Moxibustion techniques refer to the use of moxa sticks to stimulate acupuncture points on the body through specific methods, aiming to unblock meridians, regulate the internal organs, and achieve the purpose of strengthening the body and expelling pathogenic factors to treat diseases.The indications for moxibustion techniques are extensive, used for treating various common and frequently occurring diseases in internal medicine, external medicine, gynecology, and pediatrics.
I. Common Instruments and Basic Operation Methods
(1) Common Instruments
The moxa sticks used clinically are primarily made of high-quality mugwort, with types mainly categorized by their shape and size (see Table 1, Table 2).
Table 1: Moxa Stick Diameter Specification Table
|
Specification/Number |
22 |
24 |
26 |
28 |
30 |
32 |
34 |
|
Diameter/mm |
0.50 |
0.45 |
0.40 |
0.35 |
0.30 |
0.25 |
0.22 |
Clinically, moxa sticks with diameters of 32～26 (0.25mm～0.40mm) are most commonly used. Thicker moxa is often used for points on the limbs and lower back, as well as for patients with numbness or reduced sensitivity; thinner moxa is more suitable for points on the head, face, and for children or patients with weak constitutions.
Table 2: Moxa Stick Length Specification Table
|
Specification/Inch |
0.5 |
1.0 |
1.5 |
2.0 |
2.5 |
3.0 |
4.0 |
5.0 |
|
Length/mm |
15 |
25 |
40 |
50 |
65 |
75 |
90 |
100 |
Clinically, moxa sticks with lengths of 1.0～3.0 inches (25～75mm) are most commonly used, with 1.5 inches (40mm) being the most frequently utilized. Longer moxa is used for deep stimulation in areas with thick muscle, while shorter moxa is used for shallow stimulation in areas with thin muscle, such as points on the head and face.
(2) Basic Operation Methods
These include disinfection, moxa application, and removal.
1.Disinfection
Before moxibustion, it is essential to disinfect the moxa, the acupuncture points, and the practitioner’s hands.
2.Moxa Application Method
During moxa application, both hands are generally used. The right hand holds the moxa stick, while the left hand presses the area to stabilize the skin over the acupuncture point. Common methods of moxa application include:
(1) Direct Moxa Application
Using the left hand to hold the moxa stick close to the skin, the right hand quickly applies heat to the acupuncture point.
(2) Indirect Moxa Application
Using the left hand to hold the moxa stick at a distance from the skin, allowing the heat to penetrate without direct contact.
(3) Moxa with Ginger or Salt
Using slices of ginger or salt as a medium to enhance the warming effect of the moxa.
3.Retention and Removal
The practitioner can determine the retention time based on the patient’s condition, generally retaining the moxa for 15～30 minutes. When removing the moxa, the practitioner should ensure the area is cooled and apply a sterile cotton ball to prevent bleeding.
II. Common Diseases Treated with Moxibustion Techniques
(1) Stroke (Acute Cerebrovascular Disease)
Stroke is characterized by sudden loss of consciousness, hemiplegia, facial drooping, and speech difficulties. The condition arises mainly from an imbalance of yin and yang, emotional distress, overwork, or excessive sexual activity, leading to the stirring of wind and fire, and the upward rebellion of qi and blood. The diagnosis of stroke follows the standards set by the National Administration of Traditional Chinese Medicine in 1996.
Clinically, it is categorized based on the presence or absence of consciousness disturbance, focusing on the meridian treatment in this section.
[Treatment Principle] Unblock the meridians, promote qi and invigorate blood.
[Operation Steps]
Acupuncture Points: Baihui (百会), Fengchi (风池), Quchi (曲池), Waiguan (外关), Hegu (合谷), Huantiao (环跳), Yanglingquan (阳陵泉), Zusanli (足三里). Points can be selected based on symptoms, such as Qiu Xu (丘墟) for foot inversion, Tianshu (天枢) for constipation, and Lianquan (廉泉) for speech difficulties.
Needling Method: Direct insertion, using lifting and thrusting techniques. For Fengchi, the needle is inserted at an angle towards the tip of the nose, 0.8～1.2 inches, and for Lianquan, it is inserted at an angle towards the root of the tongue, 0.8～1.5 inches.
