Acupuncture points are large fields: The fuzziness of acupuncture point localization by doctors in practice

Molsberger, A.F.; Manickavasagan, J.; Abholz, Heinz-Harald; Maixner, W.B.; Endres, Heinz G.

doi:10.1002/j.1532-2149.2012.00145.x

Cited by 21 publications

(18 citation statements)

References 15 publications

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“…Although these values were not representative for all acupoints because of the actual channel paths along the body surface and the variable inter-acupoint distance along channels, they provided estimations on how close the acupoints were on the body surface – as a matter of fact, some acupoints are indeed located closer than this distance. In combination with a previous study [29] showing that the location of acupoints by CM experts demonstrated variances in range 2.7 cm 2 to 41.4 cm 2 for their location, many ‘newly discovered’ acupoints after the Yellow Emperor’s Inner Classic could be mainly due to anatomical variations on the exact location of acupoints lying inside the same dermatome. In view of this, the investigation of the actual distance between dual acupoints over the BSA and its relationship with therapeutic characteristics of acupoints is necessary.…”

Section: Discussionsupporting

confidence: 62%

“…Additionally, a recent review considered the specificity of acupoints as controversial despite some scientific evidence [28]. Although acupoints were commonly considered as small cutaneous region, it was found a large variance on the skin surface area for the exact location of acupoints by CM experts [29]. This large variation may stimulate different skin loci – and possibly different dermatomes inducing unexpected or new therapeutic effects.…”

Section: Introductionmentioning

confidence: 99%

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Role of dermatomes in the determination of therapeutic characteristics of channel acupoints: a similarity-based analysis of data compiled from literature

Ferreira

Luiz

2013

Chin Med

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BackgroundAnalysis of the relationship between the nervous system anatomy and the therapeutic characteristics of all acupuncture points in the channel network may provide new insights on the physiological mechanisms underlying acupuncture stimulation for prevention, treatment, and rehabilitation purposes. This study investigates the association between the similarity of acupoints’ dermatomes, traditional actions, and contemporary indications.MethodsChannel acupoints had their characteristics annotated from a literature review of four topographic atlases of Chinese medicine and one atlas of human anatomy: initials of the channel’s name (n = 14), sequential number in the channel (n = 67), acupoint’s name (n = 361), dermatomes related to perpendicular needle insertion (n = 31), traditional actions (n = 848), and contemporary indications (n = 1143). Jaccard’s similarity coefficient quantified the similarities between dual acupoints. All dual acupoints were evaluated to generate similarity matrices for each nominal variable. Cross-tables were generated by simultaneous classification of variables into levels of similarity with respect to: dermatomes versus traditional actions, dermatomes versus contemporary indications, and traditional actions versus contemporary indications. Goodman-Kruskal γ and Rousson γ*2 were calculated based on cross-tables, bootstrap and permutated samples to evaluate the association and determination coefficient between variables, respectively.ResultsSignificant associations were observed between levels of similarities of dermatomes and traditional actions (γ = 0.542; P < 0.001), dermatomes and contemporary indications (γ = 0.657; P < 0.001), and traditional actions and contemporary indications (γ = 0.716; P < 0.001). Similarities of dermatomes explained 16% of the variance of traditional actions and 25% of contemporary indications. Traditional actions explained 30% of the variance of contemporary indications. The association between traditional actions and contemporary indications was the highest one (γ = 0.716, 95% confidence interval (95% CI) = [0.715; 0.719]), followed by the association between dermatomes and contemporary indications (γ = 0.622, 95% CI = [0.621; 0.623]), and between dermatomes and traditional actions (γ = 0.446, 95% CI = [0.444; 0.447]), all with P < 0.001.ConclusionsThe similarity of dermatomes between dual acupoints partially determined the similarity of traditional actions and contemporary indications, therefore dermatomes partially determine the therapeutic efficacy of acupuncture.

