The clinical application of Governor moxibustion in China

Wang Yanmei (王巖梅), Zhang Jie (張潔), Zhang Yun(張蕓), and Zhang Cuidi (張翠娣)

INTRODUCTION

Governor moxibustion, which is also called moxibustion on the Governor vessel, long snake moxibustion, or spread moxibustion, means that the Governor vessel should be treated if it has problems, and that needles and drugs should be used to treat illness on the bone; in addition, drug-paste separated moxibustion should be applied to the spine segment of the Governor vessel. Governor moxibustion can be directly applied to the problematic part to treat the illness in meridians,acupoints, moxibustion, drugs, and foam to produce the treatment effects. Compared with acupuncture, people are unfamiliar with Governor moxibustion, which is an external treatment specif i cally from traditional Chinese medicine. According to the Huangdi Neijing Suwen(questions of fundamental nature) Gukong (acupoints along skeletal indentations), if the Governor vessel is ill, on acupoints along the skeletal indentations, needles and drugs should be used to treat the Governor vessel.Previous clinical studies on Governor moxibustion are summarized as follows.

PROCEDURES

Materials

The following materials should be prepared: soft moxa, fresh grated ginger, a lighter, tweezers, cotton balls, ginger juice and moxibustion powder.

Method of operation

Governor moxibustion is applied to the spine segment of the Governor vessel on a patient’s back between the Dazhui acupoint and the Yaoyu acupoint. First, the spine segment of the Governor vessel is marked out. Second,tweezers are used to pick up a cotton ball, which is used to wipe the moxibustion site. Then Governor moxibustion powder is spread on the moxibustion site,followed by grated ginger. After this, moxa is shaped into a strip, which is placed on the grated ginger. The head, middle, and tail of the moxa strip are lit; after the moxa strip is burned out and no longer emitting smoke,and one cycle is completed. More moxa is added, and the strip is lit again in the same fashion. The cycle is repeated two or three times, depending on the patient’s tolerance level.

Warnings

Seafood, lamb, chicken, dog meat, alcohol, leek,cilantro or chili pepper must be avoided prior to Governor moxibustion. After the treatment, patients should be kept warm, rest properly, get plenty of sleep,and avoid being subject to air conditioning, catching a cold, or drinking cold drinks.

Contraindications

Governor moxibustion should not be used for the following people: pregnant or breast-feeding women;patients with metrorrhagia; patients with diabetes,cardiovascular disease, cerebrovascular disease, liver disease, kidney disease, or hematopoietic system disease; patients with mental disorder or allergy;patients with disability caused by spine joint deformity;patients with spondyloarthropathies concurring with rheumatic heart disease; patients with skin problems on the spine segment; and patients with liver fi re or heart fi re. For these people, Governor moxibustion produces adverse effects.

CLINICAL APPLICATIONS OF GOVERNOR MOXIBUSTION

Orthopedic disease

Ankylosing spondylitis

Gao etc.1explored the effect of Governor moxibustion coupled with acupuncture on 30 patients with ankylosing spondylitis, observing both the effects and their quality of life. The results showed that this treatment not only improved the patients’ bodily functions and the effects, but also enhanced kidney and brain functions, Governor meridian-unblocking, and mind-regulating2. It enhanced the patients’ physiological and psychological health, as well as their social functioning and their knowledge about health. Song etc.3applied Governor moxibustion to treat 50 patients with ankylosing spondylitis; the results showed that the treatment alleviated the symptoms in 13 patients,substantially reduced the symptoms in 20 patients, and effectively reduced the symptoms in 13 patients, but had no effect on 4 patients. The effectiveness rate was 92%, indicating that Governor moxibustion can warm up the Governor vessel, activate yang, enhance kidney functions, strengthen bones, remove cold and dampness,and improve body.

Rheumatoid arthritis

Wang etc.4applied Governor moxibustion to treat 100 patients with rheumatoid arthritis of cold-dampness obstruction. The treatment alleviated the symptoms in 32 patients and effectively reduced the symptoms in 61 patients, but had no effect in 7 patients. The effectiveness rate was 93.4%, indicating that Governor moxibustion can effectively treat rheumatoid arthritis.Prolapse of lumbar intervertebral disc

Wang etc.5randomly assigned 60 patients to the treatment group and the control group (30 patients in each group). The treatment group received the Governor moxibustion with scraping therapy, and the control group received only scraping therapy. The results showed the method improved body functioning in both groups, and the treatment effectiveness rate was 86.66%in the treatment group and 53.33% in the control group,demonstrating that Governor moxibustion with scraping therapy was a more effective method than the scraping therapy alone. The scraping therapy can improve blood circulation, but did not supplement Yangqi; however,Governor moxibustion supplemente Yangqi, remove cold and dampness, and improve blood circulation.Chen6applied lumbar traction with Governor moxibustion to treat 50 patients with prolapse of the lumbar intervertebral disc. The treatment effectiveness rate of low-back pain was 90.63%. Therefore, lumbar traction coupled with Governor moxibustion can effectively treat prolapse of the lumbar intervertebral disc.

