Anatomical relevance of some acupuncture points in the head and neck region that dictate medical or dental application depending on depth of needle insertion

Many of the acupuncture points on the face, according to classic acupuncture textbooks, could be used to treat facial pain, paralysis, and toothache. But it is not specified which acupuncture point would be effective for which tooth. Many of these points, when used for the treatment of dental pain, often fail. From an anatomical point of view, we describe which acupuncture point to use for each specific area for effective treatment of dental pain. Also, we emphasize the importance of the depth of needle insertion, especially the necessity to touch the facial bone, for effective pain treatment. When performed properly, acupuncture can be very effective for relief of dental pain.     

醒脑调神针法配合足运感区治疗功能性小儿遗尿48例疗效观察

[目的]探讨醒脑调神针法配合足运感区治疗功能性小儿遗尿的临床疗效。[方法]将96例入组患儿按照随机数字表法分为对照组和治疗组,其中对照组采用常规针刺方法,选穴中极、关元、膀胱俞、双侧三阴交,治疗组着重头皮针治疗,予以醒脑调神针法针刺印堂、上星、百会、足运感区,配合体针关元穴、中极穴。[结果]治疗组的总有效率为91.7%,明显优于对照组的79.2%(P0.05);临床症状改善而言,治疗组较对照组改善更加明显(P0.05)。[结论]运用醒脑调神针法配合足运感区治疗功能性小儿遗尿效果显著,值得临床推广及进一步研究。     

NEUROANATOMICAL CHARACTERISTICS OF ACUPUNCTURE POINTS DETERMINED BY NEURAL TRACING TECHNIQUE

Objective: To investigate the regular distribution of neurons associated with different acupuncture points by using neural tracing technique.Methods: This experiment was carried out with rats, in which"Hegu"(LI4), "Quchi"(LI11), and "Jianyu"(LI15) in the large intestine meridian of hand-Yangming; as well as "Neiting"(ST44), "Zusanli"(ST36), and "Futu"(ST32) in the stomach meridian of foot-Yangming were chosen as the representative acupuncture points.Three days later, Alexa Fluor 594 conjugated cholera toxin subunit B(AF594-CTB) was respectively injected into each acupuncture point; the rats were perfused, and the dorsal root ganglia and the spinal cord were dissected out.The tissue sections were observed with a laser scanning confocal microscope to determine the distribution of neurons associated with different acupuncture points.Results: The sensory and motor neurons associated with LI4,LI11 and LI15 were located at the segments correlated with spinal cervical enlargement.In contrast, the sensory and motor neurons associated with ST44, ST36 and ST32 were located at the segments correlated with spinal lumbar enlargement.In addition, the closer to the body trunk the acupuncture point is,the higher the neurons associated with the corresponding acupuncture point situated in the spinal segment.Moreover, the motor neurons associated with the acupuncture points on the proximal, mid, and distal parts of limb regularly distribute from the lateral part to the medial part of spinal ventral horn.Conclusion: The sensory and motor neurons associated with different acupuncture points are located at definite spinal segments and regions in the nervous system.These neuroanatomical characteristics may play an important role in selecting proper acupuncture points in clinical treatment.     

Evidence-based assessment of acupuncture skills using a newly developed simulation-based test

ObjectiveAcupuncture is an efficient treatment modality for many different training, but the technique can be challenging to master. Identification of the different acupuncture points can now be practiced in a standardized and patient-safe simulation-based environment. We aim to gather additional evidence regarding simulation-based training of acupuncture skills and hope that the simulation-based test developed and will be used for simulation-based mastery learning in future develop.MethodsThe aim of this study was to develop a test of acupuncture skills using the TCM (Traditional Chinese Medicine) Meridians & Acupoints Anatomy Teaching Platform and gather validity evidence using Messick's framework. Novice medical students without prior experience in acupuncture (n = 43), intermediate medical students who had finished the mandatory acupuncture course (n = 24), and skilled acupuncture doctors (n = 17) were included in the study. One-hundred and seven acupuncture points were presented to the participants in identical randomized order and they were asked to identify each point by touching the correct anatomical location on the simulator. The simulator automatically registered the accuracy of participants’ answers.ResultsThe reliability of the final test (66 acupuncture points) was at a high level with a Cronbach's alpha of 0.98 and only 16 acupuncture points were needed to ensure a reliability of 0.90. The test could discriminate significantly between all three groups and a credible pass/fail-score of 34 points was determined which resulted in eight out of 43 (19%) novices passing the test and only two out of 17 (12%) experienced failing the test. These consequences were statistically significant (P < 0.001).ConclusionBased on Messick's framework we demonstrated strong validity evidence for a newly developed simulation-based test of acupuncture points localization skills. The test can be used as an aid to decide when trainees are ready to progress to more advanced training and clinical practice. Compared with the traditional point-point test, the point-point evaluation of the simulator can be more objective and reduce the effort of teachers.     

