic treatment techniques as follows, indicating that there are a number of other procedures that she may utilize to complete the treatment:

Treatment Course.On the first day, the patient is treated in the morning and in the evening; for the next nine days, the patient is treated once daily.Then, treatment continues at the rate of three times per week until the condition has resolved or the patient has reached what appears to be the maximum level of improvement.

Point Selection.The motor, sensory, balance, vision, and speech areas are utilized as appropriate.For unilateral paralysis, use the contralateral side, but use bilateral treatment of the zones for bilateral paralysis.In cases of generalized brain damage (as occurs with anoxic brain damage), Zhu's Eding zone is used predominantly, along with GV-24 and UB-3 bilaterally.If the patient's scalp becomes sensitive to needling, as might occur with frequent needling of the same zone, it is helpful to alternate (from one treatment to the next) between the motor and sensory points and the Eding zone.

Needling Procedure.Needles are inserted one cun obliquely into the subaproneurotic space.Needles point downwards and are angled off towards the affected limb.It is stimulated by small-amplitude, lift and thrust technique at rapid frequency (200 times per minute if possible).Body needles are also inserted, using standard procedures.Both the scalp and body acupuncture needles are retained for 20-30 minutes and stimulated every 2-3 minutes during this time.

Neuromuscular Re-education.Immediately after the basic needle treatment, the body needles are removed, but the scalp needles are retained.The patient is taken through a series of exercises while the scalp needles are being stimulated simultaneously.If the patient is comatose or otherwise unable to perform these, the practitioner (or assistant) performs the otherwise passive motions for the patient.The patient, all the while, is encouraged to try to think about doing the exercises, to visualize it, to visually watch the movements (if possible).Verbal encouragement is even given to those who are comatose.?As soon (in the treatment course) as the patient is able to perform the movements, they are encouraged to do so, even if the movement is slight.Electrostimulation may be utilized (frequency is 200/minute) in place of manual stimulation.As they become stronger, the practitioner adds resistance to each exercise (weights can be added), thus requiring the patient to apply greater strength (and, in some cases, more muscle groups) to the task.The effort put forth by the patient is of utmost importance.

For Comatose Patients.Needle PC-8 and KI-1 bilaterally plus GV-26.The needles should be stimulated strongly (manual) for 10 minutes.Then add PC-6 and SP-6 with strong stimulation before proceeding to needle the rest of the body and scalp.

APPENDIX 5:?Commentaries and Clinical Observations from the Chinese Literature

1.About needling techniques and duration.

For peripheral facial paralysis, Cui Yunmeng (7) suggests using a .38 mm needle and a 75 mm length.The needle is twirled at a speed of 200 times per minute.Needles are retained for 20-30 minutes, being twirled twice.Needling is done in the facial motor area of the scalp, on the same side as the affected part.

For treatment of hemiplegia, Wang, et al., (6) give extensive details regarding point selection (a combination of scalp and body points).Acupuncture is given once daily for 40 minutes, with 10 days as one treatment course, and a rest of 3 days between courses.After insertion, the needle is twisted for 5 minutes at a speed tolerable to the patient who is advised to exercise the limbs as best he can.Electric acupuncture is then used at a frequency of 150-200 pulses/minute for the head points and 100 pulses/minute for the body points.

Lu Shoukang (1) says that: “In scalp acupuncture there are many types of manipulation.The common one is the rapid needle-twirling method, that is, after being inserted to the lower layer of the galea aponeurotica, the needle is tightly held by the thumb and index fingers, and rapidly twirled for about 200 times per minute.This manipulation requires a high frequency and continuous movement and lasts 2-3 minutes each time.Within half an hour, the manipulation should be done 2-3 times.Owing to the fact that by this method the needle often twines the muscular fibers and causes pains, it is not well accepted by the patient.Furthermore, the metacarpophalangeal joint of the operator fatigues easily.For this, the finger twirling is replaced by electric twirling, in which the patient is given pulse electric stimulations with dense and loose waves and a current intensity tolerable by the patient.”

