Sanyinjiao
Sanyinjiao (SP6), a classical acupuncture point, was first recorded in A-B Classic of Acupuncture and Moxibustion (Zhenjiu Jiayijing). Its aliases include Chengming, Taiyin, and Xiasanli. It belongs to the Spleen Meridian of Foot-Taiyin. Location: On the medial side of the lower leg, 3 cun superior to the tip of the medial malleolus, posterior to the medial border of the tibia. Anatomy: Between the posterior border of the tibia and the soleus muscle; deep layer contains the flexor digitorum longus. It is traversed by the great saphenous vein, posterior tibial artery and vein; innervated by the medial sural cutaneous nerve (medial cutaneous nerve of the calf), and deeper by the tibial nerve. Indications: Borborygmus (intestinal rumbling), abdominal distension, diarrhea, spermatorrhea, impotence, enuresis, palpitations, insomnia, hypertension, flaccidity and pain of the lower limbs, and various patterns of yin deficiency. Needling method: Perpendicular insertion to a depth of 1–1.5 cun.
Indications
. Borborygmus (intestinal rumbling), abdominal distension, diarrhea, and other patterns of Spleen and Stomach deficiency. 2. Irregular menstruation, leukorrhea (vaginal discharge), uterine prolapse, infertility, prolonged labor (dystocia), and other gynecological and obstetrical conditions. 3. Spermatorrhea, impotence, enuresis, and other disorders of the reproductive and urinary systems. 4. Palpitations, insomnia, and hypertension. 5. Flaccidity and pain of the lower limbs. 6. Various patterns of Yin deficiency.
Precise Location
Located on the medial side of the lower leg, 3 cun superior to the tip of the medial malleolus, posterior to the medial border of the tibia.
Location Method
Sit upright or lie supine. Locate the point on the posterior border of the medial surface of the tibia, four finger-breadths (one fu) directly above the tip of the medial malleolus. Perpendicularly insert the needle to a depth of 1–1.5 cun. Needling is contraindicated during pregnancy. Moxibustion: 3–7 moxa cones, or 5–15 minutes of moxa stick (moxibustion).
Massage Method
1. In modern clinical practice, Sanyinjiao (SP6) is commonly used for the treatment of acute and chronic enteritis, bacillary dysentery, hepatosplenomegaly, ascites and edema, hepatitis, cholecystitis, nephritis, urinary tract infection, urinary retention, urinary incontinence, chyluria, diabetes mellitus, menstrual disorders, dysfunctional uterine bleeding, dysmenorrhea, leukorrhea (vaginal discharge), climacteric syndrome (menopausal symptoms), vaginitis, pelvic inflammatory disease, pruritus of the genitals, abnormal fetal position, uterine prolapse, dystocia (difficult labor), epilepsy, schizophrenia, neurasthenia, hypertension, urticaria, neurodermatitis, thromboangiitis obliterans, as well as diseases of the knee and ankle joints and their surrounding soft tissues. 2. Modern research and clinical observation have shown that acupuncture at Zusanli (ST36) and Sanyinjiao (SP6) has a favorable therapeutic effect on patients with gastroptosis. Under X‑ray observation after barium meal, comparing pre‑ and post‑acupuncture, the distance from the gastric angle and the lower gastric pole to the line connecting the iliac crests (the gastroptosis indicators), as well as gastric tension and residual fluid, were significantly improved (P<0.05). The shape of the stomach, the angle between the longitudinal axes of the gastric body and antrum, and gastric peristalsis also improved to varying degrees. 3. Acupuncture at Sanyinjiao (SP6) in children with dyspepsia quickly normalized originally low values of total gastric acidity, free acidity, and pepsin, indicating its regulatory effect on gastric secretory function. 4. Sanyinjiao (SP6) has a particularly evident effect on disorders of the lower jiao, such as frequent urination and enuresis. Acupuncture at Guanyuan (CV4) and Sanyinjiao (SP6) for 240 cases of enuresis achieved an effective rate of 97.5%. Experiments have demonstrated its regulatory effect on bladder tension – relaxing a tense bladder and tonifying a lax one. Animal studies have shown that needling “Sanyinjiao” can enhance peristalsis of the ureter in dogs. 5. Acupuncture at Sanyinjiao (SP6) affects reproductive function, the uterus, and menstruation. Some reports claim a specific contraceptive effect; when combined with Jianwaiyu (SI? unclear: “肩外俞” – likely Jianwaishu, but pinyin given), the contraceptive rate reached 66.6%. Other studies have reported that needling Sanyinjiao and other points can cause contraction of the pregnant uterus. It also affects gonadal function, promoting ovarian activity. One report noted that in patients with anovulatory uterine bleeding, needling Sanyinjiao, Zhongji (CV3), and Guanyuan (CV4) starting on the 18th day after menstruation, for several consecutive months, restored normal ovulation and menstrual cycles. Acupuncture at Sanyinjiao can also induce hormone withdrawal bleeding in patients with secondary amenorrhea. 