Needling Sensations following Real and Placebo Acupuncture – a randomised single-blinded two-period cross-over pilot study –

BackgroundPlacebo needles are accepted as the gold standard for the control in acupuncture research. Credibility is one of the essential factors which influence the placebo response. The needling sensations of the real and placebo needles may have a decisive influence on credibility. The aim of the study was therefore to test these sensations from a placebo needle compared to those of real acupuncture.Methods10 healthy volunteers were enrolled in this cross-over pilot study. In each period of the study 5 volunteers were treated with a placebo needle and 5 with a normal acupuncture needle. The LI 4 (Hegu) acupuncture point was selected for bilateral treatment and the needles stayed in place for 15 minutes. Placebo and real needles were manipulated for a short time by rotating the needles in both directions. The interval between the two periods of the study was one week. After each treatment session the volunteers had to guess which treatment condition they had received and filled in a questionnaire which assessed the pricking sensation (intensity), quality and spread of the deqi sensation. The extent of the different sensations was rated on a Verbal Rating Scale (1–10).ResultsThree volunteers receiving real acupuncture and two receiving placebo correctly identified the form of treatment. Four volunteers in the first session and five in the second session could not decide how they had been treated. No significant difference between placebo and real treatments was detected in any of the variables examined which were related to needle sensation (unpaired t-test, p-value > 0.05).ConclusionsBased on the findings of this trial, the tested placebo needle might be a suitable control condition for acupuncture trials.A study with a larger sample size is warrented to confirm the present findings.     

针刺治疗梨状肌综合征优势方案筛选研究

[目的]基于高质量临床研究,筛选针刺治疗梨状肌综合征的优势方案。[方法]检索针刺治疗梨状肌综合征的随机对照试验（RCT）,筛选出高质量临床研究,运用多指标决策法,通过加权标准化,计算理想解和负理想解,得出各针刺治疗方案的相对贴切度,选出优势方案。[结果]共筛选出9项高质量临床研究,其中内热针导热法为针刺治疗梨状肌综合征的优势方案。[结论]内热针导热法在治疗梨状肌综合征方面具有独特优势。可进一步探究利用内热针导热法针刺阿是穴联合足少阳胆经、足太阳膀胱经经穴在治疗梨状肌综合征的疗效。在RCT研究设计及报告时应加强随机化隐藏、盲法实施、研究对象撤出或退出等情况的阐述,以提高研究质量。     

针刺联合氦氖激光对比针刺联合药物治疗小儿周围性面瘫的随机对照临床试验

[目的]评估针刺联合氦氖激光与针药联合治疗小儿周围性面瘫疗效异同。[方法]本研究将60例周围性面瘫患儿随机分为试验组和对照组,每组各30例。试验组患儿留针(主穴患侧阳白、太阳、丝竹空、攒竹、四白、颧髎、上关、下关、听宫、听会、颊车、地仓、翳风、牵正、水沟、迎香、承浆、对侧合谷),针刺入皮肤后,留针30 min;同时采用氦氖激光照射患侧面部,每个照射点位分别放置于阳白、太阳、听宫、四白、颧髎、下关、迎香、承浆穴位上,停留15 min;每日1次,连续治疗2个疗程,观察其疗效。对照组患儿在针刺基础上采用药物治疗,一般常规用药:口服维生素B1、维生素B6、甲钴胺片、地塞米松等。[结果]试验组痊愈18例,显效7例,有效3例,无效2例,总有效率为93.33%。对照组痊愈9例,显效6例,有效5例,无效10例,总有效率为66.67%。临床疗效两组间有统计学差异(P0.05)。试验组中有1例发生皮下小范围电灼伤,对照组中有5例出现皮疹。[结论]针刺联合氦氖激光治疗小儿周围性面瘫优于针刺联合药物疗效,安全性更好。     

