Constructed "ashi point" / 中国针灸

Ashi point is one of the three major categories of acupoint in acupuncture-moxibustion theory nowadays. It is originally recorded in Beiji Qianjin Yaofang (Important Formulas Worth a Thousand Gold Pieces for Emergency) as one of the effective folk methods. The theoretic development of ashi point goes through the innovation period of contemporary and modern acupuncture-moxibustion theory, specifically in three aspects, definition, property and status. Through the analysis of historical data, it is found that the bias of ashi point theory results from the misunderstanding of connotation, the distortion of application techniques, the misinterpretation of semantics and the gradual promotion of status. All of these are generally caused by the reform of acupuncture-moxibustion theory in Japan, which covers the essence of ashi point, limits its connotation and clouds the concept of acupoint. It is necessary to re-understand the literal sense and theoretic construction of ashi point and timely update the knowledge system of acupuncture-moxibustion in association with the results of theoretical researches.

Interpretation of therapeutic effect of / 中国针灸

Given that the biomechanical theory cannot well explain the therapeutic effect of

Effect of electroacupuncture intervention on expression of hypoxia-inducible factor-1 alpha and vascular endothelial growth factor in injured segments of rats with spinal cord injury / 中国组织工程研究

BACKGROUND: The authors found a striking similarity between the qi and blood theory and nerve repair of spinal cord injury in terms of improving blood-oxygen microenvironment in tissues. The hypothesis is that electroacupuncture can improve the blood-oxygen microenvironment of the spinal cord and promote nerve regeneration by regulating hypoxia-inducible factor 1a and vascular endothelial growth factor signal transduction. OBJECTIVE: To investigate the effect of electroacupuncture intervention on the expression of hypoxia-inducible factor 1a and vascular endothelial growth factor in injured segments of spinal cord injury rats. METHODS: Totally 120 Sprague-Dawley female rats were enrolled to make spinal cord injury models by clamping the spinal cord (20 seconds) using a microvascular clamp. Rat models were then randomly divided into three groups: Ashi point group, Stomach Meridian of Foot-Yangming group and blank control group, 40 rats in each group. Electroacupuncture at two Aishi points or at both sides of Futu and Zusanli points was started on the 3rd day after modeling. Each rat was scored on the Basso, Beattie and Bresnahan locomotor rating scale at 1, 2, 3,4, and 5 weeks after intervention. Injured spinal cord specimens were then taken and observed histomorphologically. Hypoxia-inducible factor-1a and vascular endothelial growth factor protein and mRNA expressions were detected using immunohistochemistry staining, real-time fluorescence quantitative PCR and western blot assay. The study protocol was approved by the Animal Ethic Committee of the First Affiliated Hospital of Guangxi University of Chinese Medicine in China (approval No. 201712001). RESULTS AND CONCLUSION: The lower limb function score, hypoxia-inducible factor-1a and vascular endothelial growth factor gene and protein expression in the two electroacupuncture intervention groups were significantly higher than those of the blank control group. The number of neurons in Ashi point and Stomach Meridian of Foot -Yangming groups was significantly higher than that of the blank control group with the lapse of intervention time. Electroacupuncture intervention can effectively improve the lower limb function score of spinal cord injury rats, increase the number of neurons, and up-regulate the mRNA and protein expression of hypoxia-inducible factor-1 a and vascular endothelial growth factor, thus effectively promoting the neurological recovery of the spinal cord.

Effect of electroacupuncture on tissue elasticity and expression of muscular MyoD and myogenin in rats with acute gastrocnemius contusion / 针刺研究

OBJECTIVE: To observe the effect of electroacupuncture (EA) at "Ashi" acupoint and "Kunlun" (BL60) on elastic modulus, histopathological changes and expression of myogenic regulatory factors in gastrocnemius(GM) contusion rats, so as to explore the therapeutic effect of local acupoint selection and acupoint selection along channel. METHODS: Male SD rats were randomly divided into blank control (n＝5), model (n＝15), Ashi-point (n＝15) and BL60 (n＝15) groups. The acute GM contusion model was established by striking (free falling) the GM with a homemade hitter. EA (0.5 to 1.0 mA, 2 Hz/10 Hz) was applied to Ashi-point (local focus) and BL60 for 30 min 24 h after muscle injury. The elasticity maximum (Emax) of gastrocnemius muscle was measured by using an ultrasonic device. Histopathological changes were observed after H．E. stain, and the number of Myogenic differentiation(MyoD)- and Myogenin (MyoG)-positive cells was detected by using immunohistochemistry. RESULTS: After mdeling, the Emax value of GM was significantly increased from the 3rd h to 7th day in comparison with pre- injury of muscle (P<0.05), and was markedly increased on the 3rd day and obviously lower on day 7 in the Ashi-point group than in the model group (P<0.05). The numbers of MyoD- and MyoG-positive cells of GM were significantly increased on day 7 in the model group than in the blank control group (P<0.05), and both further increased in Ashi-point on day 3 and 5, and MyoG-positive cells further increased in BL60 group on day 5 and in Ashi-point group on day 7 relevant to the model group(P<0.05). The therapeutic effect of EA-Ashi-point was apparently superior to that of BL60 in up-regulating Emax on day 3 and in up-regulating the number of MyoD-positive cells on day 3 and 5 (P<0.05). H．E. stain showed disordered arrangement of muscle fibers, infiltration of inflammatory cells, increase of intercellular space, and edema on day 3 after modeling (which was milder in the Ashi-point group); and gradual fusion and thickening of new born muscle fibers with obvious connective tissue hyperplasia converged to the lesioned region on day 7 in the model group (convergence of new born muscle cells to the lesion region in both EA groups, and more complete tissues in the Ashi-point group). CONCLUSION: EA of Ashi-point and BL60 can up-regulate the expression of myogenic regulatory factors MyoD and MyoG of GM tissue in GM contusion rats, which may contribute to its function in promoting recovery of muscle elasticity. The role of EA-Ashi-point is superior to that of EA-BL60.