For the treatment of post-stroke syndrome, Pang Hong (9) reports the following method, based on the teachings of K.Y. Chen: “Scalp acupoints were needled with the reinforcing or the reducing method as indicated.For reinforcement, the filiform needle was inserted at an angle of 15-30 degrees to the scalp, slowly and forcefully to beneath the aponeurosis.Pressure was applied to the point for one minute, and the needle was quickly withdrawn after a retention of 10 minutes.For reduction, the manipulations were similar, except that after 10 minutes of retention the needle was withdrawn slowly, when the skin formed a mount around the retreating needle.For either reinforcement or reduction, the needling took 15 minutes, including the 10 minute period of needle retention.Courses of treatment were 10 daily sessions, with efficacy appraised after three courses.” He went on to comment that: “For the promotion of myodynamia and motile functions, the method of slow-rapid reinforcing-reducing was significantly better than the method of flat twisting.The application of reinforcing and reducing manipulations would shorten the therapeutic course, promote the therapeutic efficacy, and decrease the rate of disability.The method of slow-rapid reinforcing-reducing in scalp acupuncture had the advantages of causing less pain and inducing proper occurrence of the needling sensation; therefore, it was well received by the patients.With regard to the selection of points, Pang Hong claims that: For the treatment of apoplexy, the selection of acupoints on either the healthy or the affected side makes no difference in therapeutic efficacy.” In his clinical work, he treated both sides, alternating sides from one session to the next.

In a teaching round on apoplexy (10), Professor Guo describes his technique for scalp acupuncture: “Size 28 needles are commonly used, usually of the length of 2 cm.First, locate the upper point of the motor area, and with the left hand fixed on it, insert the needle obliquely towards the lower point at an angle of 15 degrees with the skin surface.Holding the needle with the right first three fingers, insert the needle quickly until it reaches the loose cellular tissue beneath the scalp.Then turn the needle horizontally with respect to the skin surface, and push it to a depth of about 1.5 cm.Twist and rotate the needle but never lift and thrust it.Hold the needle between the medial surface of the terminal part of the right index finger and the palmar surface of the terminal part of the right thumb.With repeated extensions and flexions of the interphalangeal joint of the index finger, one rotates the needle in one direction till it turns two rounds and then in the other direction for another two rounds.One may rotate this way 200 times for one minute, repeat rotating 5?0 minutes later, and retain the needle till 30 minutes after the insertion (including the time of rotating).With rotating of the head of the needle, the patient usually reports the feeling of local heat, numbness, and tics.There may sometimes be radiation of such feelings to contralateral and homolateral limbs.In general, therapeutic effects are achieved with mere appearance of local needling feeling; nevertheless, still better results will be had if the feelings radiate to the limbs.You may produce all the needling feelings with electrical stimulation.To do this, one inserts a 1 cun needle into the upper point of the motor area and pushes it horizontally towards the lower point, and then insert a 1.5 cun needle at the division point between the upper 1/5 and middle 2/5 [of the motor area].With these needles connected to corresponding electrodes in the electroacupuncture apparatus, one then passes electricity, often in a frequency of 3/sec [180/minute] with a tolerable intensity for 20 minutes.”

Qu Hong and his colleagues (8) described their scalp acupuncture technique for treating pseudobulbar paralysis as follows: “A filiform needle was rapidly inserted for a depth of 1.5 cun in the direction of the motor/sensory area, followed by rapid twistings for 0.5-1 minute until the appearance of the needling sensation.The needle was retained for 40 minutes, with small amplitude twistings for another 0.5-1 minute before withdrawal....Practice has shown that needling on the motor and sensory areas simultaneously, and on the affected side and the healthy side simultaneously produces better curative effects.In light of the experience of Professor Shi Xuemin, the authors adopted deeper insertion of the needles both on the scalp and on the body. Retention of the needles enhanced vasodilation of the cerebral vessels to increase cerebral circulation more than simple twistings of the needles for the recovery of nervous functions.The authors therefore lengthened the needle retention to 40 minutes.”