Anti-inflammatory mechanism of electroacupuncture involves the modulation of multiple systems,levels and targets and is not limited to “driving the vagus-adrenal axis”

In October 2021, an international collaborative study on the use of electroacupuncture (EA) to treat inflammation was published in the journal Nature by Dr. Qiufu Ma’s team. Based on the results of EA on inflammation in the mouse model of lipopolysaccharide inflammatory storm, the study showed that the distal effect of acupuncture can be achieved by “driving the vagus-adrenal axis (through the adrenal medulla, by releasing catecholamines).” PROKR2^Cre-marked sensory neurons, which innervate the deep hindlimb fascia but not the abdominal fascia, are crucial for driving this axis. The study suggests the existence of specificity distribution of acupoints, that different EA stimulation intensities or different needle penetration depths have different therapeutic effects, that photosensitive stimulation may be a substitute for needle acupuncture, and that massage, stretching and body movements may also activate PROKR2^Cre-markable dorsal root ganglion sensory neurons and elicit anti-inflammatory effects. However, results of some other studies are contrary to the conclusions of Ma’s team. For examples: low-intensity EA at GB30 point significantly reduced the inflammation in the rat model of persistent inflammation, which is more relevant to the real daily acupuncture practice, and this effect was partly related to the adrenal cortex and associated with the stimulation of corticosterone and adrenocorticotropic hormone; manual acupuncture (similar to the low-intensity EA) at KI3, Zhichuan point (an extra point), etc. was effective in a severe COVID-19 patient with sepsis; stimulating ST25 with low-intensity EA or manual acupuncture was effective against gastrointestinal inflammations; the above mentioned points are not in an area enriched with PROKR2^Cre-marked sensory nerve endings. Evidence shows that the mechanism of EA against inflammation includes modulating multi-systems, multi-levels and multi-targets, which does not limit to “driving the vagus-adrenal axis.”Please cite this article as: Fan AY. Anti-inflammatory mechanism of electroacupuncture involves the modulation of multiple systems, levels and targets and is not limited to “driving the vagus-adrenal axis.” J Integr Med. 2023; 21(4):320–323.     

Mechanical effects of needle texture on acupoint tissue

Objective: This study aims to clarify how the stimulation of acupuncture points is achieved by needles with different surface texture during acupuncture; it also seeks to lessen injury at the insertion site and increase the therapeutic efficacy of acupuncture, by simulating the mechanical effects of various needle surface patterns on Zusanli(ST36) without changing the radius of acupuncture needles.Methods: Five acupuncture needle models with different surface patterns, including the smooth needl...     

复合式针型氧传感器的研制及在体测量的应用研究

[目的]从参比电极测试仪器等对研制的复合式针型氧传感器进行了改进,测试其性能,用于在体监测氧分压.[方法]以不锈钢注射针为参比电极,将指示电极穿人注射针内与针灸针柄复合成微型针灸针型氧电极;进一步研制了智能型四通道氧分压测试仪与计算机连用,实现智能化数据处理,并对实验性胃损伤家兔胃俞穴处的氧分压进行了监测.[结果]改进后复合式氧传感针可以更好的实现连续在体、定点、微创、动态实时监测活体组织深部氧分压变化;并集传感器与执行器功能于一体.在体测量表明,实验性胃损伤家兔胃俞穴处的氧分压存在特异性变化.[结论]改进后复合式氧传感器可以更好的实现连续在体、定点、微创、动态实时监测活体组织深部氧分压变化.     

