Fan Zhiyong1 Chen Liguo2 1 Guangdong Hospital of Integrative Medicine (Nanhai, Guangdong 528200) 2 Jinan University School of Medicine (Guangzhou, Guangdong 510632) Abstract: The doctrine of “long-standing diseases entering the liao as stasis” has important significance for the diagnosis and treatment of chronic diseases. In this paper, the medical connotation of “long-standing disease entering the luo is stasis” and the relationship between blood stasis, and the mechanism of blood discharging from the luo is studied to propose the idea of acupuncture and moxibustion treatment for “long-standing disease entering the luo is stasis”, that is, using “A-Yi moxibustion” combined with acupuncture to pass the luo and remove stasis, and warm moxibustion to strengthen the root. The treatment of “prolonged illness enters into venation and blood stasis forms” may have an important guiding significance to diagnosis and treatment. Based on the relationship between the meaning of prolonged illness entering into venation and the blood stasis forms, the treatment of chronic disease may have an important guiding significance. Based on the relationship between the meaning of prolonged illness entering into venation and the blood stasis syndrome, the writer bring forward “prolonged illness enters into venation and blood stasis forms That is to say applying “A Shi” moxibustion” combined with to free collateral and dissipative treatment, the writer brings forward “prolonged illness enters into venation and blood stasis forms” from the perspective of Acupuncture Treatment. That is to say applying “A Shi” moxibustion” combined with to free collateral and dissipating blood stasis. meanwhile applying warm Moxibustion to consolidate the root. Keywords: prolonged illness enters into venation; blood stasis The “prolonged illness enters into venation; blood stasis syndrome A Shi” moxibustion; free collateral “Long-term illness enters into luo” said to lay the theoretical foundation of Chinese medicine luo pathology. “The author will discuss the idea of acupuncture and moxibustion for “prolonged illness enters into venation” with a little clinical experience, that is, chronic illnesses are mostly mixed with deficiency and reality, and the treatment should not only supplement the deficiency but also laxate the reality. The treatment should not only supplement the deficiency but also lax the reality. The medical connotation of chronic disease entering the luo is that various factors lead to the malfunction of the operation, distribution and permeation of qi, blood and fluid in the luo, and eventually the luo becomes blocked. The course of the disease is long, mostly chronic and prolonged, and if the disease is not treated for a long time, or if it is mistreated, the disease enters the luo and involves the blood vessels and becomes a luo disease. Ye Tianshi believes that “the blood vessels are the main blood vessels”, and points out that “the implementation of Qi and blood is unfavorable in long-term diseases, and there must be stagnation in the blood vessels”. Modern research suggests that the material basis of luo disease includes micro arteries, capillaries and other micro vessels and their functional regulators [1]. Therefore, “stasis in the blood vessels after prolonged illness” can be regarded as a pathological change caused by the prolonged illness and the invasion of the blood vessels, resulting in the unfavorable flow of qi and blood and the obstruction of microcirculation. 1.1 The theoretical origin of “long-standing disease into the liao” originates from “Nei Jing Su Wen”, which says: “the disease is long-standing and deep, the movement of Ying and Wei is astringent, and the meridians are sparse and therefore blocked” and “long-standing paralysis does not go depending on its blood and liao “. The “Eastern Medical Treasure”: “long illness is light day and night is blood stasis”, Fu Shan: “long illness without activating blood stasis, how to get rid of the deep illnesses of years and years, and break the stagnation of closed stagnation”. In the Qing Dynasty, Ye Tianshi clearly proposed that “the initial disease is in the qi and the prolonged disease enters the luo”, thus laying the theoretical foundation of Chinese medicine luo pathology, and later Wang Qingren refined it as “the prolonged disease enters the luo as blood stasis”, thus forming this doctrine [2]. 1.2 The mechanism of chronic diseases entering the luo as blood stasis is the opposite of new diseases, external sensation, and acute diseases, and chronic diseases usually refer to chronic diseases that are difficult to be cured, and also include some chronic diseases that cannot be cured in time. (2) the luo vasculature is smaller than other vasculature and is more prone to stagnation, resulting in abnormal permeation, which leads to a variety of diseases, and even to other evidence, (3) the luo vasculature is the main blood channel, where evil qi can easily stay. Therefore, when the luo vessels are diseased, they often show blockages such as qi stagnation and blood obstruction [3]. 