Acupuncture point

Point LI-4 known in Chinese as 合谷 (hégǔ)

Acupuncture points (Chinese: 腧穴 or Chinese: 穴位, also called acupoints) are locations on the body that are the focus of acupuncture, acupressure, sonopuncture and laser acupuncture treatment. In Traditional Chinese Medicine, several hundred acupuncture points are claimed to be located along what practitioners call meridians. There are also numerous "extra points" not associated with a particular meridian.

Scientific evidence for the efficacy of either meridians or acupuncture points is mixed; overall reviews indicate evidence is not yet sufficiently compelling[1][2] while others support the efficacy of some points for managing specific symptoms, such as labour pain[3] or nausea.[4]

Theory

Acupoints in treatment may or may not be in the same area of the body as the targeted symptom. The Traditional Chinese Medicine (TCM) theory for the selection of such points and their effectiveness is that they work by stimulating the meridian system to bring about relief by rebalancing yin, yang and qi (also spelled "chi" or "ki"). This theory is based on the paradigm of TCM and has no analogue in western medicine.

Body acupoints are generally located using a measurement unit, called the cun, that is calibrated according to their proportional distances from various landmark points on the body. Acupoint location usually depends on specific anatomical landmarks that can be palpated.[5] Many of these basic points are rarely used. Some points are considered therapeutically more valuable than others, and are used very frequently for a wide array of health conditions.

Points tend to be located where nerves enter a muscle, the midpoint of the muscle, or at the enthesis where the muscle joins with the bone.[6] Location by palpation for tenderness is also a common way of locating acupoints (see also trigger point). Points may also be located by feeling for subtle differences in temperature on the skin surface or over the skin surface, as well as changes in the tension or "stickiness" of the skin and tissue. There is no scientific proof that this method works and some practitioners disagree with the method.

Body acupoints are referred to either by their traditional name, or by the name of the meridian on which they are located, followed by a number to indicate what order the point is in on the meridian. A common point on the hand, for example, is named Hegu, and referred to as LI 4 which means that it is the fourth point on the Large Intestine meridian.

Acupuncture points often have allusive, poetic names that developed over the course of centuries, often involving synonyms to ensure similar points are located on the appropriate limb. A total of 360 points are generally recognized, but the number of points has changed over the centuries. Roughly 2/3 of the points are considered "yang", while the remaining 1/3 are considered "yin".[7]

Scientific research

Main article: Acupuncture

Overall there is only preliminary evidence to suggest acupuncture points exist.[2]

A 1997 NIH consensus statement has observed that "Despite considerable efforts to understand the anatomy and physiology of the 'acupuncture points', the definition and characterization of these points remains controversial. Even more elusive is the basis of some of the key traditional Eastern medical concepts such as the circulation of Qi, the meridian system, and the five phases theory, which are difficult to reconcile with contemporary biomedical information but continue to play an important role in the evaluation of patients and the formulation of treatment in acupuncture."[1]

There are several theories for how acupuncture works or what acupuncture points are, but none of these theories have been proven.[2] Acupuncture points may exhibit low electrical resistance and impedance but this evidence is mixed, and limited by poor-quality studies with small sample sizes and multiple confounding factors.[8]

Efficacy of P6 point against nausea with vomiting

A meta-analysis of 40 trials suggested that stimulation of the P6 acupuncture point (located on the wrist) was effective for prophylactic treatment of postoperative nausea and vomiting, with minimal side-effects. The study also said: "The risks of postoperative nausea and vomiting were similar after P6 acupoint stimulation and antiemetic drugs."[4]

Standardization

The World Health Organization (WHO) convened a Working Group on the Standardization of Acupuncture Nomenclature in 1982, with meetings of experts in 1984, 1985 and 1987, resulting in a standardized nomenclature for 361 classical acupuncture points organized according to the fourteen meridians, eight extra meridians, 48 extra points, and scalp acupuncture points. A proposed standard was published by WHO in 1991,[9] and a Standard Acupuncture Nomenclature was published in 1993.[10]

See also

Notes and references

  1. 1 2 "Acupuncture: Consensus Development Conference Statement". National Institutes of Health. 1997-11-05. Retrieved 2011-03-01.
  2. 1 2 3 Ernst, E. (2006). "Acupuncture - a critical analysis". Journal of Internal Medicine. 259 (2): 125–137. doi:10.1111/j.1365-2796.2005.01584.x. PMID 16420542.
  3. ↑ Smith, Caroline A; Collins, Carmel T; Crowther, Caroline A; Levett, Kate M (2011). Smith, Caroline A, ed. "Acupuncture or acupressure for pain management in labour". Cochrane Database of Systematic Reviews (7): CD009232. doi:10.1002/14651858.CD009232. PMID 21735441.
  4. 1 2 Lee, Anna; Fan, Lawrence TY; Lee, Anna (2009). "Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting". Cochrane Database Syst Rev (2): CD003281. doi:10.1002/14651858.CD003281.pub3. PMC 3113464Freely accessible. PMID 19370583.
  5. ↑ "General Guidelines for Acupuncture Point Locations". WHO Standard Acupuncture Point Locations in the Western Pacific Region. World Health Organization. 2008. p. 2. ISBN 978-92-9061-383-1.
  6. ↑ Ying Xia; Fei Zhou; Dengkai Huang (2010). "Neuroanatomic Basis of Acupuncture Points". Acupuncture Therapy for Neurological Diseases. Springer. pp. 53. ISBN 978-3-642-10855-6.
  7. ↑ Needham, J; Lu DG (2002). Celestial lancets: a history and rationale of acupuncture and moxa. Routledge. pp. 52–59. ISBN 0-7007-1458-8.
  8. ↑ Ahn, Andrew C.; Colbert, Agatha P.; Anderson, Belinda J.; Martinsen, ØRjan G.; Hammerschlag, Richard; Cina, Steve; Wayne, Peter M.; Langevin, Helene M. (2008). "Electrical properties of acupuncture points and meridians: A systematic review". Bioelectromagnetics. 29 (4): 245–56. doi:10.1002/bem.20403. PMID 18240287.
  9. ↑ Regional Office for the Western Pacific, WHO. 1991. A Proposed Standard International Acupuncture Nomenclature Report of a WHO Scientific Group (pdf). World Health Organization. Retrieved 5 September 2014.
  10. ↑ Regional Office for the Western Pacific, WHO. 1993. Standard Acupuncture Nomenclature, 2nd ed (pdf). World Health Organization. Archived from the original on 28 February 2011.

External links

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