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[Introduction]
Rheumatoid arthritis is a kind of chronic and general immune disease, clinically marked by pain, swelling, stiffness and deformity of the joints. It usually invades the distal small joints in the early stage and is often migra-tory. Consequently it involves the wrist, knee, elbow, ankle and shoulder, leading to muscular atrophy around the joints and irregular fever. This disease is seem more in women than in men. It pertains to the conceptions of severe and migratory arthralgia and gout in TCM. It is usually caused by weak constitution and invasion of patho-genic wind, cold, dampness and heat into the meridians and joints, hindering the flow of qi and blood; or by dys-function of the liver in dispersion and conveyance, stagna-tion of qi and unsmooth circulation of blood. Prolongation of the pathological conditions will lead to asthenia of the liver and kidney, failure of the liver to govern the tendons and the kidney to govern bones as well as infusion of phlegm and blood stasis into the joints, resulting in mus-cular atrophy and deformity of joints.
[Syndrome differentiation]
1. Cold-dampness type
Severe pain of joints, swelling and heaviness sensa-tion, numbness of skin, aggravation with cold, preference for warmth, or aversion to cold, thin, white and greasy tongue fur, taut and slippery pulse.
2. Damp-heat type
Reddish swelling and pain of joints, inflexibility, or fever, thirst, yellow urine, retention of dry feces, yellow and greasy tongue fur, slippery and rapid pulse.
[Treatment]
1. Body acupuncture
Prescription: Dazhui (GV 14) and Zusanli (ST 86 ). Upper limbs: Jianyu (LI 15), Shousanli (LI 10), Quchi(LI 11), Waiguan (TE 15), Hegu (LI 4), Yangxi (LI 5), Yangchi (TE 4), Wangu (SI 4) and Baxie (EX-UE 9). Lower limbs: Huantiao (GB .30), Juliao (GB 29), Liangqiu (ST 34), Xiyan (EX-LE 5), Yanglingquan (GB 34), Ququan (LR 8), Xuanzhong (GB 89),
Modification: For migratory pain, Fengchi (GB 20), Xuehai (SP 10) and Geshu (BL 17) are added; for heavi-ness of limbs, Yinlingquan (SP 9) is added; for fever, Hegu (LI 4) and Quchi (LI 11 ) are added; for prolonged duration, Guanyuan (CV 4), Shenshu (BL 23), Pishu (BL 20) and Sanyinjiao (SP 6) are added.
Performance. Guanyuan (CV 4), Shenshu (BL 23) and Pishu (BL 20) are needled with reinforcing needling technique and combined with moxibustion. The other acupoints are needled with reducing needling technique. Moxibustion can be applied to the location of pain. Local area with evident swelling can be punctured to let out blood.
2. Ear acupuncture
Prescription: Areas corresponding to the pathological conditions, Ear Shenmen (TF4), Liver (C012), Spleen (COla) and Kidney (CO10).
Performance; Each time 2 4 acupoints are selected and needled with medium and strong stimulation. The needles are retained for 20 - 30 minutes. The needling is done once a day.