Cervical spondylosis

Xu7randomly assigned 80 patients to the treatment group and the control group (40 patients in each group). The treatment group received the Governor moxibustion, and the control group received oral Chinese medicine (cervical rejuvenation granules). The results showed that both treatment methods effectively alleviated cervical spondylosis. The treatment effectiveness rate was 100% in the treatment group and 75% in the control group, indicating that Governor moxibustion was more effective on cervical spondylosis.

Internal medicine

Chronic obstructive pulmonary disease

Basing themselves on routine anti-infective antispasmodic asthma treatment, Li etc.8applied fire dragon moxibustion to treat chronic obstructive pulmonary disease (COPD) in the stable period. The results showed that the treatment effectiveness rate in the treatment group was 92.86%, which was higher than treatment effectiveness rate in the control group.In addition, the lung function in the treatment group was superior to that in the control group. Yang and Fu9randomly assigned 60 patients with the lung and kidney deficiency type of COPD into the observation group and the control group (30 patients in each group).The control group received the conventional treatment(including oxygen inhalation, oral bronchodilator,tiotropium bromide powder, and budesonide/fradil powder), whereas the observation group received conventional treatment and Governor moxibustion. The results showed that after 3 months, the forced expiratory volume in one second (FEV1) and the ratio of FEV1to forced vital capacity signif i cantly were increased in the observation group; moreover, these were significantly higher than those in the control group (P＜0.05,P＜0.01).The FEV1in the control group was also significantly increased (P＜0.05). The treatment effectiveness rate of the observation group was 90.0%, which was significantly higher than 53.3% in the control group(P＜0.05). Therefore, Governor moxibustion treatment can effectively improve the lung function of patients with the lung and kidney deficiency type of COPD during the stable period, and can alleviate related clinical symptoms.Insomnia

Song10applied Governor moxibustion to treat 130 patients with insomnia. The treatment effectiveness was assessed according to the patients’ average sleep time, the number of awakenings during the night, and early morning fatigue. The results showed that the patients’ sleep quality improved as the length of the treatment increased. Gao etc.11randomly assigned 69 patients with restless legs syndrome from maintenance hemodialysis to the observation group (34 patients)and the control group (35 patients). The control group received conventional hemodialysis treatment and the observation group received the conventional treatment and Governor moxibustion, once every 2 weeks, for a total of 8 Governor moxibustion sessions. After the entire treatment procedure, the severity of restless legs syndrome (International Restless Legs Scale, IRLS),the total scores on Pittsburgh Sleep Quality Index, and the treatment effectiveness were assessed and reduced in both groups (P＜0.01). The IRLS scores in the observation group were signif i cantly lower than those in the control group (P＜0.05). Moreover, the improvement rate was 58.8% (20/34) in the observation group and 22.9% (8/35) in the control group, which was of statistically significant difference (P＜0.01). Therefore,Governor moxibustion can effectively improve patients’restless legs syndrome of maintenance hemodialysis and sleep quality.

Physical symptoms caused by radiotherapy or chemotherapy

As common methods for treating malignant tumors, when radiotherapy and chemotherapy inhibit or kill tumor cells, they can also damage normal cells. Leukopenia is a common disease caused by radiotherapy and chemotherapy. Zhang etc.12applied sandwiched moxibustion on the Governor vessel to treat 45 patients with leukopenia caused by chemotherapy in treating malignant tumors. The results showed that Governor moxibustion helped the granulocyte colony stimulating factor to rapidly enhance leukocyte and platelet levels. Li13applied Governor moxibustion with thunderbolt moxibustion in treating leukopenia caused by radiotherapy and chemotherapy in 81 patients, and achieved a treatment effectiveness rate of 86.42%.Zhang etc.14indicated that hand-foot syndrome was a type of arthralgia (blockage and uneasiness) in terms of the meridian system of traditional Chinese medicine.According to their findings, Governor moxibustion(a Governor vessel meridian-based treatment) can effectively treat hand-foot syndrome.

