Guanyuan, Zhongji and Guilai

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關元、中極、歸來 (Guānyuán, Zhōngjí, Guīlái)

Point Pairs (对穴) Urogenital

Modern Chinese point-pair (对穴) teaching, as compiled by Guo Changqing and colleagues at the School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine.

Points

  1. CV4 Guanyuan midline

    Front-Mu point of the Small Intestine; supplements the Kidney and roots the lower burner.

    Supine; have the patient pass urine first. Needle straight in to 0.5–1.0 cun; the needle traverses skin and subcutaneous tissue, then the subperitoneal fascia and the median umbilical fold. Aim for an aching distension at the point that travels down to the genitals.

    • Pregnancy: contraindicated
  2. CV3 Zhongji midline

    Front-Mu point of the Bladder; clears damp-heat from the bladder and regulates the uterus.

    Supine; the bladder must be emptied first. 4 cun below the umbilicus on the midline. Needle straight in to 0.5–1.0 cun, through skin and subcutaneous tissue into the transverse fascia and the median umbilical fold. An aching distension should form at the point and travel to the genitals.

    • Pregnancy: contraindicated
  3. ST29 Guilai bilateral

    Stomach-channel point beside CV3; warms and regulates the lower burner and menstruation.

    Supine. 4 cun below the umbilicus and 2 cun lateral to the midline (level with CV3). Needle straight in to 1.0–1.5 cun, through the subcutaneous tissue, rectus abdominis and the posterior layer of its sheath; the source also names the peritoneum, but the needle should stop short of it. An aching heaviness should settle in the lower abdomen.

Needling Safety

Cited hazards for these points. Tick what applies to the patient to see the cautions that follow from it.

No cited needling data yet for ST29. No flag here does not mean no risk.

Treatment Principle

Transform dampness and clear heat, supplement the Kidney and regulate menstruation.

Indications

Lower abdominal painDifficult urinationHernia (shan disorder)Perineal painItching of the perineum and genitalsIrregular menstruationSpermatorrhoea

Method

Patient supine with an empty bladder. CV4 and CV3 are needled perpendicularly 0.5–1.0 cun until the aching distension reaches the genitals; ST29 is needled perpendicularly 1.0–1.5 cun until an aching heaviness is felt in the lower abdomen.

⚠ Cautions

CV4, CV3 and ST29 are all contraindicated in pregnancy. Empty the bladder before needling: CV3 and CV4 lie directly over it. In thin patients keep ST29 within the stated depth so as not to enter the peritoneal cavity.

About

A lower-abdominal triangle for damp-heat and deficiency in the pelvis: pain in the lower abdomen and perineum, itching of the genitals, difficult urination, hernia, irregular periods and spermatorrhoea. It clears damp-heat while supporting the Kidney and regulating menstruation.

Rationale

CV3 is the Front-Mu point of the Bladder and CV4 the Front-Mu point of the Small Intestine; both are meeting points of the Ren Mai with the Spleen, Liver and Kidney channels, whose pathways converge on the genitals. ST29, level with CV3 on the Stomach channel, warms and regulates the lower burner and the uterus. Together they cover the bladder, uterus and genital region from directly above.

Sources

  • Guo Changqing (ed.). Acupuncture of Acupoint Combinations: Quick Lookups. Daylesford: Heart Space Publications, 2020 (English edition; © China Science and Technology Press). ISBN 978-0-6489215-5-4. Chapter 3, combination 8.

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