Summarization of Constipation Treated with Tuina Therapeutics

Chronic constipation (CC) is a common clinical symptom caused by manifold disordersL’1. It not only influences the life quality of modern people, but also relates to the occurrence of large intestine cancer, thus attracts more and more attention now.
Tuina, compared with other therapeutics, is of great advantage in treating constipation. It is now summed up as follows. 1 To Treat Adults’ Constipation with Satisfactory Effects
PEI Xu-hai121 treated 45 cases of patients with constipation-predominant irritable bowel syndrome by using qi-concentrated thumb manipulation. The patient took a supine position. The therapist applied rubbing manipulation on the abdomen for about 5 min, and qi-concentrated thumb pushing manipulation with reducing method at bilateral Zusanli（ST 36)， Zhongwan (CV 12), Yanglingquan (GB 34), Xingjian (LR 2), each point for 2 min. The patient took a prone position; the therapist applied qi-concentrated thumb manipulation on acupoints from Geshu (BL 17) to Dachangshu（BL25）for about 5 min．Primary stimulation was done at Geshu (BL 17), Pishu
(BL 20), Shenshu (BL 23), Dachangshu (BL 25)； transverse scrubbing manipulation with hypothenar on the lines of Pishu (BL 20), Weishu (BL 21），Shenshu (BL 23)，Mingmen (GV 4), Baliao (BL 31，BL 32， BL 33，BL 34)，and Governor Vessel, until the warming sensation came. The patient took a sitting position, and the therapists applied twisting manipulation on the both rib-sides 3-5 times. The control group was treated with Cisapride. There was no statistical difference in effective rate after 2-month treatment between the treatment group (88．9%) and the control one (86.7%)，(P>0.05)．Six months after treatment, the relapse rate of treatment group was
12.5% and in the control group it was 56.4%, there was a statistical difference（P<0.01）．
TIAN Bin-you［，］treated 25 cases of constipation spinal adjustment manipulation. The first
manipulation is obliquely pulling manipulation of the loin, one time on each side, shaking the lumbar region -10 min; the second is digitally pressing anipulation at the Jiaji (Ex-B 2) and acupoints of ladder Meridians 2-3 times, and then at Zhigou (TE 6), Tianshu (ST 25), Zusanli (ST 36), Shangjuxu (ST 37), Xiajuxu (ST 39), Sanyinjiao (SP 6), Xingjian (LR 21），1 min for each point. The treatment as done once every 2 days and 15 times made up one treatment course. Of the 25 cases, 15 cases gotremarkable effect, 8 cases effect and 2 cases ineffectiveness, with an effective rate of 92.0%.
BAI Duan[4) treated 196 cases of laxative- dependant constipation with Tuina. The patient took a supine position. The doctor swayed the abdomen from side to side for 3 min, kneading manipulation along the distribution of colon clockwise from the upper abdomen to the lower part with the palms piled together 6 times, and then rolling and kneading manipulations along the same route 6 times. Put the palms together on the abdomen, the doctor performed kneading, vibrating, grasping and plucking manipulation of wave shape about 6 min; digital pressing on Tianshu (ST25), Daheng (S P 15) and kneading Qihai (CV 4), Guanyuan (CV 6) with palm base, each point with about 30 s. Rubbing manipulation on the abdomen 30 circles with one palm. Digitally pressed Hegu (LI 4) using one thumb, while oppositely pressed the Neiguan (PC 6) and Waiguan (TE 5) with the other thumb and index finger; digitally pressed Zusanli (ST 36), Shangqiu (SP 5), each point should be treatedl min, with 2 s strong stimulation and 1 s mild stimulation alternately changed. The patient took a prone position. The doctor performed pushing manipulation from Geshu (BL 17) to the buttocks with both palm 6 times, rolling manipulation on the same route 9 times, pressing Shenshu (BL 23），Dachangshu (BL 25), Xiaochangshu (BL 27), Baohuang (BL 53) and Zhibian (BL 54) with the elbow 3 times, tape the lumbosacral part 1 min. Digitally pressing and kneading Pishu (BL 20) with thumbs, and then oppositely pressing Yongquan (KI 1）and Taichong (LR 3）with the thumb and index finger, each point with 30 s. All these methods were performed 20 min every time and once a day, 10 times made up one treatment course. Of the 196 cases, 140 cases were cured (71.4%), 36 cases obtained remarkable effect（ 18.4%), 14 cases obtained effect (7．1％）and 6 cases (3 ．1％）were ineffective. The effective rate was
96.9%.
ZHANG Xiao-ping, et al E53 treated 15 cases of senile constipation without organic diseases. The first manipulation was reducing the large intestine and moving qi, kneading the abdomen around the umbilicus clockwise for 500-800 times with the palm base. Moxibustion at Qihai (CV 6) about 15 min was added for deficient cold; pressing Changqiang (GV 1）or Shangliao (BL 31），Ciliao (BL 32), Zhongliao (BL 33）and Xialiao (BL 34) about 20 min for having awareness of defecation but difficulty in defecating; Thenar massage is used too, reflex area of stomach,
duodenum，colon and anus，etc were selected，1-2 treatments were done every day, and 2-3 reflex areas were selected every time, every treatment lasted about 15-20 min, 7 days made up a treatment course. Of 15 cases, 8 cases were cured, 4 cases were effective, and 3 cases were failure． 2 To Treat Infantile Constipation with
Distinctive Effect
LIU Bai-xiang et al E63 treated 76 cases of infantile constipation with the age ranging from 2-11 months old. Kneading manipulation with index and ring fingers at Tianshu (ST25) was done 50-100 times; rubbing manipulation with palms was done on the abdomen, starting from the lower abdomen, and along ascending colon, transverse colon and descending colon, the circular rubbing manipulation was performed 9-36 times with two hands in tandem alternately. All the 67 cases were completely relieved in 5 days.
