Golden Needle Practitioner Library

Honora Lee Wolfe, Dipl. Ac., Lic. Ac., FNAAOM

Keywords: Chinese medicine, acupuncture, habitual constipation

Habitual constipation is a commonly seen complaint in clinical practice which affects both males and females, old and young alike. Typically, acupuncture is effective for the treatment of chronic constipation. However, many acupuncture protocols for constipation use at least 7-8 points needled bilaterally. In issue #8, 2002 of Si Chuan Zhong Yi (Sichuan Chinese Medicine), Shen Hai-ming published an article titled, “The Acupuncture Treatment of 85 Cases of Habitual Constipation.” This article appeared on page 76 of that journal. Because the protocol it described is such an easy one to employ, I have summarized it below.

Cohort description:

Of the 85 patients in this clinical trial, 37 were male and 48 were female aged 15-62 years old. These patients had been constipated from three months to 10 years and all had only one bowel movement more than every third day. Organic diseases of the intestinal tract were ruled out, and all met the diagnostic criteria for habitual constipation in the Shang Hai Shi Zhong Yi Bing Zheng Zhen Liao Chang Gui (Shanghai Municipal Chinese Medical Standards of Diagnosis & Treatment for Diseases & Their Patterns).

Treatment method:

After being disinfected, men were needled on the left side and women on the right at Nei Guan (Per 6) and Zhao Hai (Ki 6). Strong stimulation or as strong stimulation as the patient could bear was used. Needles were retained for one hour and the needles were stimulated once every 10 minutes. Treatment was given once every other day for two times.

Treatment outcomes:

Cure was defined as a bowel movement within two days of the first treatment with the substance of the stools become moist, the passage of the stools easy and smooth, and no recurrence over a short period of time. Marked effect was defined as a bowel movement within three days of the first treatment with the substance of the stools become moist and expulsion of the stools relatively easier. No effect meant that there was no improvement in the patient’s signs and symptoms. Based on these criteria, 51 of 85 patients were judged cured, 27 got a marked effect, and seven got no effect. Therefore, the total amelioration rate was 91.8%, with a cure rate of 56.9% in one treatment.

Representative case history:

The patient was a 39 year old female who was first examined on Sept. 23, 2000. This woman had had dry bound stools for the past two years with only one movement every 5-7 days. Her face and ears turned red at the time of defecation due to straining. When she took medicines for this condition, it improved, but when she stopped these medicines, it returned. Therefore, the woman was needled at right Nei Guan and Zhao Hai. The needles were retained for one hour, during which they were stimulated six times. The next day, the patient had a bowel movement which was moister and easier than before. On follow-up after one month, her bowel movements were still moist and smooth and occurred once per day.

Discussion:

Typically in Chinese acupuncture, constipation is treated by a combination of large intestine back transport, front alarm points, and lower uniting points. Then, depending on whether the patient presents a replete or vacuous, hot or cold pattern, other points are added following the patients signs and symptoms. However, the Chinese author of this article, Dr. Shen Hai-ming, likes to use Nei Guan and Zhao Hai for habitual constipation. Zhao Hai is a transport point on the foot shao yin kidney channel. It is also one of the meeting points of the eight extraordinary vessels, connecting with the yin springing vessel. It is a relatively commonly used point for the treatment of constipation recommended for this complaint by a number of famous premodern texts, such as the Zhen Jiu Ju Ying (The Assembly of Eminent Acupuncture & Moxibustion). Nei Guan is one of the five transport points on the hand jue yin pericardium channel. It is also one of the meeting points of the eight extraordinary vessels, connecting with the yin linking vessel. Clinically, it is a less commonly seen point for the treatment of constipation. However, when Zhao Hai and Nei Guan are combined together, Dr. Shen believes that they are able to engender fluids and moisten the intestines as well as promote intestinal peristalsis. According to Dr. Shen, this protocol is easy to administer and gets exceptionally good results. When this protocol is combined with appropriate dietary therapy, it achieves even better results. As for needling women on the right and men on the left, this was the habit of Dr. Shen’s teacher, Chen You–ren.

Copyright © Blue Poppy Press, 2003. All rights reserved.