| ObjectiveThe objective of this thesis is to find out the main causes and the treatment of blood stasis syndrome to provide reliable guidance in the prevention and curing of the diseases using acupuncture and moxibustion through research on clinical literature made by past doctors skilful in curing such diseases. Due to that the blood stasis is the cause of many diseases and herbs are usually used as the treatment method, the use of acupuncture and moxibustion in the treatment of blood stasis syndrome is not properly recorded and it is lacking systematic analysis. Therefore, this study researches all relevant literature summarizing the statements made by past doctors experienced in this kind of diseases analyzing causes, specific points and the ill-effects. It aims to provide guidance in curing such diseases especially in adopting the method of acupuncture and moxibustion and development of the technique. Also, based on the research outcome, quantitative analyses and the analysis of effectiveness of the curing methods are conducted from the perspective of evidence-based medicine.MethodsThrough research of volumetric relevant literature, analyzing the causes, mechanism, symptoms, diagnosis, treatment principles and methods etc. it is possible to summarise the experience of past doctors and exploring the methods of curing such diseases using acupuncture and moxibustion and the development. The choice of literature ranges from the oldest medical textbook "Nei Jing", to more recent Chinese medical books in the Ming and Ching Dynasty and the latest time.Database include CBM, CNKI, VIP and WF. The time period ranges from January1978to December2013. Besides obtaining information about the treatment of blood stasis syndrome using acupuncture and moxibustion, multiple analyses including quantitative analysis, analysis applying evidence-based medicine and acupuncture points analysis are also made.ResultsSummarization of the sources of blood stasis syndrome and the contribution of past doctors:The most systematic description of blood stasis syndrome can be traced as far back as Chin times,"Nei Jing" used some other names for diseases similar to blood stasis syndrome and described their causes and mechanism. In West Han times," Shen Nong Herbs Jing" registered herbs activating blood flow. In East Han times, Doctor Cheung Zhongjing established the name "stasis blood" based on the descriptions in "Nei Jing" and put forward new chapters to describe the diseases and the treatment. From Tsui Dynasty to Yuan Dynasty, various medical books written by famous doctors at those times added a number of prescriptions for blood stasis syndrome. In Ming and Tsing Dynasties, Doctor Cheung Kai Bung and Doctor Fu Ching Chu had good experiences in treating the diseases. In Tsing Dynasty, Doctor Ip Tin Sze made a step forward to establish the theory of cleaning the blood vessels and clearing the meridian. Doctor Wong Tsing Yam emphasized the need to understand the effect of chi and blood in curing diseases. He invented33prescriptions for the activation of blood flow. Doctor Tong Chung Hai established the four methods of treating blood diseases including blood stasis syndrome viz. stopping blood loss, removing stasis blood, reviving blood and compensating blood. With regard to the causes, mechanism, symptoms, diagnosis, treatment principles and methods of blood stasis syndrome, this study has summarized the knowledge and experiences of many past famous doctors.In recent years, Chinese doctors have made a series of research work on the diagnosis of blood stasis syndrome including diagnosis standard and score system and the relation of clinical performance to laboratory tests. In the last35years, with the development of technology and the invention of new testing equipment, more knowledge concerning blood stasis syndrome was acquired. The concept of stasis blood has expanded from bleeding, to slow blood flow due to low level of "chi" and blood content, to dirty blood. It is now visualized as any disease leading to abnormally slow flow due to blood being thickened belongs to blood stasis syndrome. With the blood flow test, much information can be obtained concerning the clinical and laboratory study using acupuncture and moxibustion to cure blood stasis syndrome. Clinical study shows that acupuncture and moxibustion has obvious improvement result in curing blood stasis syndrome involving the cardiovascular, cerebrovascular and the locomotor systems. By observing the micro-circulation system, it can be confirmed that the degree of improvement of blood stasis syndrome by acupuncture and moxibustion is proportional to the improvement of the micro-circulation system.From the statistical data, the literature of acupuncture treatment of patients with blood stasis syndrome gradually increases and the focus has changed from the effectiveness to the standardization of the treatment method. From the analysis, most of the theses are found in core Chinese medical journals.From the study of the acupuncture treatment of blood stasis syndrome, most theses recorded the therapy of acupuncture only. Acupuncture combined with Chinese herbs ranked second. Combined therapy (acupuncture+Chinese herbs+rehabilitation) ranked third.From the study of the disease type, the highest proportion was found to be neurological disorder, including cerebrovascular disease in the majority. The second was locomotor disease, mainly protruding intervertebral disc of the lumbar. In addition, a considerable number of skin diseases such as acne, alopecia areata, melasma, shingles, skin itching as well as other diseases such as breast hyperplasia, acute mastitis, hemorrhoids have been reported.For the choice of outcome, besides quantitative indicators, laboratory tests such as blood rheology checking also reflects the efficacy of acupuncture treatment of blood stasis syndrome. From the effectiveness assessment in the randomized controlled trial, the most commonly used interventions were combined acupuncture and medicine, specific acupuncture points and conventional acupuncture in that order. The first is superior to the second and the second is superior to the third.With regard to the analysis of acupuncture points, one of the usual blood stasis syndrome involving protruding intervertebral disc of the lumbar is chosen. The result indicates that the first four points frequently used are Weizhong (BL40), Geshu (BL17), Huantiao (GB30), Yanglingquan (GB34) in that order. The most frequently used meridians are Bladder and Gallbladder in that order. The blood activating effect of the blood meeting point Geshu has been confirmed by many theses. In the treatment of protruding intervertebral disc of the lumbar, Geshu is the second most frequently used point.Conelusion:Blood stasis has caused a lot of diseases. Hence the treatment of blood stasis has drawn the attention of the past doctors and they wrote books on the topic. Due to the development of blood flow analysis, we have deeper understanding of blood stasis syndrome. Together with the application of evidence-based medicine, the acupuncture treatment of blood stasis syndrome has got the recognition objectively.The statistics of acupuncture treatment of blood stasis syndrome shows that ’stroke’ ranks first. Many doctors have carried out researches into the treatment of such disease using acupuncture and moxibustion methods. Literature research shows that many papers have simply mentioned random control but were not real randomized control trials, blinding methods were not applied seriously and very seldom follow-up was carried out. Thus their quality and credibility are suspicious. To improve the situation, it is necessary to raise the research standard by increasing the breadth and depth of the studies.Blood stasis syndrome is not one type of disease but is a type of symptom in many kinds of diseases. Due to the different causes, mechanism and occurrence in different parts of the body, different points and methods are applied. In this study some usual diseases are just picked for analysis purpose. However, the same method can be applied in other type of blood stasis syndrome and the effectiveness of adopting acupuncture and moxibustion method together with the best points can be assessed. This is a good example of different curing methods for the same disease. |
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