Interpretation of data and treatment of Jing-well point temperatures′ test

Lei-Ming Wang, Kang Tan, Li-Hao Chen

Hunan University of Chinese Medicine, Hunan, China

Abstract

Key words: Jing-well point temperatures′ test, Meridian diagnostic methods, Line graphs, Data, Teatment

Background

An excellent traditional Chinese medicine doctor is often able to accurately carry on the syndrome differentiation of the disease, so as to treat the disease.The theoretical system of traditional Chinese medicine itself has the wisdom of accurate medicine [2], it is theoretical medicine rather than empirical medicine [3]; however, in practical application, there is a certain error rate in syndrome differentiation due to various objective reasons such as inadequate theoretical mastery and inadequate understanding.The well point temperature measurement method refers to a method to diagnose the disease by measuring the symmetrical well point temperature of the subjects [4].Compared with the four diagnoses of traditional Chinese medicine, its biggest advantage is that the former makes the diagnosis more objective and accurate.The emergence of this method can eあectively assist TCM doctors in clinical syndrome differentiation and reduce the error rate of syndrome diあerentiation, so it is necessary to study it.

Clinically, it is found that there is room for improvement in the intuition and readability of the data obtained by the old method; on the other hand, the data analysis is not comprehensive enough, which has become a problem in the application of this method.The jingwell point temperature measurement method inherits and evolves from the heat sensitivity measurement method [5], and mainly analyzes the symmetrical jing-well point temperature difference.They all believe that: in the normal state, the temperature of the symmetrical well points of the same meridian should be roughly the same; if the temperature difference is too large, it will be judged as the pathogenic meridian.In fact, in addition to the difference between different meridians, there is also a certain diagnostic value.How to deeply process and interpret these data and information? Testers might as well use the Excel tool to process the test data and transform it into a line chart.This method is introduced as follows.

Data introduction

The three patients with left somatosensory disturbance, lumbar muscle strain plus chronic colitis and chronic pharyngitis were numbered A, B and C.Patient A, a middle-aged male, had abnormal sensation in the left limb for more than 6 months, suspected of cutting sensation and foreign body sensation in the left limb caused by often playing Golf ball, occasional limitation of movement on the left shoulder and back, no abnormality on the right, no abnormality in physical examination, craniocerebral magnetic resonance imaging and CT, etc.he was diagnosed as "anxiety disorder" by the third-level first-class hospital.Patient B, young male, had low back pain and abdominal pain for more than 3 years, with intermittent onset, sometimes with cold pain in the waist and abdomen, frequent defecation, 2-3 times a day, sparse quality and short red urination.Patient C, young female, throat foreign body sensation for 2 years, induced by cold cough, throat foreign body sensation in the morning, pharynx itching and retching, without other abnomal feelings.

Table 1 Meridian and corresponding well point comparison table according to the order of meridional flow

According to the operational requirements of the jing-well point temperature measurement method, the testers collected the above three groups of typical data (the data isomitted, reflected in the broken line map).After 12 pairs in each group, a total of 24 pieces of data were obtained.Using Microsoft Office Excel 2019 software, change the order of well site temperature data according to the order of meridian flow (Tab.1), and get the corresponding line chart.

Data and interpretation

Line Chart data Summary

It can be seen from Fig.1 that the yellow broken line representing the temperature of the meridians and acupoints on the right side is roughly a smooth straight line, which indicates that the right meridians of the patient are in a state of relative balance.The blue broken line is obviously sunken in the interval of "Heart Meridian-bladder Meridian", forming a bowlshaped pattern with the yellow broken line.According to the length and short order, the distance between the blue line and the yellow line can be classified as heart meridian ＞ bladder meridian ＞ small intestinal meridian.

It can be seen from Fig.2 that the overall trend of the pattern is a straight line, but the two areas are in the shape of "V" and "V" respectively.At the bottom of the word "V" are the bilateral bladder meridian and the kidney meridian, and the right liver meridian at the bottom of the "▽".In this picture, the yellow-blue line of the bladder meridian and the kidney meridian is in the overall low position, and the longest distance of the yellow-blue line is the liver meridian.

It can be seen from Fig.3 that the whole is an irregular wave pattern.The blue-yellow lines in most areas are close and tight, and there is no significant difference; the corresponding blueyellow lines of the small intestine meridians form an obvious quadrilateral blank.The most obvious distance of the yellow-blue line is the small intestinal meridian.

