Dr. Shi Xue-Min and the Xing Nao Kai Qiao Legacy

By Jing Liu, OMD, LAc, PhD and Kun Liu, LAc

To the acupuncture community, Dr. Shi Xue-Min is known as a distinguished acupuncturist and academician of the Chinese Academy of Engineering and a supervisor of doctoral candidates in China. Dr. Shi Xue-Min is particularly known for his creation of the stroke acupuncture technique Xing Nao Kai Qiao (XNKQ), which is translated as "activating the brain and opening the orifices." During the Chinese Revolution, he was among a few who survived in his position. After establishing The First Teaching Hospital University of Traditional Chinese Medicine in Tianjin, China, Dr. Shi's leadership allowed the hospital to grow to an astounding degree, from 200 beds to 2,000 beds.

Dr. Shi has nearly 50 years of experience in the field of Traditional Chinese Medicine. He is the recipient of numerous awards and has published extensively. He has been the past recipient of 15 awards and two patents on the state, ministerial and municipal levels. He also published 12 major works, more than 30 theses, and authored more than 40 books. The work he has done has greatly encouraged many doctors to conduct research on the effects of acupuncture and meridians.

Watch Part 1 of 3 of our exclusive interview with Dr. Shi Xue-Min here.

As most know, Chinese acupuncture has about 5,000 years of history. Dr. Shi Xue-min's theory and techniques known as "Xing Nao Kai Qiao" (XNKQ), is a very effective method of acupuncture for the treatment of stroke. Dr. Shi inherited traditional Chinese medicine, but he also developed the modern concept of quantitative needling manipulation. He was the first doctor in the world to propose the theory of quantitative needling manipulation. He used scientific experimental methods and studied the relationship between clinical effects and needling techniques, including needle retention time, rotation angle and frequency. Moreover, through the efforts of more than 100 of his PhD students, the study of XNKQ has extended even into research at the DNA level. Dr. Shi's concept of quantitative needling manipulation is more valuable than XNKQ alone, and it greatly contributes to the development of acupuncture and research. Thus, Dr. Shi is often referred to as "China's Treasure."

Dr. Shi Xue-Min - Copyright – Stock Photo / Register Mark Photo Courtesy of Seiko Maramba Starting from 1968, Dr. Shi has traveled to countries all over the world to treat patients and to teach doctors about his XKNQ method of treating stroke patients. He has visited countries such as are Algeria, Germany, Japan, Mexico, France, Italy, and the United States, and he has flown enough miles to circle the Earth about 38 times. Nowadays, even in his seventies, he still flies around the world to spread the word about Traditional Chinese Medicine and his XNKQ method to treat stroke patients.

Last year, Dr. Shi was featured in the acclaimed documentary film 9,000 Needles. The film illustrated the treatment of severe stroke patients by Dr. Shi and his team.

What is Xing Nao Kai Qiao?

The Xing Nao Kai Qiao (XNKQ) method was created by Dr. Shi in 1972, illustrating a new approach to the treatment and rehabilitation of stroke patients. As a result of nearly 40 years of working with stroke patients, the "XNKQ" method has developed into a diagnostic and treatment system.

Watch Part 2 of 3 of our exclusive interview with Dr. Shi Xue-Min here.

According to the World Health Organization, stroke is the third leading cause of death in most countries of the world, surpassed only by heart disease and cancer. By the year 2030, it is expected to be the leading cause of death. In the United States, each year 750,000 individuals suffer a stroke and 150,000 people die from stroke. Each year in China, 5-6 million people suffer from stroke and approximately 1.5 million people die from stroke. Stroke affects three times as many women as breast cancer, and it is an important cause of prolonged disability. Survivors of strokes are often unable to return to work. The economic, social and psychological costs of stroke are enormous. In the U.S., each ischemic stroke costs an average of $140,000, according to recent reports.

The theoretical TCM basis of the XNKQ method was based on "spirit-arousing" and "spirit-regulating." Dr. Shi put forward a new conception of the etiology and pathogenesis of stroke, based on a deep understanding the theory of "spirit" in TCM combined with the anatomy and physiology of the brain in biomedicine. Dr. Shi posited that fire, phlegm, blood (stasis), and deficiency carried upwards by wind (internal wind) disturbed the lucid orifices and spirit, leading to closure of the orifices and concealment of the spirit, which in turn caused the spirit to fail to guide the qi, thus stroke occurred.

The XNKQ acupuncture method for treating apoplexy/stroke explained the main pathological keys to etiology, pathogenesis, disease location, and manifestations, and created scientific standards of points selection and acupuncture manipulation. A large amount of clinical practice has confirmed that the treatment method is effective, easy, convenient and practical with a strong scientific standard. The XNKQ method is based on activating and regulating the spirit, restoring qi and spirit, regulating yin-yang and qi-blood, calming, dredging the meridians and supplementing the marrow.

