Hepatobiliary System Comprehensive Formula: Moxibustion + Manual Techniques + Acupressure

Moxibustion: Guanyuan, Shenque, Baliao, Xuehai
Manual Techniques: Three major tendons under the armpit, Dai Mai major tendon, Liver-soothing technique, Rib interspace
Acupressure: Yinbao, Yanglingquan, Fengshi, Zhongfeng, Qiuxu

I. Physiological Functions and Pathological Characteristics of the Liver

1. Five Elements Attributes and Functions of the Liver

• Belongs to Wood in the Five Elements: Governs dispersion (regulating the flow of qi), governs tendons (limb movement), stores blood (storing and regulating blood), opens into the eyes (related to vision and eye diseases).
• Pathological Core: Abnormal dispersion (qi stagnation and blood stasis), failure to store blood (bleeding or blood deficiency), yin deficiency and yang hyperactivity (internal wind disturbance).

2. Syndrome Differentiation and Corresponding Therapies

Syndrome	Core Pathomechanism	Typical Symptoms	Treatment Principles
Liver Blood Deficiency	Insufficient blood production by the spleen/excessive blood loss	Pale complexion, dizziness, limb numbness, scanty menstruation	Nourish liver blood, strengthen spleen and stomach
Liver Yin Deficiency	Deficiency of yin fluids, internal heat generation	Dry eyes, hot flashes, night sweats, hand and foot tremors	Nourish yin and clear heat, soothe the liver and unblock the meridians
Liver Qi Stagnation	Stagnation of qi, emotional disturbance	Chest tightness, flank pain, irregular menstruation, thyroid nodules	Soothe the liver and relieve depression, regulate qi flow
Liver Yang Hyperactivity	Liver and kidney yin deficiency, uncontrolled yang hyperactivity	Dizziness, headache, tinnitus, weakness in the waist and knees	Nourish yin and subdue yang, calm the liver and extinguish wind
Internal Liver Wind	Yin deficiency and yang hyperactivity, extreme heat generating wind	Tremors, convulsions, stroke, facial paralysis	Nourish yin and extinguish wind, clear heat and unblock the meridians

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II. Syndrome Differentiation and Treatment Guidelines

1. Liver Blood Deficiency and Liver Yin Deficiency

Liver Blood Deficiency

Symptoms of weakness, insufficient liver blood. Insufficient blood production, mainly due to the spleen not producing blood; excessive blood loss from external injury or internal inflammation; chronic illness consuming liver blood.
Symptoms: Pale complexion, dizziness, insomnia, vivid dreams, poor memory ~ blood deficiency; blurred vision, night blindness, scanty menstruation, amenorrhea, limb numbness, brittle nails, joint stiffness, tremors, dizziness and blurred vision ~ liver system. (Both symptoms of blood deficiency and liver system disorders)
Treatment: Nourish liver blood
Comprehensive formula for liver blood deficiency: Moxibustion, Dai Mai major tendon, Gongsun, Yinlingquan (add Yinlingquan if the spleen is affected by dampness)

• Key Acupoints:
  • Gongsun Point (Spleen meridian connecting point, strengthens spleen and produces blood)
  • Yinlingquan (Eliminates dampness and strengthens the spleen, improves the blood-deficient environment)
  • Sanyinjiao (Intersection of liver, spleen, and kidney meridians, nourishes yin and blood)
• Special Techniques:
  • Dai Mai Major Tendon Release: Unblocks the qi and blood of the Dai Mai, alleviates waist and abdominal distension caused by liver depression.
  • Pinch Spine Technique: Boosts spleen yang, promotes the transformation of qi and blood (avoid the lumbar spine spinous process).

2. Liver Yin Deficiency—deficiency of yin fluids, leading to internal heat.

Liver yin deficiency occurs when there is insufficient liver yin, resulting in pain when not nourished, consumption of liver yin by febrile diseases, or kidney yin deficiency, damp heat invading liver yin; malnourishment of the head and eyes, dry eyes, vision loss, dizziness and vertigo; flank pain, sometimes severe burning pain, malnourishment of the meridians, pain due to lack of nourishment; malnourishment of the meridians by liver yin, hand and foot tremors; when liver yin deficiency leads to yin not controlling yang, internal heat is generated, causing facial flushing (may also be related to cardiovascular issues), hot flashes, night sweats, five-center heat; insufficient yin fluids to ascend, causing dry mouth and tongue.
Treatment: Nourish liver yin
Techniques: Pinch spine, Dai Mai major tendon, moxibustion
Using yin to nourish yang—pinch spine boosts spleen yang

3. Liver Qi Stagnation

This is an excess syndrome, where the liver’s function of dispersion is impaired, leading to qi stagnation, such as: emotional and mental issues, other pathogenic factors causing obstruction, resulting in depression, irritability, chest tightness; disordered qi flow, disruption of the Chong and Ren meridians, chest and abdominal pain, radiating pain, breast tenderness in women (also in men), irregular menstruation, amenorrhea, due to liver qi stagnation; qi stagnation and phlegm accumulation, causing thyroid issues.
Treatment: Mainly to soothe the liver and regulate qi
Techniques: Major tendons under the armpit, liver-soothing technique, Baihui, mainly to regulate qi flow

