Journal of Traditional Chinese Medicine 25 (2): 85-89, 2005 85

Effect of Blood-letting Puncture at Twelve Well-Points of Hand on

Consciousness and Heart Rate in Patients with Apoplexy
1 1 1
Guo Yi 郭义 ，Wang Xiuyun 王秀云 ，Xu Tangping 徐汤苹 ，
2 2
Dai Zhihua 戴志华 & Li Yunchen 李蕴琛
1Tianjin College of Traditional Chinese Medicine, Tianjin 300193, China

2 General Hospital of Tianjin Medical University, Tianjin 300052, China

Objective: To observe the effect of blood-letting puncture at Twelve Well-Points of Hand on

consciousness and heart rate in patients with early apoplexy. Method: Under observation were patients
with disturbance of consciousness within 3 days after the apoplectic seizure. The patients were divided
into a large injury team, a moderate injury team and a mild injury team. Each team was again randomly
divided into a puncture group and a control group, with routine treatment in both groups but blood-
letting puncture only in the puncture group. Quantitative changes in consciousness, blood pressure and
heart rate of the patients were observed. Result: Blood-letting puncture at Twelve Well-Points of Hand
can improve the consciousness and raise the systolic pressure in patients of the mild injury team, and
accelerate the heart rate in all the patients in the puncture group. Conclusion: Blood-letting puncture at
Twelve Well-Points of Hand can improve the consciousness of patients with brain injury in small area.

Blood-letting puncture at Twelve Well-Points of consciousness of patients with apoplexy. The

Hand, a first aid therapy in TCM, is recorded in
many classical medical books. According to Great
Compendium of Acupuncture and Moxibustion,
“Three-edged needles can be used for quick puncture
at Twelve Well-Points of Hand to cause bleeding as a
first aid for patients with early apoplexy.” As a
traditional therapeutic method with a history of
several thousand years in China, it has attracted great
attention from scholars in Japan, France and Egypt.
For example, a Japanese physician said: “Although
the mechanism of blood-letting puncture is not
known quite clearly, it can influence the blood flow
throughout the body, particularly the blood flow in
the brain by stirring blood flow at the tip of fingers.
Therefore, blood-letting puncture should be first
considered as an emergency treatment.” However,
due to lack of systematic clinical research, the
curative effect and indications of blood-letting
puncture remain to be known exactly, thus restricting
its popularization. Therefore, the authors first
observed the effect of blood-letting puncture on the
experimental result is as follows.
Clinical Data
Criteria for case selection and diagnosis: All the 30
Condition for diagnosis was typical clinical
manifestation of cerebrovascular disease and def
cases in the puncture group were patients with
disturbance of consciousness within 3 days after
apoplectic seizure. Patients with cerebral hemorrhage
or cerebral infarction were selected with no
restriction on their illness causes. Among patients
with cerebral hemorrhage mainly were those with
coxal hemorrhage and lobar hemorrhage with no
restriction on their bleeding amounts. Patients with
cerebral infarction were those with infarction of sites
except brain stem with no restriction on their
infarction areas. inite CT diagnosis. For the 22 cases
in the control groups, they were comparable in terms
of age, sex as well as the nature, site and scope of
pathogenic change. shaoshang
86 Journal of Traditional Chinese Medicine 25 (2): 85-89, 2005

Among the 30 cases in the puncture group were 22

men and 8 women with their average age at 66.27±
7.12 years. Among 16 cases of cerebral hemorrhage,
there were 4 cases of hemorrhage in large amount
(operation was inappropriate or disagreed), 7 cases
of hemorrhage in moderate amount and 5 cases of
hemorrhage in small amount, with hemorrhage
above moderate amount occupying 70%. Among 14
cases of cerebral infarction, there were 6 cases of
infarction in large area, 2 cases of infarction in
moderate area and 6 cases of infarction in small area,
with infarction above moderate area occupying 58%.
Among the 22 cases in the control group were 10
men and 12 women with their average age at 66.73
± 10.51 years. Among 13 cases of cerebral
hemorrhage, there were 2 cases of hemorrhage in
large amount (operation was inappropriate or Results of Treatment
disagreed), 8 cases of hemorrhage in moderate
The average age was 66.73 ± 10.51 years in the
amount and 3 cases of hemorrhage in small amount,
control group and 66.27±7.12 years in the treatment
with hemorrhage above moderate amount occupying
group with no obvious statistical difference.
76%. Among 9 cases of cerebral infarction, there
Hemorrhage above moderate amount occupied 76%
were 4 cases of infarction in large area, 2 cases of
and 70% respectively. Infarction above moderate
infarction in moderate area and 3 cases of infarction
area occupied 58% and 66% respectively. Therefore,
in small area, with infarction above moderate area the two groups were similar in pathogenic change,
occupying 66%. hence comparability.

