Electroacupuncture technology involves inserting needles into acupuncture points to obtain qi, and then applying a low-frequency pulsed electric current that closely resembles the body’s bioelectricity. This technique combines both needle and electrical stimulation to prevent and treat diseases. Clinically, it is commonly used for various chronic diseases and neurological disorders.
1. Commonly Used Instruments and Basic Operation Methods
(1)
Common Instruments
Filiform needles, electroacupuncture device.
(2)
Selection of Acupuncture Points
1. When selecting points, traditional acupuncture theory can be followed, either by meridian selection or pattern differentiation.
Each treatment must select more than two acupuncture points, with the main point paired with corresponding auxiliary points, generally selecting 1 to 3 pairs of points on the same side of the body.
2. Points can also be selected based on nerve distribution.
Head and face: Tinghui (SI19), Yifeng (SJ17) (facial nerve distribution area), Xiaguan (ST7), Yangbai (ST2), Sibai (ST4), Jiachengjiang (ST6) (trigeminal nerve distribution area).
Upper limb: C6-C7 Jiaji points, Tianding (LI16) (brachial plexus distribution area), Qingling (LI11), Xiaohai (HT3) (ulnar nerve distribution area); Shouwuli (LI5), Quchi (LI11) (radial nerve distribution area), Quze (PC3), Ximen (PC6) (median nerve distribution area).
Lower limb: Huantiao (GB30), Yinmen (GB31) (sciatic nerve distribution area), Weizhong (BL40) (tibial nerve distribution area), Yanglingquan (GB34) (common peroneal nerve distribution area); Chongmen (SP12) (femoral nerve distribution area).
Lumbar and sacral region: Qihaiyu (BL24) (lumbar nerve distribution area), Bayao (BL27) (sacral nerve distribution area).
Ahshi points can also be used as electroacupuncture stimulation points.
3. Points can be selected based on the affected area.
Facial nerve paralysis: Use Tinghui or Yifeng as the main point, with Yangbai for the forehead, Qianliao for the cheek, Dancang for the mouth corner, and Tongziliao for the eyelid. Upper limb paralysis: Use Tianding or Quepen as the main point, with Jianliao or Naozhen for the deltoid, Humerus triceps for the Humerus meeting point, and Biceps for Tianfu; use Quchi as the main point for wrist flexors and finger extensors, paired with Shouwuli or Sidu. Lower limb paralysis: Use Chongmen or Waiguan for the anterior thigh, paired with Biguan or Jimen; Huantiao or Zhibian for the buttocks and posterior thigh, Weizhong for the back of the calf, and Yanglingquan for the outer side of the calf.
(3)
Basic Operation Methods
Before using the electroacupuncture device, first set the intensity adjustment knob to zero. After inserting the needles into the acupuncture points and obtaining qi, connect each pair of output electrodes from the electroacupuncture device to the two filiform needles, with the negative electrode connected to the main point and the positive electrode to the auxiliary point, generally connecting the same pair of output electrodes on the same side of the body. If performing electroacupuncture on adjacent points, place dry cotton balls between the two filiform needles to avoid short-circuiting. Finally, turn on the power switch, select the waveform, and adjust the stimulation amount knob, gradually increasing the stimulation from none to a comfortable level, with the electric stimulation intensity adjusted to the patient’s tolerance.
1. Selection of Waveform
(1) Sparse-Dense Wave
The sparse-dense wave is a waveform where sparse and dense waves alternate automatically. Its dynamic effect is significant, with excitatory effects dominating during treatment. It can increase metabolism, promote qi and blood circulation, improve tissue nutrition, and eliminate inflammatory edema. It is commonly used for sprains, periarthritis, sciatica, facial paralysis, muscle weakness, and local frostbite.
(2) Intermittent Wave
The intermittent wave is a waveform that rhythmically alternates between on and off. Its dynamic effect is strong, enhancing the excitability of muscle tissue and providing good stimulation for skeletal muscle contraction. It is commonly used for treating atrophy and paralysis.
(3) Continuous Wave
Also known as adjustable wave, it is a waveform formed by combining single pulses in different ways. Its excitatory effect is more pronounced, with strong stimulation, commonly used for treating atrophy and various muscle, joint, ligament, and tendon injuries.
2. Electroacupuncture Intensity
When the current reaches a certain intensity, the patient will feel a tingling or prickling sensation, which is referred to as the “sensation threshold”. If the current intensity is increased slightly, the patient may suddenly feel a sharp pain, which is referred to as the “pain threshold” of the current. The intensity varies from person to person and can differ significantly under various pathological conditions. Generally, the current intensity between the sensation threshold and pain threshold is the most suitable stimulation intensity for treatment. The “pain threshold” intensity of pulsed current varies from person to person and can differ significantly under various pathological conditions, and should generally be set to a level that the patient can tolerate.
(4)
Treatment Duration
The duration of electrical stimulation is generally around 15 to 30 minutes. Needle anesthesia can last longer.