Figure 2 Data of patients B with lumbar muscle strain and chronic colitis

Figure 1 Data of patient A with left somatosensory disorder

Figure 3 Data of patient C with chronic pharyngitis

Data interpretation

The first step in analyzing the line chart is to find the abnormal location of the line chart in order to determine the location of the disease.For example, Fig.1 the three meridians that form a bowl-shaped pattern: the Heart Meridian, the bladder Meridian, and the small intestine Meridian.The bladder Meridian, the Kidney Meridian, and the liver Meridian, which form a "▽" pattern; and the small intestine Meridian, which forms a quadrilateral blank, in Fig.3.Through these three line charts, the observer can easily and intuitively find the pathogenic meridians and collaterals.Chronic pharyngitis is a suitable disease for external treatment of traditional Chinese medicine [6].Take the patients with chronic pharyngitis with throat discomfort and nausea vomiting as an example,After the data processing of the well acupoint temperature measurement method, the pathogenic meridian is the small intestine meridian, is there a theoretical basis of traditional Chinese medicine? Follow the pharynx, the lower diaphragm, reach the stomach." [7].Through the meridians and collaterals, it can be concluded that the acupoints of the small intestine meridians can treat the symptoms of pharynx and gastrointestinal tract.After the corresponding treatment (moxibustion on the right houxi point, Carpal point), the eあect is satisfactory.This proves the accuracy of this method in judging menstruation in theory and practice.

The second step is to identify the etiology and pathogenesis and carry out personalized treatment for the patients.It is of great significance to longitudinally compare the difference of symmetrical meridians, so we should be good at grasping the main contradiction.The left meridian of patient A is stable and roughly straight, and the left meridian is not treated during the treatment.in the picture, the depression of the right heart meridian, bladder meridian and small intestinal meridian is in the shape of a bowl, indicating that the three meridians on the right side of the patient are deficient or cold.moxibustion or acupuncture should be given on the specific acupoints of the three meridians on the right side of the patient.After drawing the data of patient C , there is a wave chart, the small intestine meridian is asymmetric and the difference is large (＞ 10 ℃), the value is high on the left and low on the right, so the treatment should purge the left and supplement the right.

Simply comparing the diあerence between the same symmetrical meridians and collaterals is not enough, and longitudinal comparison cannot completely judge the pathogenesis of the disease.For example, patient B, the meridian with the largest temperature difference of the symmetrical well point is the liver meridian.According to the old method, the focus of treatment is the liver meridian.According to the B patient data under the line chart, the diあerence between the bilateral bladder meridian and the bilateral kidney meridian is not obvious, but they are in the shape of "V" in the figure, indicating that the meridian value as a whole is low, deficient or cold.The "▽" shape shows that one meridian (left liver meridian) is stable, and the other (right liver meridian) is deficient or cold; the kidney and bladder belong to lower jiao, so it can be diあerentiated as lower jiao yang deficiency or cold evil invasion.In the treatment, in addition to dealing with the acupoints of the liver meridian, we should also adopt the treatment of warming yang and dispelling cold, or moxibustion or acupuncture at acupoints such as Bu Mingmen (both sides) and Shenshu (both sides), or use Fuzi and Asarum prescriptions to warm Lower Jiao.By the same token, if the figure becomes “Λ ”or "△" shape, indicating that the corresponding meridians are prosperous or hot, the catharsis method should be adopted accordingly.

Discussion

Treatment method

The therapeutic principle of well acupoint temperature measurement is to reduce the excessive and replenish the deficient, which can be understood as tonifying low and reducing high (temperature value).Acupuncture, moxibustion, cupping, scraping and other TCM external treatment methods based on meridians have their own characteristics.

