Clinical Observation on Three-character-scripture School Pediatric Tuina for Infants with Night Crying: A Report of 60 Cases

Bi Jian-qing, Li Yu-zhen, Dai Ni-ni

Qingdao Haici Medical Group, Shandong 266033, China

Clinical Observation on Three-character-scripture School Pediatric Tuina for Infants with Night Crying: A Report of 60 Cases

Bi Jian-qing, Li Yu-zhen, Dai Ni-ni

Qingdao Haici Medical Group, Shandong 266033, China

Objective: To observe the clinical efficacy of Three-character-scripture School pediatric tuina for infants with night crying.

Methods: Sixty cases with night crying were treated with Three-character- scripture School pediatric tuina, followed by observing the efficacy.

Results: Forty-nine cases were recovered, 7 cases improved, and 4 cases failed. The total effective rate was 93.3%.

Conclusion: Three-character-scripture School pediatric tuina is effective for night crying of infants. It should be spread and applied due to its manipulation with less acupoints, simple operation and no pain for infants.

Tuina; Massage; Night Crying; Infant

Night crying is a disease that an infant may be normal in daytime and fall into sleep quietly but cry and become restless at night. The infant may cry at a certain time every night or even keep crying throughout the night. Night crying is a common sleep disorder in infants, especially in newborns and infants under 6 month. It is believed in traditional Chinese medicine that night crying of infants is caused by cold, heat and terror. Night crying not only affects the rest of infants and families, if it is not treated in time, it will also seriously harm the infants’ growth, development and health. We used Three-characterscripture School pediatric tuina (massage) in treating night crying of infants in clinic. The report is showed as follows.

1 Clinical Material

1.1 Diagnostic criteria

According to the diagnostic points inCriteria of Diagnosis and Therapeutic Effects of Diseases and Syndromes in Traditional Chinese Medicine[1]and combining with the clinic, the infant may cry and become restless at night or take a rest between crying or cry at a certain time every night or even keep crying throughout the night, but the infant may be normal in daytime, excluding other primary diseases, without manifestations such as aphtha, diarrhea, furuncle sore, trauma, etc, and not caused by hunger, wet diaper, too cold or too hot.

1.2 Standards of syndrome differentiation

This is made byPediatrics of Traditional Chinese Medicine[2]. Night crying if often diagnosed as heat accumulated in the Heart Meridian. The voice of the infant is loud and may be louder when seeing light.When crying, the infant may have the symptoms such as flush face and lips, dysphoria, warm body, constipation, short and deep color of urine, a red tip of the tongue, thin yellow tongue coating and purple fingerprint.

1.3 General data

The 60 observed cases were all outpatients from the Pediatric Department of Traditional Chinese Medicine in our hospital. There were 36 boys and 24 girls, aged from 1 month to 6 months. The shortest duration of disease was three days and the longest was one month.

2 Treatment Methods

All individuals were treated by Three-characterscripture School pediatric tuina manipulations.

Qing-Clearing Tianheshui for 10 min: Put the pulps of the forefinger and middle finger at the medial side of the infants’ forearm and push from the middle of the wrist crease to the middle of cubital crease (Fig.1).

Fig.1 Qing-Clearing Tianheshui

Qing-Clearing Weijing for 10 min: Put the pulp of the thumb at the lateral border of the infants’ thenar where the red and white skin link at wrist crease and push from wrist crease to the base of the thumb (Fig.2).

Fig.2 Qing-Clearing Weijing

Dao-Pounding Xiaotianxin for 100 times: Dao-Pound the infants’ depression of the palm where thenar and hypothenar link with buckling interphalangeal joint (Fig.3).

Fig.3 Dao-Pounding Xiaotianxin

Qia-Pinching Wuzhijie for 1 time: Qia-Pinch the surface of the infants’ palm at the crease of the metacarpophalangeal and interphalangeal joints with the thumb (Fig.4).

Fig.4 Qia-Pinching Wuzhijie

Qing-Clearing Ganjing for 5 min: Put the pulps of the forefinger, middle finger and ring finger at the infant’s surface of the forefinger and push from the base of the finger to the top (Fig.5).