Treatment Course: During the acute phase, treatment is performed once daily; during the recovery and sequelae phases, treatment is performed every other day, with each session lasting 20～30 minutes, and a total of 10 sessions constitute one treatment course.
(2) Tension Headache (Cervicogenic Headache)
Headache is characterized by pain in the head. The brain is the “sea of marrow,” and the head is the meeting place of all yang and the residence of clear yang, where the qi of the five organs converges. External pathogens or internal injuries can lead to qi and blood stagnation, causing headache. The diagnosis of headache follows the standards set in the Clinical Research Guidelines for New Chinese Medicines.
Headaches are divided into external and internal types, with this section focusing on internal type headaches treated with moxibustion.
[Treatment Principle] Unblock the meridians, promote qi, invigorate blood, and relieve pain.
[Operation Steps]
Acupuncture Points: Baihui (百会), Fengchi (风池), Hegu (合谷), Taichong (太冲), Touwei (头维). Points can be selected based on symptoms, such as Shuaigu (率谷) and Jiaosun (角孙) for Shaoyang headaches, Tianzhu (天柱) and Taiyang (太阳) for Taiyang headaches, and Cuanzhu (攒竹) and Yintang (印堂) for Yangming headaches.
Needling Method: Head points are often treated with oblique or flat insertion, while limb points are treated with direct insertion. For Fengchi, the needle is inserted at an angle towards the tip of the nose, 0.8～1.2 inches, or flat insertion through Fengfu (风府). After insertion, lifting and thrusting techniques are applied.
Treatment Course: Each session lasts 30 minutes, performed once daily, with a total of 10 sessions constituting one treatment course.
(3) Facial Paralysis (Peripheral Facial Nerve Palsy)
Facial paralysis is characterized by drooping of the mouth and eyes on one side. Symptoms include facial relaxation, disappearance of forehead lines, widening of the eye fissure, flattening of the nasolabial fold, and drooping of the mouth towards the healthy side. Patients may initially experience pain behind the ear, taste reduction, or auditory hypersensitivity, and even herpes in the external ear canal. This condition often arises from the deficiency of the meridians, with wind and cold invading the Yangming and Shaoyang meridians, leading to stagnation of qi and blood, and muscle relaxation. The diagnosis follows the standards set in the Clinical Research Guidelines for New Chinese Medicines.
[Treatment Principle] Invigorate blood, unblock the meridians, and regulate the muscles and tendons.
[Operation Steps]
Acupuncture Points: Fengchi (风池), Yifeng (翳风), Dicang (地仓), Jiachao (颊车), Hegu (合谷). Additional points based on symptoms include Yingxiang (迎香) for flat nasolabial folds, Shuigou (水沟) for crooked nasal groove, Chengjiang (承浆) for crooked chin, and Yangbai (阳白) or Cuanzhu (攒竹) for inability to close the eyes.
Needling Method: For facial points, shallow and gentle insertion is recommended initially, with deeper or oblique insertion considered after one week.
Treatment Course: Each session lasts 20～30 minutes, performed once daily, with a total of 10 sessions constituting one treatment course.
(4) Frozen Shoulder (Adhesive Capsulitis)
Frozen shoulder is characterized by diffuse pain in the shoulder accompanied by limited movement. Symptoms include increased pain at night, reduced pain after morning activity, and localized tenderness, with restricted movements such as external rotation, abduction, and elevation. In the later stages, adhesions develop, leading to progressively worsening functional impairment and ultimately loss of shoulder function. This condition is often related to exposure to cold, overexertion, and chronic strain. The diagnosis follows the standards set in the Clinical Research Guidelines for New Chinese Medicines.
[Treatment Principle] Unblock the tendons and meridians, promote qi and invigorate blood.
[Operation Steps]
Acupuncture Points: Jianyu (肩髃), Jianliao (肩髎), Jianqian (肩前), Ashi points, and Tiaokou (条口). Additional points based on symptoms include Arm Pain (臂臑) and Quchi (曲池) for upper arm pain, and Quyuan (曲垣) and Tianzong (天宗) for scapular pain.
Needling Method: Direct insertion.
Treatment Course: Each session lasts 20～30 minutes, performed once daily, with a total of 10 sessions constituting one treatment course.