Liu Chunhui and Wang Ying (11) reported on their experience of treating acute apoplexy during a medical visit to Yemen.For scalp acupuncture, they reported that: “The needles were twirled once every 10 minutes at a rate of 200 times per minute, followed by retaining them for 30 minutes.The patients were asked to exercise the limb during the needle manipulation.” The manipulation was applied every 10 minutes and acupuncture (body plus scalp) was administered each morning and afternoon for a treatment course of 12 days, with an interval of 3 days between courses (using 1-6 courses).

Wu Chengxun (12) reported on using three techniques of needle manipulation.Manual twirling was done with a frequency of 200-500 times per minute and the twirling was performed every 3-5 minutes; a needle twirling machine was applied at a frequency of 300 times per minute and applied in the same fashion; an electroacupuncture device was used with a frequency of 500-700 waves per minute, with continuous stimulation for 10 minutes.After the stimulations were applied, needles were retained for several minutes so that the total duration of needling was 25 minutes.The treatment was performed daily for 12 days, and then a rest period of five to seven days was allowed before resuming another course of 12 days treatment.With a total of 1228 cases of hemiplegia so treated, it was determined that there was no significant difference in the outcome for the three methods of stimulation.

Ji Nan and colleagues (13) used scalp and body acupuncture to treat sequelae of stroke and cerebral injury, claiming improvement in all but 3 of 128 patients, with treatments deemed markedly effective in 42.8% of the total group.Needles were inserted, as appropriate to the condition being treated, into zones designated motor area, sensory area, vasomotor area, and speech zones I, II, and III.?For paralysis, they used the method of treating the side opposite the affected limb.The scalp needles were connected to a therapeutic instrument which delivered “sparse and dense waves”over an interval of twenty minutes for each session.For each session 1 or 2 scalp areas and 2-4 body points (such as ST-36, LI-10, LI-11, LI-15, GB-34, or SI-9, getting qi and then allowing 20 minutes retention) were treated.Sessions were once daily for 10 days as a course of treatment, applying 2 courses as the standard.

Zhang Naizheng (14) described treatment of tremor artuum in 35 individuals using a combination of body points and scalp acupuncture.Regarding the latter, he stated: “The dancing tremor controlling region was chosen; needling was done once per day, 10 days for a course of treatment, with an interval of four days between courses, lasting 4 courses.Using a 26 or 28 gauge, 5 cm long needle, the squeeze-holding method was used for insertion; the angle of insertion was 30 degrees, and the needle was rapidly twirled with a small scope of movement, about 200 times per minute for 2 minutes, and then retained without twirling for 5 minutes; this procedure was repeated three times and then the needle was removed.”

Zhang Mingju reported (15) on treatment of 296 cases of hallucinations using scalp acupuncture.The method used was point-through-point needling, with the needles inserted at an angle of about 15 degrees with the scalp and running from GV-19 to GV-20 (the Dingzhen 1, which affects the head); auxiliary treatment locations were needled by similar method, starting at the selected point and then needling through to the next point (examples: GB-17 to GB-16; TB-19 to TB-17).Needles were twirled and agitated for 1-3 minutes.When the needling sensation is felt is the best time to channel qi to the locality of the disease.Needles were retained for 1-3 hours.Acupuncture was performed daily, and 10 sessions constituted on therapeutic course.After the first course, acupuncture was performed every other day, with 10 sessions constituting the second therapeutic course.If still necessary, acupuncture was performed twice weekly, with 10 sessions constituting the third therapeutic course.By this method, 71% were cured and 19% markedly improved.

Zhang Hong reported (16) on treatment of 76 cases of senile urinary incontinence.Body and scalp acupuncture was used, with scalp points picked in the leg motor and sensory area (1 cm lateral to GV-20, corresponds to Eding 4) and reproduction area (Epang 2).Electrical stimulation was adopted, with a frequency of about 200 pulses per minute, with the intensity limited to the patient's tolerance.Needles were retained for 30 minutes.Treatment was given 5 times per week, with 10 treatments constituting one course, with an interval of one week between courses.After 1-2 courses, half the cases were cured, and 20 others markedly improved.