An-Pressing Jingning and Weiling for 0.5 min: An-Press the depression at the junction between the infants’ second and third metacarpal and fourth and fifth metacarpal with both thumbs (Fig.6).

All the above mentioned treatment just used at acupoints on the left side of the infant. During tuina, we used talc as medium. And it should be light, quick, soft, even and forceful. The frequency was supposed to be at the range of 150 to 300 per minute. We did the treatment everyday and three treatments constituted one course. We observed the efficacy after one course.

Fig.5 Qing-Clearing Ganjing

Fig.6 An-Pressing Jingning and Weiling

3 Treatment Results

3.1 Therapeutic effect criteria

It was made according to the diagnostic points inCriteria of Diagnosis and Therapeutic Effects of Diseases and Syndromes in Traditional Chinese Medicine[1].

Recovery: Stop crying and sleep normally and is not recurrent in two weeks.

Improved: The frequency and degree of night crying reduce and it may stop by soothing.

Invalidation: Night crying is the same as before. The time of crying doesn’t decrease or has no difference.

3.2 Results

In these 60 cases, 49 cases were recovered, 7 cases improved, and 4 cases were invalid. The total effective rate was 93.3%.

3.3 Case study

The patient was a 4-month boy, and his parents told the disease history.

Chief complaint and history of present illness: One week before the first visit, with no special reason, the patient started to become restless and cry at night, cried several times one night and had constipation but was as usual in daytime. The infant had a flush face and lips. The breath from nose and mouth was hot. And the body was warm with a red tip of the tongue, yellow tongue coating and slippery and rapid pulse.

Traditional Chinese medicine diagnosis: Night crying (heat accumulated in the Heart Meridian).

Treatment procedure: The patient was treated by aforementioned tuina manipulations. We used Qing-Clearing Tianheshui for 10 min, Qing-Clearing Weijing for 10 min, Qing-Clearing Ganjing for 5 min, Dao-Pounding Xiaotianxin for 100 times and Qia-Pinching Wuzhijie for 0.5 min, for 3 d. After the first treatment, the infant cried less times at night, and there was a bowel movement on the next day but the stool was hard as before. After two-day treatments, the parents told us the infant slept longer obviously, crying times were less than before, and he was quiet when be awake, could fall asleep again easily and defecated normal. After three-day treatments, the boy slept stably and just cried some times. So we gave him two extra treatments, the infant didn’t cry at night any more, the sleep quality became much better, defecated everyday and the other symptoms all disappeared. We followed up for one month and found no abnormality.

4 Discussion

Night crying is a common sleep disorder in infants. It is recorded inZhu Bing Yuan Hou Lunthat night crying is caused by cold of Zang organs. Night crying is categorized into spleen-cold and heart-hot byBao Ying Cuo Yao. It is pointed out byYou You Ji Chengthat night crying is often caused by cold in the Zang organs, heat in the heart, restlessness, vomiting, diarrhea and diseases. Night crying of infants is mainly divided into three types. Among them, pattern of heat accumulated in the Heart Meridian is very common. If the mother gets impatient or eats too much pungency during pregnancy, the heat from these will affect the infant. If the infant is fed something too hot after birth, it will affect the heart and cause disease. And the heat accumulated in the Heart Meridian also might be caused by exopathy of pathogenic heat or seasonal pathogens. When the night comes, yin becomes excessive and yang becomes deficient, the pathogenic heat can trouble heart which will make the infant uncomfortable and crying incessantly. We chose to remove pathogenic heat and tranquilize the mind in the treatment.

Pediatric tuina has a long history, rich contents and significant curative effect. It is one of the most important academic branches and clinical subjects in tuina science of traditional Chinese medicine. Pediatric tuina established its own system in theory, syndrome differentiation treatment, some special acupoints and operation in early Ming Dynasty and Qing Dynasty. In the year of Guangxu of the Qing Dynasty, the bookTuiNa San Zi Jingwritten by Xu Qian-guang established the Three-character-scripture School pediatric tuina. In 1920, Li De-xiu set up a clinic in Qingdao City and became the founder of Three-character-scripture School pediatric tuina. He treated the diseases with tuina and saved many infants’ lives.