(5) Low Back Pain (Acute Lumbar Strain, Lumbar Disc Herniation)
Low back pain is characterized by self-reported pain in the lower back, presenting as heavy pain, soreness, and stiffness, with difficulty bending or straightening, or pain radiating to the buttocks and legs. This condition is primarily related to external pathogens and injuries. The diagnosis follows the standards set in the Clinical Research Guidelines for New Chinese Medicines.
This condition is categorized into three types: cold-damp low back pain, blood stasis low back pain, and kidney deficiency low back pain, with this section focusing on blood stasis low back pain treated with moxibustion.
[Treatment Principle] Unblock the meridians, promote blood circulation, and resolve stasis.
[Operation Steps]
Acupuncture Points: Shenshu (肾俞), Yaojiaji (腰夹脊), Weizhong (委中), and Ashi points.
Needling Method: Direct insertion.
Treatment Course: Each session lasts 20～30 minutes, performed once daily, with a total of 10 sessions constituting one treatment course.
III. Contraindications
1.Pregnant women should avoid moxibustion on the lower abdomen, lumbar region, and points such as Hegu (合谷), Sanyinjiao (三阴交), and Zhiyin (至阴).
2.Children with unclosed fontanelles should avoid moxibustion on the top of the head.
3.Areas with skin infections, ulcers, or tumors should not be treated with moxibustion.
4.Patients with bleeding tendencies should exercise caution with moxibustion.
IV. Precautions
1.Patients should not undergo moxibustion when overly hungry, fatigued, or under excessive mental stress.
2.For patients with weak constitutions or qi and blood deficiency, the moxibustion technique should not be too strong, and patients should be encouraged to lie down.
3.Deep moxibustion should be avoided on points located over the chest, ribs, waist, and back.
4.When moxibustion is applied to the eye area and neck points (such as Fengfu and Yamen), care should be taken to control the angle and depth to avoid significant lifting, thrusting, or prolonged retention to prevent injury to important organs.
5.For patients with urinary retention, deep moxibustion on the lower abdomen should be avoided.
V. Management and Prevention of Abnormal Situations During Moxibustion
1.Fainting: Common in first-time moxibustion patients due to nervousness, improper positioning, or excessive stimulation. Patients may suddenly experience dizziness, pallor, palpitations, sweating, or fainting. Moxibustion should be stopped immediately, and the patient should be laid down flat. Acupoints such as Shuigou (水沟), Suli (素髎), Neiguan (内关), Hegu (合谷), Taichong (太冲), Zusanli (足三里), and Yongquan (涌泉) can be stimulated for emergency relief, along with other necessary measures.
2.Stuck Moxa: This occurs when the patient is tense, or local muscle spasms occur due to pain, or if the patient’s position changes after moxibustion, causing the moxa to become stuck. The practitioner should advise the patient to relax, or apply pressure or tap the moxa stick near the stuck area, or insert another moxa stick nearby.
3.Bent Moxa: This occurs due to unskilled technique, or if the moxa encounters hard tissue, or if the patient’s position changes during moxibustion, making it difficult to apply or remove the moxa. The practitioner should stop the application and slowly withdraw the moxa in the direction of the bend.
4.Broken Moxa: This can occur due to poor quality of the moxa or excessive force during application, resulting in breakage within the body. The practitioner should apply pressure around the moxa to expose the broken end, and use tweezers to remove it; if the broken part is deeply embedded, X-ray localization and surgical removal may be necessary.
5.Hematoma: This can occur due to puncturing a blood vessel, leading to minor subcutaneous bleeding and localized bruising or swelling, which generally resolves on its own. If there is significant swelling and pain, cold compresses followed by heat compresses can be applied.
6.Pneumothorax: Deep moxibustion on points near the chest, back, and collarbone can puncture the thoracic cavity and lung tissue, leading to pneumothorax, with symptoms such as chest pain, tightness, and difficulty breathing. If pneumothorax occurs, moxibustion should be stopped immediately, and the patient should be placed in a semi-reclining position. Do not panic or change positions. Generally, small amounts of air can be absorbed naturally; for severe cases, timely rescue measures such as thoracentesis and slow oxygen supplementation may be required.