2 The luo disease and blood stasis are different pathological concepts with overlapping connotations and extensions. The luo disease mainly refers to the diseases that occur when evil enters the fifteen luo, sun luo, and floating luo, of which “luo vascular paralysis” is the pathological basis of luo disease. Western medicine vasculopathy mainly refers to small and medium-sized blood vessels, microvessels and microcirculation, and the blockage of luo qi leads to vasculopathy, which is similar to the dysfunction of neuroendocrine immune regulation and vascular endothelium. The common clinical manifestations are: pain, numbness, bleeding, etc. Modern scholars have studied the relationship between erythrocyte deformation and long-standing disease into the luo as stasis, which is considered to be “into the blood” and “capillary lesions” [2], and blood stasis refers to the pathological changes of sluggish blood flow, astringent stagnation, or even stagnation, which is the same as that in Western medicine. Western medicine refers to the pathological process related to abnormal blood rheology and microcirculatory disorders, mainly referring to the qualitative changes of blood, such as increased blood viscosity and easy formation of blood clots, etc. Clinical pain, pain with a fixed location, wrong skin nail, lips, tongue, claw nail purple and dark or with petechiae, and astringent pulse, etc. The two are both closely related and belong to different pathogenic categories, and the overlap between the two refers to stasis of the veins and channels [4]. The blood stasis evidence focuses on blood stagnation and viscosity, but does not fully reflect the pathology of the ligaments themselves. Liao disease, on the other hand, mainly reflects the stasis and deficiency of the ligaments. Although prolonged stasis can enter the ligaments and lead to stasis and obstruction of the ligaments, blood stasis and obstruction of the ligaments is not the whole picture of ligament disease [5]. If we are familiar with the above, we can carry out targeted treatment for either long-standing disease into the ligament as stasis or long-standing stasis into the ligament. For example, the mechanism of acupuncture and moxibustion is to dredge the meridians, help the positive and dispel the evil, which is especially effective for the condition where the positive deficiency and the evil coexist. 3.1 Modern mechanism of bloodletting study Stabbing, now called bloodletting therapy, is a special method to treat diseases by releasing a small amount of blood to stimulate the meridian qi, and some studies have shown that the change of local blood flow can cause corresponding changes in the endothelial cells of blood vessels. endothelial cells, and this change is the primary factor in activating endothelial cells, and activated endothelial cells can cause complex physiopathological effects causing complex signal transduction changes in vascular smooth muscle cells, producing intracellular, intercellular, and vascular local and overall regulatory responses [6]. It has been argued that studies on the relationship between each acupoint and microvasculature indicate that the essence of acupoints are microcirculatory units with specific diastolic frequencies, so to speak, and that stimulation of acupoints increases the amplitude of microvascular autoregulatory movements and increases the blood flow velocity in the acupuncture area [7-8], so that each acupoint can be pricked to release blood. Many scientific studies have confirmed that acupuncture points have the effect of tonic deficiency, health care and disease prevention, and that acupuncture point bloodletting mobilizes the body’s immune defense function, positively affects blood vessels and blood components, and also produces benign stimulation of neuromuscles [9]. 