Acupuncture for Abdominal Pain - Treatment Protocols

Below you will find some of the more common tcm diagnoses and acupuncture treatment protocols for abdominal pain. There are many ways to treat this condition with Eastern Medicine and our presentation is only one of many possible options.

• Etiology & Pathology:
  • Xinnong (CAM) Differentiations:
    • Direct Stike of Cold to the Intestines
    • Retention of Food
    • Chronic lower abdominal pain due to SP Yang Deficiency
  • Maciocia Differentiations:
    • Cold
    • Damp Heat
    • Retention of Food
    • Stagnant Qi
    • Stagnant Blood
    • SP Yang Deficiency/Empty Cold
  • Differentiation:
    • Direct Strike of Cold to the Intestines (Maciocia Cold)
      • Signs & Symptoms:
        • Sudden onset, lower abdominal pain, patient feels cold, chills, diarrhea
        • Tongue: White coat
        • Pulse: Deep, tight & slow (with dehydration the pulse may appear fast, but it is still a cold pathology)
      • Treatment Points:
        • Xinnong (CAM) Point Selection:
        • CV 12 - ST Mu
        • CV 8 - w/salt moxa, warms lower jiao
        • ST 36 - tonify ST/SP
        • SP 4 - clear ST excess
        • Maciocia Point Selection:
        • ST 25 - warm lower jiao
        • SP 15 - warm lower jiao, esp. w/constipation
        • ST 27 - warm lower jiao
        • CV 10 - direct ST Qi downwards
        • SP 6 - tonify ST/SP
        • ST 36 - tonify ST/SP
        • Valaskatgis Point Selection:
        • ST 25 - warm lower jiao
        • ST 37 - reinforce ST 25
        • ST 27 - warm lower jiao
        • CV 6 - tonify Qi
        • SP 4 - clear ST excess
        • SP 6 - tonify ST/SP
    • Retention of Food
      • Signs & Symptoms:
        • Constipation, abdominal fullness, burping, flatulence.
        • Tongue: Thick, greasy coat
        • Pulse: Slippery (indicates retention of food esp. w/thicker coat)
      • Treatment Points:
        • Xinnong (CAM) Point Selection:
        • CV 12 - ST Mu
        • ST 25 - LI Mu
        • CV 6 - moves food/Qi in the lower abdomen
        • ST 44 - moves the stools (may not be necessary)
        • Maciocia Point Selection:
        • CV 10 - move food/Qi downwards
        • CV 6 - move Qi in the lower abdomen
        • SP 15 - constipation
        • SP 16 - ST 25 possibly better
        • ST 27 - pain in the lower abdomen
        • TH 8 - regulate the TH and promote bowel movements (not commonly used, TH 6 for heat w/excess is more commonly used)
        • ST 36 - tonify ST/SP
        • UB 25 - LI Shu
        • UB 27 - SI Shu
    • SP Yang Deficiency
      • Signs & Symptoms:
        • Dull pain, better with the application of heat, fatigue
        • Tongue: Pale
        • Pulse: Weak
      • Treatment Points:
        • Xinnong (CAM) Point Selection:
        • UB 20 - SP Shu
        • UB 21 - ST Shu
        • ST 36 - tonify ST/SP
        • SP 6 - tonify ST/SP
        • CV 12 - ST Mu
        • LV 13 - SP Mu
        • Maciocia Point Selection:
        • ST 36 - tonify ST/SP
        • SP 6 - tonify ST/SP
        • CV 6 - tonify Qi
        • UB 20 - SP Shu
        • UB 21 - ST Shu
    • Retention of Food
      • Signs & Symptoms:
        • May effect either the ST or the intestines.
        • Can be acute or chronic, depending on dietary habits.
        • Usually from overconsumption of food, overeating when tired a/or contaminated food.
        • Persistient pain that is constant or colic-like, worse with pressure and eating, fullness and discomfort in the epigastric area, nausea, foul belching, vomiting of undigested food.
        • LI symptoms - constipation a/or flatulence.
        • No desire to eat.