The principles of traditional acupuncture treatment in stroke patients include "calming liver-yang and smoothing liver wind" in the acute period. "Smoothing meridians" is the main principle in stable cases and the sequela period. The points chosen were based on the theories of "using three yang meridians to treat wind" and "using Yang-Ming meridians to treat apoplexy." A comparison of clinical effects and research shows that the traditional acupuncture treatment for stroke patients has a definite effect in stabilizing the disease and improving physical function. However, to improve cerebral circulation and protect the brain cells, the changes in brain function are not obvious. Dr. Shi's XNKQ mainly uses Yin meridians and the Du meridian to activate the brain and open the orifices and nourish the liver and kidney; smoothing the meridians is supplementary.

Watch Part 3 of 3 of our exclusive interview with Dr. Shi Xue-Min here.

The theory of quantitative acupuncture manipulation put forward first by Dr. Shi determines a new definition and quantitative manipulation for reinforcing and reducing methods of needle manipulation. Particular attention is given to twirling and rotating, including four important factors. The direction of applied force is an important factor in determining reinforcing vs. reducing technique. The reinforcing or reducing nature of twirling and rotating is directly related to the applied force, the best duration of reinforcing or reducing manipulation based on twirling and rotating the needle is 1-3 minutes for each point. Finally, the best interval between two sessions of acupuncture is three-to-six hours, allowing acupuncture therapy to be more reproducible, standardized, and controlled.

Additionally, Dr. Shi investigated the most commonly used methods of manipulation for reinforcing and reducing in terms of frequency, range, and direction of applied force. His research on quantification of reinforcing and reducing manipulation techniques resulted in two significant definitions: 1) The twelve channels are positioned with the Ren and Du channels in the center; in regard to the right or left direction of needle rotation, directing the rotation towards the heart is reinforcing and directing the rotation away from the heart is reducing. 2) Rotating the needles within a narrow range with light force is reinforcing; the force is light and the range of rotation is narrow, but the frequency is high, the needles are rotated under 90 degrees and the frequency of rotation reaches 120 times per-minute. By contrast, a wide angle of rotation, increased force, and relatively less frequent rotation is reducing; the angle of rotation is greater than 180 degrees and the frequency is approximately 50-60 times per minute.

The manipulation and composition of the XNKQ needling method

Dr. Shi Xue-Min - Copyright – Stock Photo / Register Mark Photo Courtesy of Seiko Maramba One of the main reasons for the efficacy of the XNKQ method lies in its strict application of principles, in particular its special specifications in terms of manipulation technique. The principle points in clinical use are the most important because they free and regulate the spirit; this emphasis is one of the most important differences between the XNKQ method and traditional acupuncture.

The principle points of the XNKQ method include Du 26, P 6, Sp 6, Lu 5, Ht 1, and UB 40. Du 26 is a point that was highly regarded historically for emergency situations; it can directly excite and activate the restrained state of the brain cells. It has a special characteristic of increasing the circulation of the carotid artery, which helps the dynamics of blood circulation and improves cerebral circulation. Thus, the use of this point with sparrow pecking stimulation can open the orifices, arouse the original spirit, and regulate the bowels and viscera. P 6 is the luo point of the pericardium channel, it can benefit stroke patients by improving cardiac output and oxygen supply while calming the heart, regulating the blood, and quieting the spirit. Sp 6 supplements the three yin channels, boosts marrow, regulates qi and blood, and quiets the spirit. Ht 1, Lu 5 and UB 40 can dredge the channels, move qi and blood, and improve the function of the limbs. Within these points, Du 26 is the chief, P 6 and Sp 6 are ministers, and Ht 1, Lu 5, and UB 40 are assistants and couriers; together they regulate and brighten the original spirit, balance yin and yang, regulate qi and blood, and free the channels. One treatment course constitutes 10 days of twice daily treatments; 3-5 treatment courses are used continuously.

Needle Manipulation Techniques Used in XNKQ

The efficacy of XNKQ is closely related to its strict attention to techniques of needle manipulation. One of the key differences between XNKQ and traditional acupuncture methods is the importance placed upon principle points that arouse the spirit and open the orifices in order to achieve the essential effect of regulating and freeing the original spirit.

The principle points used in XNKQ are DU-26 (ren2 zhong1), PC 6 (nei4 guan1), SP 6 (san1 yin1 jiao1), HT 1 (ji2 quan2), LU 5 (chi3 ze2), and BL 40 (wei3 zhong1). Ancient doctors greatly valued DU-26 (ren2 zhong1) as an important point to arouse the brain in emergency situations; it has an excitatory effect on the nervous system and it has an idiosyncratic effect of increasing blood flow in the carotid artery while improving cerebral circulation. Using sparrow pecking technique to drain DU-26 (ren2 zhong1) opens the orifices, arouses the original spirit, and regulates the bowels and viscera.