Yang-def i ciency and Qi-def i ciency symptoms

Lu15applied Governor moxibustion to treat 286 patients with repeated Qi-deficiency colds; after receiving the Governor moxibustion treatment, 201 patients developed colds less than twice a year (with some patients not catching a cold at all during the year). Therefore, the Governor moxibustion effectively reduced the relapse rate of repeated Qi-deficiency colds. The results showed that Governor moxibustion can regulate Qi and increase Yangqi to prevent from a cold. For people with a cold who are physically weak,Governor moxibustion could enhance their body’s resistance to diseases and reduce the relapse rate of Qi-deficiency colds. Pang etc.16applied Governor moxibustion to treat 30 patients with subpar health due to Yang def i ciency. The patients received the treatment once a week, for 4 weeks; after completing the entire treatment procedure, 2 patients recovered completely,11 patients showed substantial improvement, 16 patients showed effective improvement, and 1 patient showed no improvement. The effectiveness rate was 96.7%,thus proving that Governor moxibustion significantly improved subpar health caused by Yang def i ciency.

Stroke sequelae

Wei etc.17randomly assigned 50 patients with Qideficiency and the blood-stasis type of stroke to the control group (25 patients) and the treatment group(25 patients). The patients received acupuncture once daily and Governor moxibustion once every other day,for 2 weeks. Effectiveness was assessed 1 week and 2 weeks after the patients received the treatment. The results showed that in the treatment group, 4 patients recovered, 8 patients showed substantial improvement, 6 patients showed improvement, 7 patients showed slight improvement, and 1 patient showed no improvement;in the control group, 2 patients recovered, 5 patients showed substantial improvement, 5 patients showed improvement, 8 patients showed slight improvement,4 patients showed no improvement, and 1 patient showed deterioration. The treatment effectiveness rate in the treatment group was 96% (24/25), which was significantly higher than 80% (20/25) in the control group (P＜0.05). Therefore, Governor moxibustion can relieve the clinical symptoms and improve the quality of life of patients with the Qi-def i ciency and blood-stasis type of stroke.

Erectile dysfunction

Gao etc.18randomly assigned 70 patients with erectile dysfunction to the treatment group and the control group according to a random number table. The control group took capsules for enhancing liver functions and Yangqi and the treatment group received Governor moxibustion and psychological therapy. The results showed that in the treatment group, erectile dysfunction was effectively treated. The Governor vessel was the main Yang channel containing Yangqi and was called the “sea of Yang pulses”. Therefore, the Governor moxibustion treatment can regulate Yang channel and Qi, and effectively treat erectile dysfunction.

CONCLUSION

After years of research and exploration, the Governor moxibustion has made substantial progresses in treating various common diseases. It is an inexpensive, safe, and effective treatment method suitable for modern health care. However, numerous clinical studies have presented a simplistic research design, included an insufficient number of samples, or had a short study period. Future researchers should use improved research designs, large sample sizes, and explore the mechanism of Governor moxibustion in depth to provide the clinical workers with detailed and useful information for the benef i t of human health.

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4 Wang DZ, Zheng XQ, Xu H. The use of Governor moxibustion to treat rheumatoid arthritis of cold-dampness obstruction and patient care. Road Health, 2013, 12(11):316.

5 Wang HY, Ma WP. The use of long snake moxibustion combined with scraping therapy to treat prolapse of lumbar intervertebral disc: observation on 30 cases. Clin J Chin Med, 2013, 5(16): 46-47.

6 Chen X. The use of lumbar traction and moxibustion on the Governor vessel to treat prolapse of lumbar intervertebral disc and patient care. Nei Mong J Tradit Chin Med, 2014,33(14): 145.

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12 Zhang Y, Luo YX, Cai XP. The effect of sandwiched moxibustion on the Governor vessel on leukopenia caused by chemotherapy used to treat malignant tumor: clinical observation on 45 cases. Tradit Chin Med Clin Med, 2013,4(5): 42-43.

13 Li YF. The effect of moxibustion on the Governor vessel combined with thunderbolt moxibustion on leukopenia caused by radiotherapy and chemotherapy: 81 cases. Extern Treat Chin Med, 2013, 22(2): 40-41.

14 Zhang XQ, Zhang YD, Liu PM. Governor meridian-based treatment and hand-foot syndrome following chemotherapy.Chin Foreign Women Health, 2016(24): 41-42.

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