        • Tongue: Thick, greasy coat
        • Pulse: Full, slippery (which can indicate, phlegm, damp a/or pregnancy as well as stagnation of food)
      • Treatment Principle:
        • Resolve food stagnation.
        • Promote digestion.
      • Treatment Points:
        • Valaskatgis Point Selection:
        • CV 10 - direct Qi downwards
        • LV 13 - SP Mu, moves stuck food in the epigastric area
        • ST 36 - regulates ST Qi, tonifies Qi, can disperse excess above, descends the ST Qi
        • ST 44 - cools heat in the ST and conducts Qi downwards
        • LI 10 - arm equivalent of ST 36
        • Maciocia Point Selection:
        • CV 13 - useful w/vomiting a/or nausea
        • CV 10 - directs Qi downwards
        • ST 21 - excesses in the epigastric area, reinforces Cv 12
        • ST 20
        • ST 44
        • ST 45 - ST fire, possibly effecting the mind (may not be necessary)
        • ST 25 - LI Mu, epigastric pain, constipation
        • SP 4 & PC 6 - Yin Wei Chong Mai, move excesses in the epigastric area
    • Damp Heat (common clinically)
      • Signs & Symptoms:
        • Chron's Disease, IBS patients may have damp heat in the LI.
        • Lower abdominal pain, loose, urgent stools w/strong odor, possibly with mucus a/or blood, burning anus.
        • Tongue: Greasy, yellow coat
        • Pulse: Slippery, fast
      • Treatment Principle:
        • Clear Heat in the Intestines.
        • Resolve dampness.
      • Treatment Points:
        • Maciocia Point Selection:
        • ST 25 - LI Mu
        • ST 37 - regulate intestines
        • UB 25 - LI Shu
        • SP 6 - tonify ST/SP, resolve damp
        • SP 9 - very good for dampness in the lower warmer w/SP 6
        • TH 6 - cool heat
        • LI 11 - cool heat
        • CV 10 - regulate Qi downwards
        • CV 6 - possibly instead of CV 10
    • Stagnant Qi
      • Signs & Symptoms:
        • Result of the LV invading the SP
        • Pain that is directly related to emotions, moodiness, irritability, belching, flatulence, borborygmus, lower abdominal bloating, alternating constipation and diarrhea
        • Tongue: Normal or slightly purplish
        • Pulse: Wiry
      • Treatment Principle:
        • Regulate the Intestines.
        • Tonify SP.
        • Move Qi in lower abdomen
      • Treatment Points:
        • Maciocia Point Selection:
        • CV 6
        • GB 34 - w/CV 6 for moving Qi in the lower abdomen
        • LV 3
        • SP 6 - w/LV 3 to harmonize LV & SP
        • UB 18 - LV Shu
        • PC 6 - useful with LV Qi stagnation
        • TH 6 - moves intestines w/constipation
    • Stagnant Blood
      • Signs & Symptoms:
        • Masses in the lower abdomen, dark complexion, dark stools possibly w/blood.
        • Tongue: Purple
        • Pulse: Deep, choppy or firm
      • Treatment Principle:
        • Move Qi/Blood in Lower Abdomen.
      • Treatment Points:
        • Maciocia Point Selection for Phlegm Fire differentiation:
        • LV 3 - resolve blood stagnation
        • GB 34 - resolve blood stagnation
        • TH 6 - useful w/constipation
        • SP 6 - move LV/SP Qi
        • UB 17 - Diaphragm Shu
        • SP 10 - w/UB 17 to move Blood
        • Possibly Yin Qiao Ren Mai, KD 6 & LU 7 - move Blood in the lower warmer

The information on our site is drawn from our own lecture notes and clinical experience. The following lecture notes were consulted within this section:

• St. John, Meredith: New England School of Acupuncture, Etiology and Pathology Lecture Notes
• Valaskatgis, Peter: New England School of Acupuncture, Etiology and Pathology Lecture Notes

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