Rheumatoid arthritis (类风湿关节炎) is a systemic disease characterized by chronic symmetrical polyarthritis. Clinically, the main symptoms include symmetrical swelling and pain in small joints, as well as recurrent morning stiffness. The onset age is commonly between 35 and 50 years, with a higher prevalence in women.
Etiology and Pathogenesis
The etiology includes both internal and external factors: internal factors are due to congenital weakness or insufficient postnatal nourishment; external factors involve the invasion of wind, cold, dampness, and heat, which obstruct the meridians, leading to the disease.
The fundamental pathogenesis involves the invasion of wind, cold, and dampness, which penetrate the body through the meridians and settle in the joints, causing obstruction of qi and blood, resulting in wind-cold-damp obstruction (风寒湿痹). The invasion of wind-heat combined with dampness can lead to wind-damp-heat obstruction; or if the body constitution is yang excess or yin deficiency with heat, it is easy to transform into heat upon encountering external pathogens; or due to prolonged wind-cold-damp obstruction, the pathogens can remain in the meridians and joints, leading to heat accumulation. Prolonged obstruction can result in phlegm and blood stasis, gradual depletion of qi and blood, deficiency of essence and blood, and deficiency of both liver and kidney, leading to chronic pain and deformity in joints, and in severe cases, kidney yang deficiency, resulting in cold pain and swelling of joints, with clear and prolonged urination.
Method One
Acupuncture Points: Ah Shi points (阿是穴) and local joint points.
Local Acupuncture Points: For fingers: Ba Xie (八邪); for toes: Ba Feng (八风); for wrist joints: Yang Xi (阳溪), Yang Chi (阳池), Yang Gu (阳谷); for ankle joints: Jie Xi (解溪), Qiu Xu (丘墟), Shang Qiu (商丘).
Procedure: First, use a filiform needle to locate local tender points, then use a fine or medium fire needle to puncture the Ah Shi points and local joint acupoints. Depth: 0.1 to 0.3 cun, 3 times per week, for 10 sessions.
Method Two
Acupuncture Points: Hualun Jiaji points (华伦夹脊穴) (for upper limbs: neck 4 to chest 3 Jiaji, for lower limbs: waist 1 to 5 Jiaji).
Procedure: Use a fine or medium fire needle to puncture the Hualun Jiaji points, with rapid insertion and no retention of the needle, depth: 0.3 to 0.5 cun. All Jiaji points once per week, 3 times per week, for 10 sessions.
Method Three
Acupuncture Points: For affected upper limb joints, select Ah Shi points and neck Jiaji points, where shoulder joint pain is treated with Jian Liao (肩髎), Jian Yu (肩髃), and Bing Shen (臂臑); elbow joint pain with Zhou Liao (肘髎), Qu Chi (曲池), and Shou San Li (手三里); wrist joint pain with Yang Chi (阳池), Yang Xi (阳溪), and Yang Gu (阳谷); for affected lower limb joints, select Ah Shi points and lumbar Jiaji points, where knee joint pain is treated with Xi Yan (膝眼), Liang Qiu (梁丘), Zu San Li (足三里), and Yang Ling Quan (阳陵泉); ankle joint pain with Jie Xi (解溪), Tai Xi (太溪), and Qiu Xu (丘墟).
Procedure: Use shallow puncture technique for Ah Shi points of hands and feet, and deep rapid puncture technique for other major joints. Once every other day, for 15 sessions.
Remarks: Using fire needle therapy on Ah Shi points can directly reach the affected area, utilizing its warming power to disperse cold and eliminate dampness, promote blood circulation, and relieve tension in the meridians. The Jiaji points are adjacent to the Du Meridian (督脉), and puncturing them with fire needles can stimulate yang energy and unblock the meridians. Modern studies have shown that fire needle therapy can significantly increase the temperature of the affected area, improve local microcirculation, and regulate overall immune function, thereby alleviating symptoms and preventing disease progression.
Method Four
Acupuncture Points: Main points include Zu San Li (足三里), Guan Yuan (关元), and Qu Chi (曲池).
For migratory joint pain, select Xue Hai (血海) for severe pain, and add Qi Hai (气海) if pain worsens with cold; for heavy joints, add Yin Ling Quan (阴陵泉); for red, swollen, hot, and painful joints, add Da Zhui (大椎) point. Combine with local points: for shoulder, select Jian Yu (肩髃), Jian Liao (肩髎), and Jian Zhen (肩贞); for elbow, select Chi Ze (尺泽), Qu Ze (曲泽), and Shao Hai (少海); for fingers, select Yang Xi (阳溪), Yang Chi (阳池), and Ba Xie (八邪); for knees, select Xi Yan (膝眼) and Yang Ling Quan (阳陵泉); for ankles, select Zhao Hai (照海), Qiu Xu (丘墟), Shen Mai (申脉), and Kun Lun (昆仑); for toes, select Tai Xi (太溪), Ba Feng (八风), and Kun Lun (昆仑).
Procedure: Use medium fire needles with rapid insertion and no retention, depth of 0.3 to 0.5 cun, or puncture the affected area with fire needles; for other points, use fine needles. For heat obstruction, use draining technique; for other conditions, primarily use tonifying technique. Shallow puncture for wind obstruction, deep puncture for pain obstruction, and retain needles for 30 minutes.