基于数据挖掘技术探析针灸治疗乳腺癌相关淋巴水肿取穴规律＊

目的 基于数据挖掘技术，探析针灸治疗乳腺癌相关淋巴水肿的干预措施和腧穴应用规律。方法 检索中国期刊全文数据库（China National Knowledge Infrastructure， CNKI）、万方数据库（WanFang Data）、维普中文科技期刊全文数据库（Chinese Scientific and Technological Journals， VIP）、PubMed、Embase和the Cochrane Library，检索时间区间为建库至2020年9月9日。依据制定的标准筛查、评估研究设计和提取针灸处方，在WPS 2019软件工作表建立针灸治疗乳腺癌相关淋巴水肿处方数据库，采用频数分析、聚类分析、关联规则分析技术研究针灸治疗乳腺癌相关淋巴水肿取穴规律。结果 共收集到60篇文献，整体研究设计循证评价质量中等，提取出62条处方；干预措施主要为艾灸、针刺和艾灸针刺结合运用；腧穴频次排名前5的为：外关、曲池、足三里、肩髃和合谷；经脉使用频次依次为：手阳明大肠经、手厥阴心包经、任脉、手少阳三焦经和足阳明胃经等；特定穴频次依次为五腧穴、交会穴、络穴、八脉交会穴和原穴等；聚类分析发现7类临床取穴聚类，关联分析发现了以外关为中心关联配伍曲池、肩髃、阴陵泉和水分等强关联穴组。结论 针灸治疗乳腺癌相关淋巴水肿具有一定的规律，临床用穴较为广泛，许多高频腧穴、核心聚类群和关联规则，可直接配伍组成相关针灸处方，为临床应用提供参考和指导。     

常用实验动物穴位的标准化定位方法研究

随着针灸科研水平的逐渐提高和针灸标准化进程的不断加快,急需对常用实验动物穴位制定国家级标准,因此研究科学的实验动物穴位定位方法对于针灸学的发展具有重要意义。笔者结合近年来动物穴位的相关研究,对常用实验动物穴位定位方法进行了分析,总结出常见的4种方法:1)中国兽医针灸学是实验动物穴位定位的参考,参考家畜的穴位对实验动物穴位进行模拟定位。2)比较解剖学是实验动物穴位定位的基础,将人的腧穴模拟到实验动物身上。3)经络穴位特性的现代研究是实验动物穴位定位的科学依据,利用现代科学技术手段来进行检测定位。4)穴位的效应是实验动物穴位定位的关键因素,把发挥效应的检测点作为穴位。以上4种方法各有利弊,可以综合利用上述方法,从而提高动物穴位定位的准确性,使常用实验动物穴位的标准化成为可能。     

肩周炎的经筋病机实质与治疗探讨

[目的]探讨肩周炎的经筋病机实质与治疗方法。[方法]从《黄帝内经》原文及现代相关文献出发,分析经筋与肩关节的生理解剖联系、肩周炎发病机制及治疗方法。[结果]生理上,肩关节与手六经之经筋和足少阳、足太阳经筋相联属;病理上,分为"瘀沫期"、"经筋拘急期"、"筋结病灶形成期",但三病理过程相互杂揉与绞结;治疗上,宜遵循"以痛为俞"、采用粗银质针温针治疗,是解除瘀、沫、筋结病灶的重要手段与方法,临床疗效显著。[结论]认真探讨中医生理、解剖学,有利于中医理论的深入理解及拓展临床治疗思路。     

耳穴皮内针治疗失眠:随机对照试验

ObjectiveTo compare whether there is clinical effects difference between intradermal needle at auricular acupoint and conventional acupuncture for insomnia.MethodsA total of 70 patients were randomly assigned into an intradermal needle group and an acupuncture group, 35 patients in each group. Finally 34 patients completed the study in the intradermal group, 32 patients completed validly in the acupuncture group. The patients in the intradermal needle group received intradermal needle therapy, in which the needle was imbedded subcutaneously at auricular acupoint: Shénmén (神门 TF₄), Pízhìxià (皮质下 AT₄), Zhĕn (枕 AT₃₎, Xīn (心 CO₁₅), and back-shu point: Gānshū (肝俞 BL18), Xīnshū (心俞 BL15), Shènshū (肾俞 BL23) and Pǐshū (脾俞 BL20), as well as Ānmián (安眠 EX-HN18) retained for 2 days, and the patient would received a second therapy every other day, one course of treatment consisted of 3 times of treatment. The patients in the acupuncture group received a conventional acupuncture therapy, in which Zhàohăi (照海 KI6), Shēnmài (申脉 BL62), Shénmén (神门 HT7), Sānyīnjiāo (三阴交 SP6), EX-HN18, Sìshéncōng (四神聪 EX-HN1) were punctured conventionally with needle and the needle was retained for 30 min, once per day, one course of treatment consisted of 5 times of treatment. Before and after the4 courses of treatment, Pittsburgh sleep quality index (PSQI) of the patients in the two groups were evaluated, and their clinical therapeutic effects were evaluated too.ResultsThere were no statistically significant differences of PSQI scores and clinical therapeutic effects of the patients with insomnia in two groups after treatment (both P>0.05).ConclusionsIntradermal needle at auricular acupoint and conventional acupuncture therapy have comparable clinical therapeutic effects.     