3.2 Pricking the ligaments also has the characteristic of tonic deficiency: for real evidence, especially when there is blood stasis, pricking the ligaments and releasing the blood is effective, at present most clinical doctors believe that pricking the ligaments and releasing the blood mainly treats the real evidence, while the deficiency is listed as a contraindication, some scholars believe that this is not true, from ancient literature, Su Wen – Blood and Qi Shape Zhi Yun: “All treatment of disease first remove its blood . … and then diarrhea surplus to fill the deficiency.” Zhang Congzheng in “Confucianism – Volume 1 – The most urgent bleeding for eye disease and head wind” said: “Bleeding is to nourish the blood.” It is proposed that bleeding is to nourish blood, and it is pointed out that deficiency can also be the treatment scope of blood pricking therapy. Some studies have proved that blood pricking has the function of promoting hematopoiesis, improving microcirculation and stimulating the body’s own anti-disease and disease prevention. The effect of blood pricking is to mobilize the body’s own energy to play the role of tonic deficiency, health care and disease prevention [10]. The key to stimulate the deficiency is to master the amount of stimulation and the time of stimulation intervention. Stabbing is a stimulation method, and releasing a small amount of blood is only a concomitant condition, and blood release is not the main purpose. Therefore, when stabbing the luo to remedy deficiency, it is enough to stab the luo, which can be used to make it filled with blood or slightly see blood traces, or release a small amount of blood, so as to avoid “stabbing the large vein in the Qie, which will make people lose color” (Suwen – Theory of Stabbing). At the same time, the stimulation of the veins is used to stimulate the body to improve its ability to resist disease. Some scholars[3] believe that the pathogenesis of loxopathy can be summarized in four words, namely “stagnation, deficiency, toxicity and injury”. Although there are different types of ligament diseases, “stagnation” is their common pathogenesis, and the argument of “long-standing diseases entering the ligaments” reveals one of the general trends of the development of various pathologies, indicating that all pathologies exist at a certain stage of development, which is the basis of many chronic common diseases. It is also the pathological basis for the treatment of multiple diseases at the stage of “entering the luo”, which is the essence of the luo disease. The origin of the disease lies in the paralysis and obstruction of the ligaments, so the treatment should be based on the principle of opening the ligaments and eliminating stasis. The “Ivana” through the “Wan”, Wang Bing note “Ivana, accumulation also; Chen, long also; in addition, remove also. It is said that blood accumulation in the ligaments and veins for a long time should be removed by acupuncture” [11]. Long-term chronic diseases are mostly mixed with deficiency and reality, so when treating them, we should seize the “long time and luo and stasis”, and we should not only supplement the deficiency but also exorcise the reality, and when treating them, we should not only open the luo and activate blood stasis, but also supplement the deficiency and consolidate the root. The idea of acupuncture and moxibustion treatment is to use “Ah Yes Moxibustion” and blood pricking to open the ligaments and remove stasis, and warm moxibustion to nourish the deficiency and consolidate the root. It is well known that moxibustion treatment can warm the meridians and disperse cold, eliminate blood stasis and disperse nodules, and it is often effective for some chronic diseases by using “a is moxibustion” combined with blood pricking. “The purpose of moxibustion is to create the conditions for the next step of bloodletting, i.e., after the application of moxibustion, the blood flow in the application area is accelerated and the blood vessels are filled, and then bloodletting is applied to achieve the treatment purpose. Bloodletting therapy. In the treatment of chronic low back and leg pain, we often encounter a situation where the bleeding volume after puncture does not reach the therapeutic goal, especially in winter or in older people. In this case, electro-acupuncture is first applied at the site to loosen the surrounding tense muscles, followed by moxibustion (i.e. “aye-moxibustion”) at the site of operation to make the blood release smooth, and then warm moxibustion is applied at the foot San Li, Shen Que, Guan Yuan and Qi Hai to strengthen the root. This combination of moxibustion and acupuncture allows for a combination of tonicity and diarrhea. The time and amount of moxibustion and warm moxibustion are the key points of the procedure, i.e., warm moxibustion should be long, while the time of moxibustion should be short, and the amount of warm moxibustion should be large, while the amount of blood released from moxibustion should be small. Whether it is bloodletting or moxibustion, or a combination of both, if used properly, it plays a two-way regulatory role. References: [1] Zhou, Xiaolin Tong, Xu, Yuan. Chinese Archives of Traditional Chinese Medicine. 2002, 20(6):724–726 [2] Mao Bingyu. 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