(5)
Types of Electroacupuncture Devices
1. Buzzer-type electroacupuncture device
This device uses the principle of electric bell oscillation to convert direct current into pulsed current. The waveform of this pulsed current is narrow, resembling a needle tip, and is asymmetrical. Due to high power consumption and noise, it is rarely used now.
2. Voltage-reducing alternating current electroacupuncture device
This device uses a standard alternating power supply, reducing the voltage to below 25 V through a transformer, and then regulates the output through resistors and potentiometers to achieve appropriate stimulation intensity. Due to non-adjustable frequency, it is also rarely used now.
3. Audio oscillation electroacupuncture device
This device uses an audio oscillator to generate frequency-adjustable sine wave electroacupuncture within the range of 20 to 200 Hz. Although the frequency and output intensity can be adjusted, the waveform is simple, and the therapeutic effect is poor. This type of electroacupuncture device is also rarely used now.
4. Transistor noise-type electroacupuncture device
This type of electroacupuncture device operates on a direct current of 6 V, with a noise frequency of 15000 to 20000 Hz, modulation frequency of 3 to 30 Hz, and output voltage of 0 to 50 V. The E1332 electroacupuncture device belongs to this type, mainly suitable for needle anesthesia and analgesic treatment.
5. Sonic electroacupuncture device
This device, also known as sound electroacupuncture, inputs various sound sources generated by a sound wave generator, such as music, drama, songs, and broadcasts, into the electroacupuncture device, outputting through wires connected to the needle handle inserted into the acupuncture points, thus producing a complex, irregular, and randomly fluctuating composite sound wave stimulation, making it less likely to cause adaptation in the body, allowing for prolonged treatment without diminishing its effect. Due to the absence of strong fundamental wave interference, the stimulation is more comfortable and easily accepted by patients. Sonic currents have better analgesic effects than general pulsed waves.
6. Pulsed electroacupuncture device
This type of electroacupuncture device has been widely used in recent years both domestically and internationally. A typical model is G6805. It uses an intermittent oscillator as a pulse generator, with variable resistors changing the time constant of the circuit to control the pulse frequency. Multiple isolated output windings are wound on the oscillation transformer, and the output of the auxiliary winding is divided through a potentiometer. A multi-harmonic oscillator outputs square waves, allowing for sparse-dense waves and intermittent waves, but the frequency of these two waveforms is not adjustable. The fluctuations generated by the square wave can modulate its amplitude, allowing for fluctuating waves and sawtooth waveforms.
2. Common Diseases Treated with Electroacupuncture
(1)
Facial Paralysis (Peripheral Facial Paralysis)
Facial paralysis is often caused by external invasion of wind and cold, affecting the facial meridians, leading to paralysis of one side of the facial muscles, disappearance of forehead wrinkles, widening of the eye fissure, tearing, shallowing of the nasolabial fold, and deviation of the mouth corner towards the healthy side. Some patients may initially experience pain behind the ear. This condition is often due to deficiency of righteous qi, allowing wind evil to invade the meridians, resulting in obstruction of qi and blood, and insufficient nourishment of the facial muscles, leading to the onset of the disease. This condition is diagnosed according to the “Standards for Diagnosis and Efficacy of Traditional Chinese Medicine Diseases” issued by the National Administration of Traditional Chinese Medicine in 1994.
[Treatment Principle] Disperse wind and open the meridians, promote qi and invigorate blood.
[Point Selection] Recovery phase of facial paralysis: Use Dancang (ST4), Daying (ST5), Jiachengjiang (ST6), Yangbai (ST2), Sibai (ST4), Taiyang (EX-HN5), Yifeng (SJ17), and Hegu (LI4); for sequelae of facial paralysis: based on the above points, add Kuahe (ST7) for upper lip deviation, and Jiachengjiang (ST6) for lower lip deviation; if unable to flare the nostrils, use Yingxiang (LI20); if unable to wrinkle the brow, use Yuyao (EX-HN4) and Cuanzhu (BL2).
[Operation] Use a 0.35mm x 50mm stainless steel needle for rapid insertion into the skin, either horizontally or obliquely, to connect the Jiachengjiang and Dancang points, and insert the remaining points to a depth of about 25mm until a sensation of soreness and distension is felt. When using electroacupuncture, one group is placed on Dancang and Jiachengjiang, and another group on Yangbai and Sibai. The output intensity should be adjusted to achieve slight twitching of the facial muscles, with continuous electrical stimulation for 20 minutes, once daily, for a total of 7 sessions.
(2)
Neck Pain (Cervical Spondylosis)
Neck pain is often caused by damage to the Du meridian, qi and blood deficiency, or invasion of external pathogens, leading to obstruction of the meridians, with symptoms including neck and back pain, upper limb weakness, finger numbness, lower limb fatigue, difficulty walking, dizziness, nausea, vomiting, and even blurred vision, tachycardia, and difficulty swallowing. This condition is diagnosed according to the “Standards for Diagnosis and Efficacy of Traditional Chinese Medicine Diseases” issued by the National Administration of Traditional Chinese Medicine in 1994.
[Treatment Principle] Disperse tendons and open the meridians.