2.About needling pain and needle sensation

Lu Shoukang observes (1): “In scalp acupuncture, the needle is usually inserted by the penetration needling along the skin.Since the scalp is rich in nerves and blood vessels and is more painful than the limb when punctured, the needle insertion should be rapid and kept away from the hair follicles and the tip of the needle should be sharp.After insertion, the needle body should be rapidly pushed to the lower layer of the galea aponeurotica that is the loose connective tissue to allow the needle to be manipulated freely to cause less pains.In order to strengthen the stimulative sensations, the point-through-point method is used, that is, the needle penetrates several points at the same time.Sometimes the method of two needles punctured to each other is used.For instance, one needle is punctured from qianding [GV-21] to baihui [GV-20] while the other needle from baihui to qianding, both along the midline of the vertex.”

Chen Zaiwen and Chen Ling (4) described treatment of enuresis in children with scalp acupuncture.It was mentioned that: “For scalp acupuncture, the selection of acupoints needs to be accurate and the manipulation mild to avoid unnecessary pain which might dispose the child unfavorably to acceptance of the treatment.The author’s choice was a 30-32 gauge filiform needle, 1.5 cun in length.It was desirable to insert the needle rapidly through the skin in a vertical direction and then the needle was bent to an angle of 30 degrees to the skin to be pushed forward, preferably under the epicranial aponeurosis.A stronger stimulation often brought about better curative effects.” Although the authors reported good clinic effect of scalp acupuncture for enuresis, it was said that: “Owing to the needling pain, only 59 cases [out of more than 100] were willing to accept the treatment for a complete course [10 to 15 sessions, undertaken either every day or every other day] or longer.”

3.About the effectiveness of scalp acupuncture in clinical practice

In a general review of acupuncture therapy (5), it was said that: “Clinical reports of 2,917 cases of hemiplegia treated in 34 units [clinics] reveal an effective rate of 94.5%, with 58.9% markedly improved....Observation of the graphic [EEG] changes of amplitude, decrease of frequency, decrease of the angle of the main peak, deepening of the valley of the wave indicate that scalp needling dilates blood vessels, improves vascular elasticity, reinforces cardiac contraction, and increases cerebral blood flow.”

A problem with claimed effectiveness rates for scalp acupuncture is that there is rarely a control group (or one that is well-matched) to help sort out improvements that might occur spontaneously or due to other therapeutic measures (such as ordinary physical therapy) that might be undertaken.However, there may be some benefit to examining the disorders that have been treated by this method and the extent of improvements, whatever the cause, that were noted during the treatment period.

In the article by Chen and Chen regarding enuresis treatment (4), effectiveness was moderate (only 9 out of 59 were cured), but it was said that: “It seemed to be a general rule that older children were apt to have better curative results; treatment in the afternoon seemed to be better than in the morning, and a longer time of needle retention was better than short time needle retention....A stronger stimulation often brought about better curative effects.”

In an article on scalp acupuncture for hemiplegia (6), Wang and his colleagues reported that of 110 cases, 29 were essentially cured, with mobility of limbs recovered.They state that: “Snalysis of the 110 cases showed that the location, number and extent of the cerebral lesions correlated closely with the therapeutic effects, and early institution of the acupuncture treatment led to better results....Among 29 cases that were essentially cured, most involved lesions in the external capsule or cerebral lobes, with some single lesions in the internal capsule or brain stem.However, the 5 ineffective cases had mostly multiple lesions in the basal ganglia, the brain stem, and cerebral ventricles.”

In an article by Cui Yunmeng (7), scalp acupuncture for facial paralysis was described.It was reported that 71 out of 100 cases were cured, using 5-40 treatment sessions, given once daily.

In a report on pseudobulbar paralysis (8), Qu Hong, Ren Liping, and Guo Yi describe their results of combining scalp acupuncture and body acupuncture: “The treatment was effective in all 28 cases.19 cases (68%) were cured and 9 cases (32%) were markedly effective.The shortest course of treatment was 4 sessions and the longest 4 courses [40 sessions]....The patients in this series were all difficult cases of pseudobulbar paralysis refractory to western and Chinese drugs.?The good therapeutic effects indicated the superiority of this modality.”