Therapeutic Methods Blood-letting puncture at Twelve Well-Points of

Routine treatment was given to both groups but
blood-letting puncture only to the puncture group.
Three-edged needles were used for quick puncture at
Twelve Well-Points of Hand first on the left hand
and then on the right hand to let out a drip of blood.
Changes in consciousness, blood pressure,
respiration and pulse were observed before puncture
and 15, 30 and 45 minutes after puncture in the
puncture group. The same observation was, at the
corresponding time, given to the control group with
no blood-letting puncture. Consciousness was judged
according to Glasgow Consciousness Disturbance
Scale (see Table 1). Comparison before and after
treatment and t test were used in statistical analysis.
Hand resulted in improvement of consciousness in
patients with brain injury in small area (see Table 2
and Table 3).
Raised systolic pressure in patients with brain injury
in small area after blood-letting puncture at Twelve
Well-Points of Hand may be one of the causes for the
improvement of consciousness (see Table 4 and
Table 5).
Blood-letting puncture at Twelve Well-Points of
Hand has little influence on respiration of patients
with early apoplexy (see Table 6 and Table 7)
Blood-letting puncture at Twelve Well-Points of
Hand can accelerate the heart rate of patients (see
Table 8 and Table 9).
Journal of Traditional Chinese Medicine 25 (2): 85-89, 2005 87

Table 1: Glasgow Consciousness Disturbance Scale

Eye-opening reaction Mark Language reaction Mark Movement reaction Mark

Automatically open eyes
Open eyes after call
Open eyes after puncture
Fail to open eyes after
puncture
4 Correctly answer questions 5 Free movement 6
3 Can not answer questions 4 Can fix position after 5
correctly stimulation
2 Speech out of order 3 Can dodge after stimulation 4
1 Only utter voice 2 Can bend after stimulation 3
Fail to utter voice 1 Can not bend after simulation 2
No movement in limbs 1

Table 2: 45-minute natural change in consciousness of patients with apoplexy in control group (Δ x ±s, mark)

Extent Cases 15 min 30 min 45 min

Large injury area 6 0.00±0.00 0.40±0.55 0.58±1.55
Moderate injury area 11 0.27±0.46 0.36±0.51* 0.55±0.52*
Small injury area 5 0.20±0.45 0.40±0.55 0.40±0.55
*P<0.05, Δx=xt-x0

Table 3:Influence of blood-letting puncture at Twelve Well-Points of Hand

on consciousness of patients with apoplexy (Δ x ±s, mark)

Extent Cases 15 min. after puncture 30 min. after puncture 45 min. after puncture
Large injury area 10 0.10±0.32 0.20±0.42 0.30±0.62
Moderate injury area 9 0.00±0.00 0.45±0.73* 0.56±0.73*
Small injury area 11 0.09±0.30 0.37±0.51* 0.63±0.81*
*P<0.05, Δx=xt-x0

Table 4: Natural change in blood pressure of patients with apoplexy in control group (Δ x ±s, kPa)

15 min 30 min 45 min

Extent Cases Systolic Diastolic Systolic Diastolic Systolic Diastolic
pressure pressure pressure pressure pressure pressure
Large injury area 6 0.00±0.00 0.00±0.00 -1.67±4.08 1.67±4.08 -1.67±4.08 -3.37±5.17
Moderate injury area 9 0.00±0.00 -1.82±4.05 -1.82±4.05 -3.64±6.74 -1.82±4.45 -4.45±6.17*
Small injury area 5 2.00±4.42 0.00±0.00 2.00±4.47 0.00±0.00 2.00±4.47 0.00±0.00
*P<0.05, Δx=xt-x0
88 Journal of Traditional Chinese Medicine 25 (2): 85-89, 2005

Table 5: Influence of blood-letting puncture at Twelve Well-Points of Hand

on blood pressure of patients with apoplexy (Δ x ±s, kPa)