XU Hua, et al }73 treated 76 cases of infantile constipation with Tuina. Fifty-one cases of excess syndrome treated with clearing Large Intestine 300 times, reducing Six Bowels 200 times, clearing Spleen 150 times, tonifying Spleen 150 times, pushing the inner Eight Diagrams 300 times, rubbing the abdomen 200 times, pressing and kneading Zusanli (ST 36) 100 times, pushing Lower Seven Spine 200 times; 25 cases of deficiency pattern treated with pushing Kidney 300 times, clearing Large Intestine 200 times, pushing Upper San Guan 100 times, rubbing the abdomen 200 times, pinchingspine 5 times, pressing and kneading Zusanli (ST 36) 100 times. The treatment was done once every day, 5 treatments made up one treatment course, after 2 courses’ treatment, 60 cases were cured, 9 cases were remarkably effective, 3 cases were effective and 4 cases were failure, the effective rate was 94.7%. 3 To Treat One’s Own Constipation with Simply and Conveniently ZAN Tao, et aP3 introduced an effective method for treating habitual constipation, that is anus-elevating exercises according to respiratory rhythm 30 times, kneading manipulation around navel clockwise on abdomen 3-5 min, scrubbing manipulation on lower abdomen 30 times. LIU Gui-hong, et a1193 treated constipation with digital pressing at points. For the patients without awareness of defecation, Yingxiang (LI 20) was pressed 5-10 min before defecation; moreover, the Lower Seven Spine was pushed. It can produce effects rapidly.
Traditional Chinese medicine holds that irregular diet, emotional disturbance, aging process and
external pathogen attacking are all pathogenic factors for constipation. The disease is located at Intestine, and related to function disorder of Lung, Spleen, Stomach, Liver and Kidney. The main mechanism is abnormality of Intestine conduction due to Intestine and Stomach dryness-heat, qi stagnation, deficiency of qi, blood, Yin and Yang or stagnation of Yin-cold. Since the Six Fu-organs should always be unblocked, the therapeutic principle of constipation is regulating qi movement and relaxing bowels. The patient with large intestine heat should be treated by clearing heat and downbearing the turbidity; those with qi stagnation should be treated by soothing the liver and regulating qi; those with qi, blood, yin and yang deficiency should be treated by fortifying the spleen and stomach, harmonizing qi and blood; those with congealing cold should be treated by warming yang and dissipating cold. In summary, constipation is treated based on syndrome differentiation, notby laxatives alone or abuse of laxatives.
Chronic Constipation might contribute to the occurrence of colon carcinoma, hepatic encephalo-3 To Treat One’s Own Constipation with Simply and Conveniently ZAN Tao, et aP3 introduced an effective method for treating habitual constipation, that is anus-elevating exercises according to respiratory rhythm 30 times, kneading manipulation around navel clockwise on abdomen 3-5 min, scrubbing manipulation on lower abdomen 30 times.
LIU Gui-hong, et a1193 treated constipation with digital pressing at points. For the patients without awareness of defecation, Yingxiang (LI 20) was pressed 5-10 min before defecation; moreover, the Lower Seven Spine was pushed. It can produce effects rapidly. Traditional Chinese medicine holds that irregular diet, emotional disturbance, aging process and external pathogen attacking are all pathogenic factors for constipation. The disease is located at Intestine, and related to function disorder of Lung, Spleen, Stomach, Liver and Kidney. The main mechanism is abnormality of Intestine conduction due to Intestine and Stomach dryness-heat, qi stagnation, deficiency of qi, blood, Yin and Yang or stagnation of Yin-cold.
Since the Six Fu-organs should always be unblocked, the therapeutic principle of constipation is regulating qi movement and relaxing bowels. The patient with large intestine heat should be treated by clearing heat and down bearing the turbidity; those with qi stagnation should be treated by soothing the liver and regulating qi; those with qi, blood, yin and yang deficiency should be treated by fortifying the spleen and stomach, harmonizing qi and blood; those with congealing cold should be treated by warming yang and dissipating cold. In summary, constipation is treated based on syndrome differentiation, notby laxatives alone or abuse of laxatives.
Chronic Constipation might contribute to the occurrence of colon carcinoma, hepatic encephalo-pathy, galactophore disorders and senile dementia, etc. Constipation existing in the cases of acute myocardial infarction and cerebrovascular accidents may even lead to death. Using laxatives alone not only results in many adverse reactions, but also increases the medical expense and wastes the resources of medical treatment. Tuina, operated on the body surface, is agentle and mild manipulation, and has exact and lasting curative effect. As a safe, convenient, painless method with less adverse reactions, Tuina is especially suitable for the infantile and elderly patients; it should be popularized in clinical practice.