Yun Min, Kai Guowei (Department of Radiology, the Hospital of Nanjing College of Traditional Chinese Medicine)
Qiu Maoliang (Department of Acupuncture and Moxibustion, ditto.)
Success has been made in treating diseases of the biliary tract by combined traditional Chinese and western medicine. In our hospital, the treatment of cholelithiasis with needling had achieved good result too. In order to study the mechanism of expelling of stones by needling, a trial was made using intravenous cholangiography and films were taking successively at definite periods to observe the effect of acupuncture on the biliary tract. The results are as follows:
1. Method: 20 ml. of 50% biligrafin added to 100 ml. of 10% glucose was given by intravenous dripping within an hour. 15 minutes after, 5 mg. of morphine was injected subcutaneously to cause spasm of the Oddi's sphincter. Needling was given when the biliary tract was fully developed and films were taken successively at 3 respective periods, i.e., during manipulation and retention of needles and after withdrawal of needles.
2. Groups: Two groups were under observation--needling group and control group. In the needling group, points Jujue, Burong (right side), Yanglingquan (right side) and Zusanli (right side) were punctured. In the control group, no needling was given. The methods used for observation were the same in the two groups.
3. Results: 55 cases were observed. Among the 41 cases of the needling group, 37 cases showed changes after needling and only 4 cases remained uneffected the effective rate being 90%. While among the 14 cases of the control group, only 4 cases showed changes, accounting for 28%. The difference was very significant statistically (P<0.01).
(1) Needling group.
a. Effect of needling on the Oddi's sphincter: In 36 cases, the Oddi's sphincter opened right after the needles were inserted. In one case, it opened 10 minutes later. During retention of needles, it was observed that the concentration of the contrast medium in the intestinal tract was raised at first, lowered 30 minutes after, and further lowered after needles were removed till the discharge of the contrast medium stopped.
b. Effect of needling on the common bile duct: Half of the cases responded to needling right after needles were inserted. The effect lasted during retention of needles, became attenuated after the 30 minutes' film was taken, and faded away gradually after withdrawal of needles.
c. Effect of needling on the gall bladder: None of the cases showed appreciable response.
(2) Control group
In 4 cases, only a few amount of contrast medium was discharged to the intestinal tract at the time corresponding to the 20 minutes' film was taken. No control medium was discharged in the other 10 cases. None of the 14 cases showed precise changes in the common bile duct.
4. Conclusion:
(1) Needling Jujue, Burong (right side), Yanglingquan (right side) and Zusanli (right side) has marked effect on relieving spasm of the Oddi's sphincter and promoting contraction of the common bile duct. The effect is strong during manipulation of needles, weakened during retention of needles and fades away after withdrawal of needles.
(2) In addition, needling the above points can promote bile secretion and yield a good effect of relieving pain, thus helping the expelling of stones. It is suggested that the therapeutic effects would be further raised if the stimulation given by needling is further intensified and needles are manipulated more frequently or for a longer duration.
Qiu Maoliang (Department of Acupuncture and Moxibustion, ditto.)
Success has been made in treating diseases of the biliary tract by combined traditional Chinese and western medicine. In our hospital, the treatment of cholelithiasis with needling had achieved good result too. In order to study the mechanism of expelling of stones by needling, a trial was made using intravenous cholangiography and films were taking successively at definite periods to observe the effect of acupuncture on the biliary tract. The results are as follows:
1. Method: 20 ml. of 50% biligrafin added to 100 ml. of 10% glucose was given by intravenous dripping within an hour. 15 minutes after, 5 mg. of morphine was injected subcutaneously to cause spasm of the Oddi's sphincter. Needling was given when the biliary tract was fully developed and films were taken successively at 3 respective periods, i.e., during manipulation and retention of needles and after withdrawal of needles.
2. Groups: Two groups were under observation--needling group and control group. In the needling group, points Jujue, Burong (right side), Yanglingquan (right side) and Zusanli (right side) were punctured. In the control group, no needling was given. The methods used for observation were the same in the two groups.
3. Results: 55 cases were observed. Among the 41 cases of the needling group, 37 cases showed changes after needling and only 4 cases remained uneffected the effective rate being 90%. While among the 14 cases of the control group, only 4 cases showed changes, accounting for 28%. The difference was very significant statistically (P<0.01).
(1) Needling group.
a. Effect of needling on the Oddi's sphincter: In 36 cases, the Oddi's sphincter opened right after the needles were inserted. In one case, it opened 10 minutes later. During retention of needles, it was observed that the concentration of the contrast medium in the intestinal tract was raised at first, lowered 30 minutes after, and further lowered after needles were removed till the discharge of the contrast medium stopped.
b. Effect of needling on the common bile duct: Half of the cases responded to needling right after needles were inserted. The effect lasted during retention of needles, became attenuated after the 30 minutes' film was taken, and faded away gradually after withdrawal of needles.
c. Effect of needling on the gall bladder: None of the cases showed appreciable response.
(2) Control group
In 4 cases, only a few amount of contrast medium was discharged to the intestinal tract at the time corresponding to the 20 minutes' film was taken. No control medium was discharged in the other 10 cases. None of the 14 cases showed precise changes in the common bile duct.
4. Conclusion:
(1) Needling Jujue, Burong (right side), Yanglingquan (right side) and Zusanli (right side) has marked effect on relieving spasm of the Oddi's sphincter and promoting contraction of the common bile duct. The effect is strong during manipulation of needles, weakened during retention of needles and fades away after withdrawal of needles.
(2) In addition, needling the above points can promote bile secretion and yield a good effect of relieving pain, thus helping the expelling of stones. It is suggested that the therapeutic effects would be further raised if the stimulation given by needling is further intensified and needles are manipulated more frequently or for a longer duration.
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