[Point Selection] Main points: C2-C7 Jiaji points. Auxiliary points: Yanglao (BL10), Tiuzhu (BL9), Dazhui (GV14), Shenyang (BL23), Dazhu (BL11), Quchi (LI11), Waiguan (TE5), Hegu (LI4), Yanglingquan (GB34), and Zhibian (BL54).
[Operation] Insert the main points with a 50mm filiform needle at a 45° angle towards the spine, manipulating the needle until a sensation is transmitted, and obtain qi at the auxiliary points. Use even tonification and reduction for 1 minute, then connect the electroacupuncture device, with the negative electrode connected to the main point and the positive electrode to the auxiliary point, using a continuous wave at a frequency of 120-250 times/minute, with the current intensity adjusted to a comfortable level for the patient, generally between 1-1.5 mA.
[Special Note] The current intensity of electroacupuncture should not be too high, and the patient’s sensations during treatment should be monitored.
(3)
Lumbar Disc Herniation
Lumbar disc herniation is often caused by acute injury, damage to the Du meridian, or invasion of cold pathogens, leading to obstruction of the meridians, with symptoms including low back pain, numbness, and pain in one or both lower limbs. This condition is diagnosed according to the “Standards for Diagnosis and Efficacy of Traditional Chinese Medicine Diseases” issued by the National Administration of Traditional Chinese Medicine in 1994.
[Treatment Principle] Invigorate blood and open the meridians.
[Point Selection] Main points: Shenyang (BL23), Dazhu (BL11), Zhibian (BL54), Weizhong (BL40), Huantiao (GB30), or Ahshi points. Auxiliary points: for cold dampness with wind, add Yaoyangguan (GV3); for strain, add Ge Shu (BL17) and Ci Liao (BL31); for kidney deficiency, add Mingmen (GV4) and Taixi (KD3); for acute lumbar sprain or strain, use Shuigou (ST8) and Houxi (SI8).
[Operation] After routine disinfection of the acupuncture points, select 3-4 main points based on the condition, use different filiform needles to obtain qi at the corresponding points, and connect the electrotherapy device, using a continuous wave at a frequency of 80-100 times/minute, with the intensity adjusted to the patient’s tolerance.
[Special Note] Each treatment session should not be too long to avoid affecting the therapeutic effect.
(4)
Chorea Minor
Chorea minor, also known as rheumatic chorea, is a neurological manifestation of acute rheumatic fever, characterized by irregular, involuntary dance-like movements, decreased muscle tone, weakened muscle strength, motor disturbances, and emotional changes. This condition is diagnosed according to the “Standards for Diagnosis and Efficacy of Traditional Chinese Medicine Diseases” issued by the National Administration of Traditional Chinese Medicine in 1994.
[Point Selection] Use points from the scalp acupuncture technique as the main points, along with the dance tremor area. Auxiliary points: motor area and auditory area (see Figure 1).
Figure 1: Schematic Diagram of the Auditory Area
[Operation] For those primarily experiencing tremors, only the main points are selected; for those with enhanced muscle strength, add the motor area. For those experiencing dizziness or adverse reactions from medication, add the auditory area. In the early stages, if tremors or enhanced muscle strength are present on one side, only select the corresponding scalp acupuncture area on the opposite side. In later stages, if symptoms appear bilaterally, select the corresponding areas on both sides. Based on the different affected areas of the limbs, select the corresponding regions, such as the middle 2/5 area of the motor area if upper limb symptoms are prominent. Use a 0.32mm filiform needle for rapid insertion, pushing to the desired depth, and electroacupuncture can be applied with a frequency of 240-280 times/minute, continuous wave, with intensity adjusted to the patient’s tolerance, for 20 minutes. It is preferable if warmth, numbness, or distension is felt in the opposite limb.
3. Contraindications
1. Avoid using electroacupuncture near the heart, especially for patients with severe heart disease, as care should be taken to prevent the current circuit from passing through the heart; do not apply electrical stimulation across the spinal cord and heart to prevent spinal cord injury or even spinal shock.
2. For the treatment of psychiatric patients, as they cannot articulate their sensations and may be agitated, electroacupuncture should be avoided.
3. Patients in critical condition, pregnant women, those who are overly fatigued, hungry, or intoxicated.
4. Precautions
1. Before each treatment, check that the output of the electroacupuncture device is normal. After treatment, all output adjustment knobs should be returned to zero, and then the power should be turned off and the wires removed.
2. The strong sensation of electroacupuncture can cause muscle contractions after electrical stimulation, so patients should be informed in advance to prepare mentally, which will help them cooperate better during treatment. The intensity of electroacupuncture stimulation should gradually increase from low to high; do not suddenly increase it to avoid fainting, bending needles, or breaking needles.
3. When using electroacupuncture on symmetrical acupuncture points on both sides of the scalp, if one side feels too strong, the output electrodes can be switched. After switching, if the originally strong sensation becomes weak and the weak sensation becomes strong, it is due to the performance of the electroacupuncture device’s output current; if there is no change, it is due to the needle being in different anatomical locations.
Source: Xinglin Academy (xinglinxy)
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