Clinical study on the treatment of knee osteoarthritis with point penetration method of long needle

Objective: To compare the therapeutic effect of point penetration method of long needle and that of western drug in the treatment of knee osteoarthritis.Methods: The simple and randomized grouping method was used in present study.Results: The effective rate in the acupuncture group was 87.5%, and in the western drug group was 55.6%, the significant difference was found between two groups in the therapeutic effect (P<0.01).Conclusions: The therapeutic effect of point through point with long needle in the treatment of knee osteoarthritis was better than that of western drug. Author: ZHANG Bi-meng (1974-), male, doctor Translator: ZHU Zhong-chun     

子午流注择时皮肤针疗法改善特应性皮炎患者皮肤屏障功能疗效观察

目的 比较子午流注择时皮肤针疗法与子午流注针刺组在治疗特应性皮炎的临床疗效差异.方法 将60例特应性皮炎患者随机分成子午流注择时皮肤针组(皮肤针组)和子午流注择时针刺组(针刺组),各30例.2组选穴均按照子午流注纳甲法选择申时相应穴位进行开穴,皮肤针组进行皮肤针叩刺疗法,针刺组则进行常规针刺疗法.2组均每日治疗1次,1...     

基于复杂网络分析针刺治疗纤维肌痛综合征的临床选穴及配伍规律研究＊

目的 探究临床针刺治疗纤维肌痛综合征（Fibromyalgia syndrome，FMS）的选穴及配伍规律，为临床运用和针刺新处方的开发提供参考。方法 检索中文数据库中国知网、万方、维普和中国生物医学文献数据库，依据纳入与排除标准，筛选临床治疗FMS的处方，运用Microsoft Excel 2019、SPSS Statistics 25.0、IBM SPSS Modeler 18.0、Cytoscape3.8.2软件统计分析绘图特定穴的频次，腧穴的使用频次、归经、关联规则、腧穴核心复杂网络和聚类分析。结果 经筛选后共纳入处方102首，腧穴145个。腧穴使用频次较高的为阿是穴、足三里、夹脊等，腧穴归经以膀胱经、督脉、胆经、胃经等为主，特定穴使用频次最多的为五输穴，腧穴部位分布最多的为背腰部，最常用的补泻手法为平补平泻法，留针时间以30 min为主。关联规则分析得到穴对7条，3个穴组41条，4个穴组7条。聚类分析可见针刺治疗FMS潜在新处方4首。结论 针刺治疗FMS时，以调神解郁，调和脏腑，补益气血，通经止痛为临床选穴原则，最常用“阿是穴、百会、神庭、足三里、三阴交、太冲”等配伍。     