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Section: Discussionsupporting

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Role of dermatomes in the determination of therapeutic characteristics of channel acupoints: a similarity-based analysis of data compiled from literature

Ferreira

Luiz

2013

Chin Med

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“…In the literature, opinions on nonacupoints were controversial, especially the distance between nonacupoint and normal acupoint. Some researchers consider that acupoint is not located at a point on skin but in a field [ 14 ]; therefore the more proper name of acupoint is “acupuncture field” [ 15 ]. Moisberger recommend “a minimum distance of 6 cm between verum and sham points on face, hands and feet, and up to 12 cm for all other parts of the body” [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness of Electroacupuncture for Functional Constipation: A Randomized, Controlled, Clinical Trial

Wang

Liu

et al. 2015

Evidence-Based Complementary and Alternative Medicine

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Background. Electroacupuncture (EA) has been reported to treat functional constipation (FC). The aim of this study was to investigate the efficacy and safety of EA with different needle insertion method for FC. Methods. Sixty-seven participants were randomly assigned to control (EA with shallow puncture) and EA (with deep puncture) groups. Every patient received 5 treatments per week in the first two weeks, then 3 treatments per week during the following six weeks. Complete spontaneous bowel movements (CSBM), spontaneous bowel movements (SBM), Bristol stool scores (BSS), and Patient Assessment of Constipation Quality of Life (PAC-QOL) were assessed. Results. Both shallow and deep EA significantly increased CSBM frequency compared to the baseline. CSBM was increased from 0.50 ± 0.59/wk to 2.00 ± 1.67/wk with deep EA and from 0.48 ± 0.59/wk to 1.33 ± 1.09/wk with shallow EA (P < 0.05, resp.). Similar finding was noted in SBM. Deep EA was more potent than shallow EA (P < 0.05) during the treatment period. No difference was found on BSS and PAC-QOL between two groups. Conclusion. It is effective and safe with EA to treat FC. Studies with large sample size and long-term observation are needed for further investigation.

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“…Locating the acupoint and the nonacupoint is rather arbitrary, and the surface area and spatial structure of an acupoint vary with the acupoint [39]–[41]. Thus, stimulating the nonacupoint and TE5 might have similar effects since these two points were close to each other, and the small difference in location might contribute to the differences in functional connectivity.…”

Section: Discussionmentioning

confidence: 99%

Modulatory Effect of Acupuncture at Waiguan (TE5) on the Functional Connectivity of the Central Nervous System of Patients with Ischemic Stroke in the Left Basal Ganglia

et al. 2014

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ObjectiveTo study the influence of acupuncture at Waiguan (TE5) on the functional connectivity of the central nervous system of patients with ischemic stroke.MethodsTwenty-four patients with ischemic stroke in the left basal ganglia were randomized based on gender to receive TE5 acupuncture (n = 12) or nonacupoint acupuncture (n = 12). Each group underwent sham acupuncture and then verum acupuncture while being scanned with functional magnetic resonance imaging. Six regions of interest (ROI) were defined, including bilateral motor, somatosensory, and bilateral basal ganglia areas. The functional connectivity between these ROIs and all voxels of the brain was analyzed in Analysis of Functional NeuroImages(AFNI) to explore the differences between verum acupuncture and sham acupuncture at TE5 and between TE5 acupuncture and nonacupoint acupuncture. The participants were blinded to the allocation.ResultThe effect of acupuncture on six seed-associated networks was explored. The result demonstrated that acupuncture at Waiguan (TE5) can regulate the sensorimotor network of the ipsilesional hemisphere, stimulate the contralesional sensorimotor network, increase cooperation of bilateral sensorimotor networks, and change the synchronization between the cerebellum and cerebrum. Furthermore, a lot of differences of effect existed between verum acupuncture and sham acupuncture at TE5, but there was little difference between TE5 acupuncture and nonacupoint acupuncture.ConclusionThe modulation of synchronizations between different regions within different brain networks might be the mechanism of acupuncture at Waiguan (TE5). Stimulation of the contralesional sensorimotor network and increase of cooperation of bilateral hemispheres imply a compensatory effect of the intact hemisphere, whereas changes in synchronization might influence the sensorimotor function of the affected side of the body.Trial RegistrationChinese Clinical Trial Registry ChiCTR-ONRC-08000255

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Acupuncture points are large fields: The fuzziness of acupuncture point localization by doctors in practice

Cited by 21 publications

References 15 publications

Role of dermatomes in the determination of therapeutic characteristics of channel acupoints: a similarity-based analysis of data compiled from literature

Role of dermatomes in the determination of therapeutic characteristics of channel acupoints: a similarity-based analysis of data compiled from literature

The Effectiveness of Electroacupuncture for Functional Constipation: A Randomized, Controlled, Clinical Trial

Modulatory Effect of Acupuncture at Waiguan (TE5) on the Functional Connectivity of the Central Nervous System of Patients with Ischemic Stroke in the Left Basal Ganglia

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