A study by Wan Zhijie and colleagues on the mechanism of action of scalp acupuncture (17) indicates that cholinesterase is inhibited and, at the same time, muscle force of the extremities is increased. Further, microcirculation is notably enhanced.In treating hemiplegia, a single treatment (about 25 minutes, including insertion, three sessions of 3-minute twirling with two 5-minutes breaks, and withdrawal of the needles) muscle strength in upper and lower extremities improved by about 20%, whole blood cholinesterase was reduced by about 15%, and speed of blood flow through nail bed capillaries increased by over 30%.These changes slowly reverted after treatment to reach pretreatment values after 24 hours, confirming the need for daily scalp acupuncture therapy.

Two reports on aphasia (inability to speak) were presented in the Shanghai Journal of Acupuncture and Moxibustion.In one report, from the Guangdong Provincial Hospital, 72 cases of stroke-caused aphasia were treated and evaluated (19).The zones selected were from the “speaking zones”(from a different set of zones than used in Zhu’s  scalp acupuncture).After applying the needles and getting the qi reaction, the needles were hooked up to an electroacupuncture device and stimulated for 20 minutes (once per day).In addition, body acupuncture was applied (mainly GB-20 on one day and GV-16 on the alternate day, with some non-standard, “extra points”)Those needles were stimulated for about 20 seconds and then retained for 30 minutes (once per day).After 30 days of treatment, 46% of the patients showed marked improvement, and another 50% showed some improvement.In the other report (20), from the Central Hospital of Shantou City (also in Guangdong), aphasia in nine children ages 16 months to 14 years was treated.The causes were numerous, including viral encephalitis and meningitis.The speaking zone was treated as the main therapy, and as an adjunct a treatment comprised of needling GV-20, GV-24 and the four points of Sishencong (Extra-6) were treated.Three needles were used in the speaking zone, they were twirled rapidly for two minutes, then connected to an electroacupuncture device and stimulated for 30 minutes (at 14 Hz).Treatment lasted from 4-21 days.Of the 9 patients treated, 4 were reported recovered and 2 improved.

According to the content of these reports, compared to Zhu’s techniques there is shorter duration of individual treatments, reliance on electroacupuncture as stimulation, and no mentioned focus on patient breathing or movements during treatment (e.g., for aphasia, Dr. Zhu needles Eding zone #1 and has the person try to count from 1 to 10, say their address, sing, etc., to use both voice and memory).

4. About the mechanism of action for stroke

In a study of scalp acupuncture applied immediately following a stroke (21), it was reported that both thromboxane B2 (TXB2) and 6-ketone prostaglandin F10 (6KP) levels in the blood plasma were affected.These biochemicals are the stable metabolites of substances involved in platelet clumping: thromboxane A2, which induces clumping of platelets and contraction of arteries, and prostaglandin I2, which inhibits platelet clumping and inhibits formation of arterial atheromas (by reducing cell proliferation).

The physicians treated 20 patients who had suffered a stroke within the prior 10 days.For scalp acupuncture, the major areas selected were the “motion”zone and the “diastole-systole”zone.Body points were also needled; alternating from one day to the next between treatment of yang meridians (points would be selected from LI-15, LI-11, LI-4, TB-5, GB-30, GB-34, GB-39, or UB-60) and treatment of the yin meridians (points would be selected from HT-1, LU-5 PC-6, SI-13, SP-6, or LV-3)?The scalp needles were strongly stimulated with twirling at 200 times per minute for 2-3 minutes, and followed by the lifting maneuver to get the full qi reaction.Body points were stimulated less, but it was important to get a qi reaction.Needle retention was for 30 minutes, with electrostimulation used after getting the qi reaction.Treatment was carried out for 6 consecutive days, followed by a 1 day rest, as one course of treatment, for a total of 4 courses (one month).Drugs that might affect thromboxane or prostaglandin levels were discontinued prior to the study.

It was shown that stroke patients had higher plasma TXB2 levels and lower plasma 6KP levels than healthy persons.After performing acupuncture on the stroke patients, the TXB2 levels declined and the 6KP levels rose.The changes were statistically significant, though the parameters did not reach the levels of healthy patients.The improvements in TXB-6KP levels were interpreted as a biochemical manifestation of harmonizing yin and yang.The authors thought that the effect of acupuncture was mediated by the cerebral cortex and the nervous humoral system.