基于数据挖掘苍龟探穴针法的临床应用研究＊

目的 基于古今医案云平台（V2.2.1）挖掘苍龟探穴针法的临床应用规律及特点，为临床运用提供参考。方法 计算机搜索中国知识资源总库（China Knowledge Resource Database，CNKI）、维普网、中国学术期刊数据库（万方数据）近20年（2000年1月1日-2020年12月31日）收录的苍龟探穴临床相关文献，采用Excel表格建立数据库并录入古今医案云平台（V2.2.1），采用系统集成的数据挖掘方法如统计分析、关联分析、社团分析、复杂网络分析等对纳入的数据进行分析，总结苍龟探穴针法所治疗的疾病、腧穴选取、操作过程及主治疾病等方面的应用特点及规律，并运用新颖多彩的图表对数据进行直观展示。结果 筛选后，纳入文献150篇，涉及疾病个数65个，腧穴总数103个，总取穴频次435次，针刺手法4种，留针时间总数12种，治疗方式总个数6个，辅助治疗方式总个数37个，总辅助治疗方式频次108次。其中治疗疾病频次前10位为肩关节周围炎、膝关节骨性关节炎、第三腰椎横突综合征、神经根型颈椎病、中风后偏瘫、腰椎间盘突出症、中风后腕手功能障碍、偏头痛、中风后吞咽功能障碍及肱骨外上髁炎。取穴频次最高的穴位为阿是穴，针刺手法频次由高到低排序为未提及、平补平泻、开阖泻法及提插泻法。留针时间频次前3位的为留针30分钟、不留针及留针20分钟，治疗方式频次由高到低排列分别为毫针、穴位注射、针刀、粗针、刃针及皮试针头。辅助治疗方式频次由高到低排列前5位的是中药汤剂、电针、基础治疗、康复治疗及功能锻炼。主治疾病见于肩关节周围炎、膝关节骨性关节炎、第三腰椎横突综合征及神经根型颈椎病等。结论 运用古今医案云平台（V2.2.1）分析数据总结苍龟探穴针法的临床应用规律及特点，并佐以图表进行直观展示，可对临床实践提供借鉴，临床应用仍应结合具体情况，随症加减。     

揿针针刺局部压痛点治疗肱骨外上髁炎的疗效观察

[目的] 观察揿针疗法针刺局部压痛点治疗肱骨外上髁炎的临床疗效。[方法] 选取肱骨外上髁炎患者60例,随机分为毫针针刺组30例及揿针组30例,分别给予毫针针刺及揿针治疗,1周治疗2次。于治疗前及治疗2周后采用视觉模拟评分法（VAS）及四级加权评分法进行疗效评价。[结果] 治疗后2组VAS评分、四级加权评分均较治疗前降低（P<0.01）,且揿针组VAS评分、四级加权评分均低于毫针针刺组（P<0.05）。毫针针刺组总有效率为73.3%,揿针组为96.7%,两组比较差异具有统计学意义（P<0.05）。[结论] 揿针针刺局部压痛点治疗肱骨外上髁炎疗效显著,可以明显减轻肘关节疼痛,改善肘关节功能运动,疗效优于毫针针刺法。     

热刺法对皮肤局部温度的影响:一项临床研究

ObjectiveThis clinical study was performed to examine the influence of heat-producing acupuncture (HPA) treatment on the local skin temperature of Zúsānlĭ (足三里ST36) acupoint in healthy participants.Methods30 healthy participants received four successive sessions of heat-producing acupuncture (HPA), non-acupoint HPA (NAHPA), normal stable acupuncture (Norm) and non-invasive sham acupuncture (Sham) on the ST36 acupoint in random order. Within each treatment session, the local skin temperature of ST36 acupoint and basal body temperature of each participant were measured at 1 min before needle insertion (T1B), just after needle insertion and manipulation (T0), 5 min after needle insertion (T5) and 5 min after needle removal (T5A). Visual Analogue Scale (VAS) scores of the participants’ perceived needling and heat sensation felt during the acupuncture treatment period (T0-T5) were also recorded on a scale of 1 to 10.ResultsIntra-session group statistical analyses of the different time points in the HPA treatment session group demonstrates that ST36 local skin temperature remained relatively stable between T1B and T0, increased significantly between T0 and T5 and decreased significantly between T5 and T5A. For inter-session group statistical analysis of all treatment session groups, the increase in local skin temperature of ST36 acupoint between T0 and T5 in the HPA treatment session group was significantly higher than those of the NAHPA treatment session group (P < 0.01), Norm treatment session group (P < 0.01) and Sham treatment session group (P < 0.01). The decrease in local skin temperature of ST36 acupoint between T5 and T5A in the HPA treatment session group was also significantly more than those of NAHPA treatment session group (P < 0.05), Norm treatment session group (P < 0.01) and Sham treatment session group (P < 0.001).ConclusionOur study provides evidence that HPA treatment performed significantly better than the other three treatments in elevating the local skin temperature of ST36 acupoint temporarily. Our results also align with those of many previous clinical studies on HPA and related acupuncture manipulations.