Three-character-scripture School pediatric tuina is one of the most important schools of pediatric tuina and focuses on the acupoints below the elbow joint on the left upper limb. It is characterized by the following five points[3-5]: ① Manipulation with less acupoints usually not more than 3 to 5 acupoints. Mr Li thought that if we treated all over the bodies, qi and blood would keep moving and only led to confusion, so we used only few acupoints. ② Using only one acupoint. In some certain situations, we only manipulate on one acupoint for a long time until it works. ③ Simple operation. Three-character-scripture School pediatric tuina only uses eight operations which are Tui-Pushing, Na-Grasping, Mo-Rubbing, Yun-Moving, Dao-Pounding, Qia-Pinching, Fen-Parting and He-Gathering. The practitioner should be skillful, spirit concentrated, using proper power continuously. ④ Manipulating for a long time. It is recorded byTui Na San Zi Jingthat an adult should be manipulated for about 30 000 times, a teenager should be manipulated for about 3 000 times while an infant should be manipulated for about 300 times. In clinic, we manipulate on every acupoint for about 5 to 15 min. For an infant aged 1 to 3 years old, every treatment should last 20 to 30 min. ⑤ Good efficacy. During treatment, we differentiate syndromes, use less acupoints, simple operation and keep for a long time, consequently the efficacy is significant.

In this research, Qing-Clearing the Tianheshui could clear the accumulated heat in the Heart Meridian, and calm the spirit[6-7]. “Disorder of the stomach can lead to insomnia.” Qing-Clearing Weijing could purge the stomach heat and regulate the ascending qi[8]. “Liver is usually abundant in infants.” Qing-Clearing Ganjing could purge the unnecessary heat in the liver not to trouble heart. Dao-Pounding Xiaotianxin, Qia-Pinching Wuzhijie and An-Pressing Jingning and Weiling could calm the mind[9-10]. Choosing these operations to clear heat, keep balance of liver and stomach, so the heat in the Heart Meridian could be cleared, vitality could be restored and the night crying was cured. Moreover, this disease is related to feeding patterns and local climate, so it should be concerned during the treatment.

Pediatric tuina is the best therapy to the infants who is difficult to take medicine or injection. It is a green therapy for its painlessness, without side effects. Three-character-scripture School pediatric tuina should be spread and applied due to its good efficacy, repeatable and simple operation and reliable effect.

[1] State Administration of Traditional Chinese Medicine. Criteria of Diagnosis and Therapeutic Effects of Diseases and Syndromes in Traditional Chinese Medicine. Nanjing: Nanjing University Press, 1994: 307.

[2] Wang SC. Pediatrics of Traditional Chinese Medicine. 2nd Edition. Beijing: China Press of Traditional Chinese Medicine, 2007: 124.

[3] Yao X. Several characteristics of Three-character-scripture School pediatric tuina. Anmo Yu Daoyin, 2000, 16(1): 5-6.

[4] Cheng HY, Ge MF. Clinical observation of 70 cases on Three-character-scripture School pediatric tuina for anorexia of infants. Xin Zhongyi, 2007, 39(12): 45.

[5] Zhao JQ. A Valuable Book of Three-character-scripture School Pediatric Tuina. Qingdao: Qingdao Publishing House, 2008: 1-2.

[6] Kong XB, Chen SB. The clearing heat mechanism of Qing-Clearing Tianheshui. Anmo Yu Kangfu Yixue, 2012, 3(7): 176-177.

[7] Shan J, Zhuang AS. Treatment of 40 cases of infantile convulsion by tuina. J Acupunct Tuina Sci, 2005, 3(2): 41.

[8] Luo W, Huang LH. Electrogastrographic change after acupuncture and massotherapy in 50 children with chronic superficial gastritis. Shanghai Zhenjiu Zazhi, 2007, 26(5): 5-6.

[9] Zha W. Introduction to infantile tuina. J Acupunct Tuina Sci, 2004, 2(2): 8-10.

[10] Xiao LY. Treatment of 20 cases of infants with night crying by tuina plus auricular point sticking. Shanghai Zhenjiu Zazhi, 2008, 27(3): 27.

Translator: Ni Wen-ting

R244.1

A

Date: November 5, 2012

Author: Bi Jian-qing, bachelor, resident doctor. E-mail: bjq-qd1@163.com