Acupuncture can be divided into tonifying and reducing.other single-form techniques such as strengthening and rducing by slowquick needling, reinforcing-reducing method by respiration, etc.can also be used as appropriate.There is "heat under the needle" after acupuncture for redcing the excessive, and the phenomenon of "cold under the needle" may occur after replenishing the deficient.Acupuncture reinforcing and reducing techniques that can directly produce a sense of heat and cool, represented by heat-producing needling and cool-producing needling [8].The operation of heat-producing needling and coolproducing needling proposed in the planning textbooks of colleges and universities of traditional Chinese medicine is complicated, and patients may be too painful to tolerate treatment.The simplified method of heatproducing needling and cool-producing needling is as follows: after the needle sensation appears in acupuncture, the thumb and index finger are slightly twisted to use invigoration method, making the muscle tight and astringent, and then moderately pressed downward to make it produce a sense of heat, and the slight twist and diarrhea of the thumb and index finger, after the muscle is tight and astringent, lift the needle upward moderately, there can be a sense of coolness [9].In addition, retaining the needle after the acupuncture manipulation is invigoration method.

In modern times, it is generally believed that moxibustion is partial to tonifying asthenia.Moxibustion has slow firepower to replenish, and fierce to purge.Some scholars believe that moxa stick mild moxibustion is partial to strengthening and tonifying, while bird-pecking moxibustion is partial to dispelling pathogens and purging [10].Therefore, when using moxibustion to replenish deficiency, we must pay attention to the way, with slow firepower of warm moxibustion is appropriate.Clinical studies have shown that moxibustion, long snake moxibustion, ginger moxibustion and other forms of moxibustion can significantly improve the constitution of Yang deficiency [11-14].

Compared with acupuncture, cupping, scraping and other methods are easier to operate, and their therapeutic effect is partial to dredging collaterals.Generally speaking, TCM syndrome differentiation belongs to the patients with blood stasis and cold dampness, which can be combined with cupping therapy for comprehensive treatment.Modern research has proved that cupping therapy can produce the effect of unblocking collaterals on the benign physical stimulation of local skin [15].Zhu Chenghui and others have successfully created a rabbit model of cold coagulation and stasis syndrome by means of cold stimulation.It is found that the treatment group can significantly improve the signs of cold coagulation and blood stasis, and the content of peripheral blood epidermal growth factor (EGF) is significantly higher than that of the control group and the blank group, There were statistical diあerences.Scraping belongs to the method of reducing pathogenic factors in traditional Chinese medicine, and its principle can be summarized as " In order to reduce its evil, then conduct bloodletting ", which is applicable to the demonstration of superficial pathogenic factors in TCM syndromes [16].When the pathogenic factor is deep, it should be supplemented by acupuncture, Chinese medicine and other means.Deficiency syndrome should not be scrapped.Modern research has confirmed that scrapping can increase the number of granulocytes and lymphocytes in the body [17], and also has a positive effect on human immune function and anti-oxidation [18].

Select points

"Meridians pass, indications reach", the treatment site of well point temperature measurement method focuses on the level of meridians, rather than a certain point.Selecting the right acupoints can increase the therapeutic eあect and play a role of icing on the cake.In this paper, the commonly used acupoint selection methods are summarized as follows, but whether there is difference in treatment effect, which is better or worse is unknown, which needs to be studied.

Use Zimu point to increase tonic and reducing eあect

In addition to manipulation and treatment, acupoints can also be used to increase the therapeutic effect.Each of the five acupoints of meridians has its own five element attribute and is arranged according to the relationship of origination.The tonic and purgative therapy of mother and son relies on the attribute of acupoint itself (acupoint nature) to achieve this goal.There are two ways to select the mother and son acupoints in this meridian [19]; in combination with the well temperature measurement method, the mother and son acupoints in this meridian should be selected.

Select sensitive acupoints

"Pain points as acupoints" is the acupoint selection method proposed in "Lingshu Jingjin".When the Jingjin disease and Qi and blood lose harmony, its pathological manifestations are symptoms and signs of pain and tenderness [20].During the treatment, the doctor can ask the patient if there is any pain in the special part, at the same time, combine the physical examination to find the tenderness point, and use it as the treatment point.

Heat sensitive moxibustion is the achievement of Professor Chen Rixin from Jiangxi Province.It is a method to stimulate the sense of heat sensitive moxibustion and the conduction of meridians and Qi by means of suspending moxibustion on the heat sensitive acupoints, and to apply the individualized saturated amount of heat sensitive moxibustion.Attaching importance to the sense of heat sensitive moxibustion can improve the clinical efficacy [21].

In the way of using well point temperature measurement and selecting the best acupoints by combining with tenderness point or heat sensitive moxibustion，It may have better clinical effect and further research value to determine the pathogenic meridians and collaterals.