Dr Shi Needling - Copyright – Stock Photo / Register Mark Photo Courtesy of Seiko Maramba PC 6 (nei4 guan1) is the luo-connecting point of the pericardium channel; it is traditionally said to quiet the heart, regulate the blood, and calm the spirit, and it improves the cardiac output of stroke patients and improves the supply of oxygen to the brain. SP 6 (san1 yin1 jiao1) supplements the three yin channels of the leg and boosts marrow while regulating qi and blood and calming the spirit. HT 1 (ji2 quan2), LU 5 (chi3 ze2), and BL 40 (wei3 zhong1) smooth the channels and network vessels while moving qi and blood to improve movement of the limbs.

DU-26 (ren2 zhong1) is regarded as the sovereign point in the prescription, while PC 6 (nei4 guan1) and SP 6 (san1 yin1 jiao1) are ministers. HT 1 (ji2 quan2), LU 5 (chi3 ze2), and BL 40 (wei3 zhong1) are assistants and couriers. This combination regulates the original spirit and brings out brightness. It creates yin-yang balance and rectifies qi and blood to harmonize the thoroughfare (chong) vessel. By freeing the channels, it promotes uninhibited movement. Treatment is given twice per day for 10 days per treatment course, and three-to-five continuous courses of treatment are recommended.

The XNKQ method of needling has a clear effect in stroke patients, with pronounced positive effects in multiple systems. Dr. Shi has studied its clinical effects for over 30 years in numerous systems involving many different disciplines of treatment, prevention, and rehabilitation. He has contributed standards of integration and management for the diagnosis and treatment of stroke, which has been called a unique "chapter on the treatment methods of Master Shi." It has been shown to reduce mortality and enhance rehabilitation in stroke patients, and is widely regarded as an excellent method of treatment.

Another key aspect of the XNKQ method is the emphasis on manipulation techniques for the principle points. Each point has clear specifications on direction, depth, and hand techniques, which have been assessed with numerous scientific studies. Thus, the needling method is based on established science and standards that enhance clinical results.

After Dr. Shi published his work with the XNKQ needling method, a clinical system of stroke diagnosis and treatment was developed. Altogether, more than two million stroke patients have been treated with this system of acupuncture therapy. In recent years, 9,005 patients with stroke at various different stages were assessed based on strict, harmonized diagnostic standards and treated principally with the XNKQ method. Based on their specific condition, patients utilized drug therapies including medication for hypertension, infections, and other concerns based on internationally accepted standards of care. Marked results were seen in 95-98 percent of patients with a variety of different stages and conditions, including acute stages, hemorrhagic stroke, and recovery stages.

Over the past 40 years, Dr. Shi's humble yet highly innovative work has truly entered the history books.

Dr. Jing Liu, OMD, LA., PhD, China, has almost 11 years of schooling in Western Medicine and Traditional Chinese Medicine (TCM).Upon completion of her initial residency in the 1980's, she was chosen for her unique talent and abilities and was trained to work on high government officials in China. She then completed a 3 year Ph.D. program under Dr. Shi Xue Min who is the Father of Acupuncture and the world's #1 TCM doctor. Dr. Shi has called Dr. Liu "The Master of the Masters." Dr. Liu has studied under many top doctors in their respective specialites in both Eastern and Western medicine for the last 20 years and continues her education in China every year. Dr. Liu's extensive knowledge is well rounded and her areas of expertise encompass the treatment of common illness, pain management, cancer support, men and women's health issues as well as neuropathy.

Kun Liu is a licensed acupuncturist in the State of Arizona and in the State of California. She is an active licensed Traditional Chinese Doctor in China as well. Kun Liu was born in a traditional Chinese medical family and raised in China. She is the third generation in her family to practice acupuncture and herbal medicine. She has an ideal goal that she wants to treat all of her patients both physically and psychologically. After she finished her 5 years of training in acupuncture to receive her Bachelor's degree in China from Tianjin University of Traditional Chinese Medicine, she came to the U.S. to get her Master's degree in Psychology from California State University. Kun Liu has experience in treating stroke and stroke sequela patients and was trained in Dr. Shi Xue-Min's University and Hospital, which is the Tianjin University of Traditional Chinese Medicine and No.1 Teaching Hospital of Tianjin University of TCM. She is proficient at treating insomnia and depression patients and has had great success in treating pain problems, such as headache, shoulder pain, lower back pain.

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