15 min. after puncture 30 min. after puncture 45 min. after puncture

Extent Cases Systolic Diastolic Systolic Diastolic Systolic Diastolic
pressure pressure pressure pressure pressure pressure
Large injury area 10 1.00±2.11 -0.50±2.84 2.50±3.54* 0.00±2.36 3.50±7.09 -1.00±4.60
Moderate injury area 9 0.56±1.61 0.00±0.00 -0.56±4.64 -0.57±1.67 0.00±4.33 -1.11±4.17
Small injury area 11 2.73±4.10* -0.46±9.25 6.36±9.25* -1.82±5.60 4.09±12.01 0.00±0.00
*P<0.05, Δx=xt-x0

Table 6: 45-minute natural change in respiration of patients with apoplexy

in control group (Δ x ±s, times per minute)

Extent Cases 15 min 30 min 45 min

Large injury area 6 0.30±1.16 0.50±1.27 0.10±1.37
Moderate injury area 9 0.00±2.24 0.45±1.95 0.11±2.26
Small injury area 5 0.09±1.82 0.46±2.25 0.55±1.57
Δx=xt-x0

Table 7: Influence of blood-letting puncture at Twelve Well-Points of Hand

on respiration of patients with apolexy (Δ x ±s, times per minute)

Extent Cases 15 min. after puncture 30 min. after puncture 45 min. after puncture
Large injury area 10 0.00±0.00 －1.17±1.60 －1.17±1.43
Moderate injury area 9 －0.27±0.65 －3.31±6.08 －0.55±0.93
Small injury area 11 －0.20±1.10 －0.40±1.67 －1.20±2.10
Δx=xt-x0

Table 8: Natural change in heart rate of patients with apoplexy in control group (Δ x ±s, times per minute)

Extent Cases 15 min 30 min 45 min

Large injury area 6 －0.17±0.98 －1.50±3.39 1.61±4.01
Moderate injury area 11 －0.37±0.81 －1.09±3.39 －0.05±1.17
Small injury area 5 －0.60±0.89 －1.00±1.00* －0.08±1.30
*P<0.05, Δx=xt-x0

Table 9: Influence of blood-letting puncture at Twelve Well-Points of Hand

on heart rate of patients with apoplexy (Δ x ±s, times per minute)

Extent Cases 15 min. after puncture 30 min. after puncture 45 min. after puncture
Large injury area 10 2.40±2.63* 3.20±3.29** 3.40±2.84**
Moderate injury area 9 0.78±1.39 3.45±2.19** 2.33±2.74**
Small injury area 11 1.91±2.91* 3.85±1.87** 5.00±3.65**
*P<0.05, ** P<0.01, Δx=xt-x0
Journal of Traditional Chinese Medicine 25 (2): 85-89, 2005
86

Discussion Well-Points of Hand can improve consciousness of

patients in the treatment group, but routine treatment
Apoplexy is a commonly seen and frequently
can also improve the consciousness of patients in the
encountered disease. However, in current studies on
control group. With only a small number of cases in
acupuncture treatment of apoplexy, greater
the observation, it is difficult to sum up a law. The
importance is attached to the treatment of its sequel
effect of this method needs to be proved with more
rather than its first aid. Because of delayed or
cases at more places. Blood-letting puncture at
improper first aid, many patients suffer from
Twelve Well-Points of Hand can raise the systolic
irreversible injury to their cerebral cells by ischemia
pressure of patients with small injury area and
and hypoxia, resulting in serious sequel or even
increase the blood supply to the brain, which may be
death. Therefore, to find out a simple and effective
one of the reasons for the improvement of
first aid therapy is of clinically significance.
consciousness. In addition, Blood-letting puncture at
Blood-letting puncture at Twelve Well-Points of
Twelve Well-Points of Hand can accelerate the heart
Hand, a first aid therapy in TCM, has been clinically
rate of patients, which may also increase the blood
used in China for several thousand years. However,
supply to the brain. However, its exact mechanism is
its curative effect and indications are not known
to be studied.
quite clearly, thus restricting its popularization. The
result of this research has shown that blood-letting
puncture at Twelve Well-Points of Hand can indeed References
improve the consciousness of apoplectic patients 1 谭德福. 中国实用刺血疗法. 重庆: 重庆科学技术出
with brain injury in small area. As to patients with 版社 1990．
moderate injury area, it is difficult to reach a
conclusion. Blood-letting puncture at Twelve (Translated by Duan Shumin 段树民)