Acupuncture treatment for obesity caused by qi stagnation and blood stasis and spleen and kidney yang deficiency

4. Qi Stagnation and Blood Stasis Type. [Clinical Manifestations]Obesity in this type is often accompanied by a purplish-red or dark red complexion, chest tightness and hypochondriac distension, frequent headaches, chest pain, hypochondriac pain, irregular menstruation, irritability, insomnia or restless sleep, increased appetite, constipation, a dark red tongue with ecchymosis or petechiae, sublingual veins, and a choppy or deep and wiry pulse. [Treatment Principle]Activate blood circulation, remove blood stasis, promote qi circulation and disperse stagnation. [Basic Prescription]Zhongwan (CV12), Tianshu (ST25), Qimen (LR14), Xuehai (SP10), Yanglingquan (GB34), Zusanli (ST36), Sanyinjiao (SP6), Taichong (LR3), Geshu (BL17), Ganshu (BL18), Danshu (BL19), Pishu (BL20).

[Acupuncture Points and Prescription] For headache, chest tightness, and hypochondriac pain, add Xiaxi (GB4) and Neiguan (PC6); for chest fullness and discomfort, add Zhangmen (LR13); for irregular menstruation, add Ligou (LI6) and Diji (SP8); for irritability, add Waiguan (TE5) and Qiuxu (GB40); for poor sleep and excessive dreaming, add Neiguan (PC6) and Shenmen (HT7); for lower abdominal pain, moxibustion is applied to Qihai (CV6) and Guanyuan (CV4). [Procedure] Depending on the thickness of the patient's abdominal fat, use 30-gauge 1.5-2 inch filiform needles for abdominal acupuncture, and 1.5-inch filiform needles for acupuncture points on the limbs and back. Disinfect the selected acupuncture points routinely with 75% alcohol or povidone-iodine. Use the perpendicular insertion method for acupuncture points on the abdomen and limbs.

After inserting the needles, perform lifting, thrusting, and rotating manipulations using the reducing method until the patient experiences a sensation of soreness and numbness. Apply warm needling to Xuehai, Zusanli, and Sanyinjiao acupoints for 1-2 cones. For the remaining acupoints on the abdomen and limbs, connect an electroacupuncture device using sparse-dense waves at a frequency of 10-15Hz, with the intensity adjusted to the patient's maximum tolerance. Retain the needles for 30 minutes. Treat once daily for 5 consecutive days, then every other day for 10 days as one course of treatment. [Explanation] Zhongwan and Zusanli are both important acupoints for regulating gastrointestinal function; Zhongwan is the Mu point of the Stomach Meridian.

Local acupoints are selected on the abdomen to directly regulate the digestive function of the spleen and stomach; Tianshu acupoint can resolve phlegm and dampness, regulate Qi, and when Qi flows smoothly, digestion is normal without obstruction; Taichong, the "Yuan-Source Point" of the Liver Meridian, soothes the liver and relieves depression, helping to clear liver fire; Yanglingquan, the "He-Sea Point" of the Foot Shaoyang Meridian, clears heat from the gallbladder and helps to calm the liver and clear fire. These acupoints work together to invigorate blood, remove blood stasis, and disperse stagnation. 5. Spleen and Kidney Yang Deficiency Type. [Clinical Manifestations]Obesity in this type is often accompanied by weak and flaccid muscles, pale complexion, puffy face, and lethargy.

Symptoms include shortness of breath, fatigue, spontaneous sweating, wheezing, worsening with exertion, aversion to cold, lower back and knee pain, lower limb edema, frequent and clear urination (few during the day and frequent at night), loose stools, thin and clear vaginal discharge, lack of libido, a swollen and tender tongue with a moist white coating, and a deep and slow pulse. [Treatment Principle] Warm and tonify the spleen and kidneys, promote diuresis and eliminate phlegm. [Basic Prescription] Zhongwan (CV12), Qihai (CV6), Guanyuan (CV4), Shuifen (CV9), Zusanli (ST36), Yinlingquan (SP9), Sanyinjiao (SP6), Taixi (KI3), Taibai (SP3), Pishu (BL20), Shenshu (BL23), Qihaishu (BL67), Guanyuanshu (BL40), Mingmen (GV4). [Additional Acupoints] For fatigue and lower abdominal pain, add Qihai (CV6) and Guanyuan (CV4), and apply warm needling.

[Procedure] Based on the thickness of the patient's abdominal fat, use 30-gauge, 1.5-2 inch filiform needles for abdominal acupuncture, and 1.5-inch filiform needles for acupoints on the limbs and back. Disinfect the selected acupoints routinely with 75% alcohol or povidone-iodine. Use the straight insertion method for acupoints on the abdomen and limbs, followed by lifting, thrusting, and rotating manipulations using the reducing method, until the patient experiences a sensation of soreness and numbness. Apply warm needling to Xuehai, Zusanli, and Sanyinjiao acupoints for 1-2 cones. Connect the remaining acupoints on the abdomen and limbs to an electroacupuncture device using a sparse-dense wave at a frequency of 10-15 Hz.

The intensity should be adjusted to the patient's maximum tolerance, with needles retained for 30 minutes. Treatment is given once daily for 5 consecutive days, followed by treatment every other day. A course of treatment consists of 10 treatments. Each session involves 2-3 acupoints per group, using tonifying needling techniques. Warm needling can be used, and moxibustion is also suitable. [Explanation] Kidney Yang Qi is the fundamental driving force of life. As the Daoists point out, "When the Qi from grains surpasses the primordial Qi, the person is fat but short-lived; when the primordial Qi surpasses the Qi from grains, the person is thin but long-lived." The Guanyuan and Qihai acupoints on the Ren meridian can warm and tonify Yang Qi, invigorate Yang Qi, aid Qi transformation, and enhance the body's metabolic capacity.

Select the back-shu points Pishu and Shenshu, as well as the original points of the spleen and kidney meridians Taibai and Taixi, to nourish the yin of the spleen and kidneys, so that yang can be assisted by yin and generate endlessly; select the points Qihaiyu, Guanyuanyu, and Mingmen, and use acupuncture and moxibustion together to warm and tonify kidney yang and nourish the life fire.