Heat-sensitive moxibustion for post-stroke constipation

Constipation is one of the most common complications that often occur after a stroke. Due to the damage of the central nervous system and the reduced function of the vegetative nerves, as well as the side effects of medications, dietary changes and prolonged bed rest, stroke patients suffer from gastrointestinal peristalsis and reduced secretion of gastrointestinal mucus, leading to constipation. Chinese medicine believes that Qi deficiency, blood stasis and Yin deficiency are the main causes of constipation in stroke patients. Stasis of blood leads to intestinal dysmotility, Qi deficiency leads to weak propulsion, Yin deficiency leads to intestinal dryness and loss of moistening, which leads to constipation due to loss of large intestine conduction function. Constipation leads to a large amount of endotoxin absorption, affecting the metabolism of blood sugar and cholesterol in stroke patients, hindering the repair of neurological damage, and affecting the recovery of late stroke. The Materia Medica Zheng states, “Mugwort, which can pass through the twelve meridians, …… is good at warming the middle, expelling cold, and moving the qi in the blood and the stagnation in the qi.” It indicates that moxibustion therapy has the function of warming the middle and dispersing cold, returning Yang and fixing stagnation, and moving Qi and resolving stagnation. Thermal moxibustion therapy is a new moxibustion therapy, which is guided by the meridian theory, using moxa suspension moxibustion heat-sensitive acupuncture points on the body surface to stimulate moxibustion sensibility, in order to achieve the method of qi to the disease. The clinical results of using thermal moxibustion to treat constipation for many years show that thermal moxibustion is effective in treating constipation. According to the theory of thermal moxibustion, there are two different functional states of acupuncture points in the human body: resting state and sensitized state, and the sensitized acupuncture points can show “big response to small stimulation” to external related stimulation. The clinical characteristics of thermal acupuncture points are that when moxibustion is applied to thermal acupuncture points, the acupuncture points can show heat transmission, heat expansion, heat transmission, local non-heat (or slight heat) but distal heat, surface non-heat (or slight heat) but deep heat or other non-heat sensations (such as soreness, swelling, pressure, heaviness, etc.), and other moxibustion meridian sensations. Heat-sensitive moxibustion therapy is characterized by the selection of heat-sensitive acupoints for moxibustion therapy, which can highly and easily stimulate moxibustion sensory transmission (occurrence rate of 95%), so that the qi can reach the place of disease and achieve the effect of efficient dredging of meridians and regulating the internal organs, thus improving clinical efficacy [1]. The “Ling Shu? The nine needles and twelve principles of the description: “five organs also have diseases, should be out of the twelve original, and the original each out of the original, clear knowledge of its original, see its response, and know the five organs of the harm is carried out.” When the five organs of the human body have diseases, the twelve original points will appear acupuncture point functional state changes, and the “Ling Shu? Back acupuncture point” and discussed: “chest in the big acupuncture point in the end of the loom bone, …… are holding the ridge to three inches. Then want to get and check the place, according to its place, should be in the middle and pain relief, is also its acupuncture point.” This means that as early as the era of the Nei Jing, medical practitioners began to emphasize the importance of finding acupuncture points by paying attention to the changing parts of the functional state of the acupuncture point. According to Chinese medical theory, “if there are internal, there must be external”, and diseases of the internal organs often react to the acupuncture points on the surface of the body, therefore, the functional state of acupuncture points is different for different diseases and different periods of disease, i.e., different states of sensitization. As we all know, the key to the efficacy of acupuncture lies in the arrival of qi, which is recorded in the Nei Jing: “The key to acupuncture is the arrival of qi to be effective. What is qi to? The best acupuncture efficacy can be achieved by the “letter of efficacy, like the wind blowing clouds, clear as if seeing the sky” in the Nei Jing. Thermosensitive acupoints are newly discovered types of acupuncture point sensitization, which are highly sensitized to moxa heat stimulation and can efficiently stimulate the sensory transmission of qi through the meridians. The study found that moxibustion of heat-sensitive acupuncture points often stimulates the transmission of qi through heat and heat transmission, which is in line with the principle of “qi to the place of disease” as described in the Nei Jing, and its clinical efficacy is significantly better than that of the conventional moxibustion control group.