Dr. Xu Fu believes that retention of urine is characterized by root deficiency and manifestation excess. But ultimately, it is caused by yin-yang disharmony. We should focus on regulating yin and yang, selecting the needle manipulation technique of lifting-thrusting and twirling, which can guide qi of yin and yang and strengthen yang to restrain water, thereby achieving the balance of yin and yang through treatment with both reinforcement and elimination. When selecting acupoints, it is importance to reinforce kidney, invigorate spleen, free yang and promote qi transformation, such as Zhongji (CV 3), Guanyuan (CV 4), Pishu (BL 20), Shenshu (BL 23), Taixi (KI 3), Sanyinjiao (SP 6), Zhibian (BL 54), etc. Among them, the needling sensation should reach the perineum when needling Zhongji (CV 3). And the treatment is combined with moxibustion. After got qi by conventional needling, put a moxibustion box at Guanyuan (CV 4) to warm and tonify kidney yang, dredge channels and activate collaterals.

Case: Mr. Jiang, 88 years old, complains of repeated attack of frequent and urgent urination for over 5 years. He complained about 4-5 times of urination every night, accompanied by a sense of distention in the lower abdomen as well as urinary urgency and pain. Manifestations: Mild abdominal distention, mild hypertrophy of the prostate with tough parenchyma, smooth surface and swallowed central groove, no obvious tenderness, reddish teeth-marked tongue with white greasy coating, and deep thready pulse. It was the syndrome of spleen-kidney yang deficiency. Treatment was tonifying kidney, invigorating spleen, warming yang and excreting water. Acupoints: Zhongji (CV 3), Guanyuan (CV 4), Shenshu (BL 23), Pishu (BL 20), Taixi (KI 3), Sanyinjiao (SP 6) and Zhibian (BL 54). Firstly, the needle manipulation technique of lifting-thrusting and twirling was performed for 3 times at Zhibian (BL 54). The patient felt the flow of qi in the lower abdomen. Secondly, twirling reinforcement was performed at Shenshu (BL 23) and Pishu (BL 20) for 1 min before removing the needles. Thirdly, the patient was maintained in a supine position. Twirling reinforcement was performed at Zhongji (CV 3), Guanyuan (CV 4), Taixi (KI 3) and Sanyinjiao (SP 6). Then a moxibustion box was put at Zhongji (CV 3) and Guanyuan (CV 4). After 2 moxa sticks were burned up, the needles were removed. The needling sensation reached the perineum when needling Zhongji (CV 3). After removing the needles, cupping was applied at Pishu (BL 20) and Shenshu (BL 23), and the cups were retained for 10 min. The next day, the patient said the urinary frequency was reduced. After 10 times of treatment, urination was no more than once during the night.