4. Liver Yang Hyperactivity

Liver and kidney yin deficiency, yin not controlling yang—nourish yin; relative liver yin deficiency, excessive anger, excessive liver qi rising, causing headaches, dizziness, tinnitus; upper excess and lower deficiency, insomnia, vivid dreams, irritability, weakness in the waist and knees, headache and eye pain
Treatment: Nourish liver yin, subdue liver yang
Techniques: Three major tendons under the armpit (liver evil hidden in the ribs), Baihui (meeting point of all yang, Baihui corresponds to Yongquan, aiding in kidney nourishment; patting is a draining technique, subduing liver yang), Yinbao (treating the mother for the child’s disease), guiding fire downward

• Moxibustion Plan:
  • Guanyuan + Shenque: Warm and supplement the original qi, guide fire back to its source.
  • Baihui + Yongquan: Raise yang and lift the sunken (Baihui) + nourish yin and descend fire (Yongquan), bidirectional regulation of yin and yang.
• Contraindications and Warnings:
  • Patients with liver yang hyperactivity should avoid moxibustion on the Dazhui point (it may exacerbate yang rising).
  • Hypertensive patients should use strong stimulation on head acupoints with caution.

3. Internal Liver Wind and Extreme Heat Generating Wind

Liver Yang Transforming into Wind Syndrome: Yin deficiency and yang hyperactivity, excessive and uncontrolled liver yang generation
Symptoms: Dizziness, headache, tinnitus, limb tremors, facial paralysis, Parkinson’s, tics. Wind and yang rushing upward, causing vertigo; wind in the meridians, causing limb tremors, difficulty in speaking; upper excess and lower deficiency, unsteady walking, severe cases leading to stroke, hemiplegia, wind and phlegm obstructing the meridians
Treatment: Mainly to nourish yin
Techniques: Chize (auxiliary to nourish yin), Gongsun, three major tendons under the armpit, guiding fire downward
Extreme Heat Generating Wind Syndrome: Excessive pathogenic heat, damaging liver yin, causing meningitis, high fever with convulsions, neck stiffness, etc., heat disturbing the mind, heat blocking the heart orifices
Treatment: Mainly to clear heat
Techniques: Guiding fire downward

• Emergency Acupoint Combination:
  • Chize Point (Lung meridian He-Sea point, clears metal to control wood, calms liver fire).
  • Taichong Point (Liver meridian Yuan-Source point, guides fire downward).
• Modern Medical Correlation:
  • Parkinson’s tremors are related to internal liver wind, acupuncture can regulate dopamine levels in the basal ganglia (Neural Plasticity, 2022).

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III. Clinical Data and Efficacy Verification

1. Efficacy of Moxibustion in Treating Liver Diseases

• Patients with Liver Blood Deficiency: Moxibustion on Guanyuan + Xuehai points, average hemoglobin increase of 15g/L (Chinese Acupuncture and Moxibustion, 2021).
• Headache due to Liver Yang Hyperactivity: Baihui penetrating needling combined with Yongquan plaster application, effectiveness rate of 89.3% (randomized controlled trial).

2. Standardized Manual Techniques

• Three Major Tendons under the Armpit Release:
  • Procedure: Press the deep tendon knots at the axillary horizontal crease with the thumb, perform plucking technique until the axillary lymph nodes soften.
  • Mechanism: Unblocks the liver meridian qi, improves breast hyperplasia and chronic pharyngitis (Shanghai Journal of Acupuncture and Moxibustion, 2020).

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IV. Patient Education and Home Care

1. Self-Massage Plan

• Liver Qi Stagnation: Pat the rib area (Qimen, Zhangmen points) in the morning, 5 minutes each time.
• Liver Blood Deficiency: Massage Sanyinjiao + Xuehai points before bed, combined with Angelica and Mutton Soup dietary therapy.

2. Dietary Restrictions

• Avoid spicy and heat-inducing foods (exacerbates liver yang hyperactivity).
• Avoid raw, cold, and sticky foods (hinders spleen yang transformation, worsens blood deficiency).

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V. Authoritative Literature and Traditional Basis

• The Yellow Emperor’s Inner Canon: “The liver suffers from urgency, treat with sweetness to soothe it” — Licorice, jujube to harmonize liver urgency.
• WHO Recommendation: Acupuncture for migraine (liver yang hyperactivity type) included in the Traditional Medicine Strategy.
• Classic Formula Extensions:
  • Xiaoyao San (Liver Depression and Blood Deficiency): Bupleurum + White Peony to soothe and soften the liver.
    Zhengan Xifeng Tang (Liver Yang Transforming into Wind): Achyranthes bidentata + Hematite to guide blood downward.

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Note: The therapies described in this article should be applied by a licensed TCM practitioner based on syndrome differentiation. In acute phases (such as stroke, severe Parkinson’s), combined treatment with Western medicine is necessary. Before clinical application, organic diseases (such as liver cancer, cerebral hemorrhage) must be ruled out.