6. It also affects male reproductive function. For example, acupuncture at Sanyinjiao, Guanyuan (CV4), and Shenshu (BL23) has shown significant efficacy in treating impotence and also some effect on oligospermia. 7. Acupuncture at Sanyinjiao (SP6) influences cardiac function, showing certain efficacy in paroxysmal atrial tachycardia, atrial fibrillation, and ventricular premature beats. 8. The effect of needling Sanyinjiao on the neuro‑humoral system is also evident. For example, needling Sanyinjiao increases the number of eosinophils in peripheral blood, an effect comparable to that of ACTH injection. In non‑insulin‑dependent diabetic patients, needling Sanyinjiao lowers blood glucose. Using radioimmunoassay to measure plasma insulin during blood glucose testing, it was found that when blood glucose decreased by >10% after needling, plasma insulin levels significantly increased. Conversely, in patients with impaired insulin function, plasma insulin levels did not change or decreased, indicating that needling Sanyinjiao appears to regulate insulin secretion in the pancreas with normal physiological function. 9. The analgesic effect of needling Sanyinjiao (SP6) during gynecological surgery is quite pronounced. For cesarean section, the success rate of acupuncture anesthesia reached 95.29–96.4%. Experiments indicate that the acupuncture anesthesia effect may be related to an increase in cGMP. For instance, intracerebroventricular injection of cGMP in animals enhanced analgesia. The mechanism may involve direct activation of opioid receptors or excitation of the cholinergic system, thereby strengthening the analgesic effect of acupuncture. Intracerebroventricular injection of naloxone antagonized the analgesic effect of cGMP and reduced the efficacy of acupuncture, suggesting that naloxone blocks the cGMP‑enhanced acupuncture analgesia. Another experiment showed that intracerebral injection of enzyme inhibitors (as protectors of heptapeptide and met‑enkephalin) combined with electroacupuncture at Zusanli (ST36) and Sanyinjiao (SP6) raised the pain threshold significantly more than electroacupuncture alone; the electroacupuncture‑plus‑inhibitor group also prolonged the analgesic effect for 15 minutes, with significant differences (P<0.01) compared to the electroacupuncture‑plus‑saline group at 5, 10 and 15 minutes after stopping stimulation. This prolongation could be partially blocked by naloxone, indicating that electroacupuncture releases brain heptapeptide, which participates in acupuncture analgesia. 10. Needling “Sanyinjiao” significantly increases the number of lymphocytes and lymphoid cells in animals, with a notable increase in T‑lymphocytes after needling compared to before. No significant change was observed when needling non‑acupoint areas, suggesting a certain specificity of Sanyinjiao (SP6).
Compatibility
1. Paired with Zhongji (CV3) and Shenshu (BL23) for irregular menstruation. 2. Paired with Yangjiao (GB35), Zhongji (CV3), Shenshu (BL23), and Taichong (LR3) for amenorrhea. 3. Paired with Hegu (LI4) and Kunlun (BL60) for dystocia (difficult labor). 4. Paired with Zusanli (ST36) and Zhigou (TE6) for postpartum blood collapse (puerperal fainting) and unconsciousness. 5. Paired with Zhaohai (KI6), Zhongji (CV3), and bilateral Zigong (EX-CA1) for long‑term coldness of the uterus with infertility. 6. Paired with Guanyuan (CV4), Jianshi (PC5), Taichong (LR3), Taixi (KI3), Shenshu (BL23), and Duyin (EX-LE4) for an abdominal mass (as large as a basin) below the umbilicus. 7. Paired with Ciliao (BL32), Guanyuan (CV4), Shenshu (BL23), and Zhongji (CV3) for impotence. 8. Paired with Ququan (LR8), Taixi (KI3), Dadun (LR1), and Shenshu (BL23) for genital swelling. 9. Paired with Shimen (CV5) for water retention (edema/abdominal distension). 10. Paired with Hegu (LI4) (reinforcing method) and Sanyinjiao (SP6) (reducing method) for abortion (induction of labor/termination of pregnancy) – strictly in indicated situations. 11. Used alone for dystocia (difficult labor).
Efficacy & Actions
Activate blood and regulate menstruation, supplement Qi and fortify the Spleen, and tonify the Liver and Kidney.