Effect of long-snake moxibustion on nonspecific low back pain with symptom of cold and dampness / 中国针灸

OBJECTIVE@#To compare the clinical therapeutic effect of long-snake moxibustion and ginger-partitioned moxibustion at point on nonspecific low back pain (NLBP) with symptom of cold and dampness.@*METHODS@#A total of 120 patients were randomized into a long-snake moxibustion group, an ashi point group and a waiting for treatment group, 40 cases in each one. Ginger-partitioned moxibustion was applied from Dazhui (GV 14) to Yaoshu (GV 2) of governor vessel in the long-snake moxibustion group, and was applied at point of affected area in the ashi point group, 40 min each time, once every other day and totally 8 times were required. No intervention was adopted in the waiting for treatment group, and after the trial, long-snake moxibustion was applied. Before and after treatment, the visual analogue scale (VAS) scores of rest and activity, the Oswestry disability index (ODI) score and the score of cold and dampness symptom were observed in the 3 groups.@*RESULTS@#Compared before treatment, the VAS scores of rest and activity, the ODI scores and the scores of cold and dampness symptom after treatment were decreased in the long-snake moxibustion group and the ashi point group (<0.05). After treatment, the variations of the above indexes in the long-snake moxibustion group and the ashi point group were larger than those in the waiting for treatment group (<0.05), and the variations of the above indexes in the long-snake moxibustion group were larger than those in the ashi point group (<0.05).@*CONCLUSION@#Long-snake moxibustion can effectively improve the pain, dysfunction and the symptom of cold and dampness in patients with nonspecific low back pain, and the improvement is superior to the ginger-partitioned moxibustion at point.

Ultrasound-guided needle-knife for trigger finger / 中国针灸

OBJECTIVE@#To explore the efficacy of ultrasound-guided needle-knife with precise three-dimensional stereotactic localization of points for stenosing tenosynovitis of flexor tendon (trigger finger).@*METHODS@#A total of 74 patients were randomly divided into an observation group and a control group, 37 cases in each group. The patients in the observation group were treated with ultrasound-guided intrathecal injection and releasing method of needle-knife, while the patients in the control group were treated with ultrasound-guided intrathecal injection. The self-made 9-score scale of trigger finger was recorded before treatment, immediately after treatment, 1 month and 3 months after treatment; the curative effect of the two groups was evaluated.@*RESULTS@#The results of self-made 9-score scale in the observation group immediately after treatment, 1 month and 3 months after treatment were lower than that before treatment (all <0.01); the scores in the observation group were lower than those in the control group at each time point after treatment (all <0.01). The excellent and good rate immediately after treatment was 100.0% (37/37) in the observation group, which was superior to 8.1% (3/37) in the control group (<0.05); the cured rates in the observation group were 100.0% (37/37) 1 month after treatment and 97.3% (36/37) 3 months after treatment, which were superior to 13.5% (5/37) and 10.8% (4/37) in the control group, respectively (<0.05).@*CONCLUSION@#The needle-knife with three-dimensional stereotaxic location of point could significantly improve the symptoms of trigger finger, with superior immediate and long-term efficacy.

Definition ofpoint from the view of linguistics / 中国针灸

The definition ofpoint has not been unified yet till now. Likewise, the precise explanation on its connotation has always been an elusive question in acupuncture theory. By collecting diverse definitions onpoint in the textbooks of, dictionaries and term standards, several rational elements in definitions with consensus were screened. With the assistance of two important theories of cognitive linguistics, such as figure-ground theory and distance iconicity theory, the concept ofpoint was newly defined. Additiona-lly, on the base of the understanding on several similar terms such as "taking the painful site as acupoint", "responding point" and "reactive point", the semanteme analytic method was used to distinguish the difference among them so that the more profound explorations on acupuncture therapy are expounded.

Discussing the relationship among thepoint, tender point and myofascial trigger point / 中国针灸

The conception and the history ofpoint, tender point and myofascial trigger point are described in the paper. All of three kinds of point are the reaction of musculoskeletal pain and visceral diseases. Theoretically,point originates from the theory of muscle region of meridian, tender point from the theory of soft tissue and muscles and myofascial trigger point from the theory of muscular fasciae. Anatomically,point is localized in the muscle region of meridian, on the boundary between muscles, tender point is on the muscular attachment to skeleton (the starting and ending points) and myofascial trigger point is on the motor point of neuromuscles. Pathologically,point reflects the disorders of soft tissue and internal organ, tender point reflects the disorders of soft tissue and myofascial trigger point reflects the disorders of soft tissue and few disorders of internal organ. To identify the relationship among them is very significant in the target treatment with acupuncture.

Ultrasonic imaging research atpoints in neck-type cervical spondylosis / 中国针灸

<p><b>OBJECTIVE</b>To conduct the preliminary positioning and qualitative research of high-frequency ultrasonic imaging atpoints (including tender points and trigger points) in neck-type cervical spondylosis and explore the relevant law so as to provide the evidence for the selection of acupuncture scheme.</p><p><b>METHODS</b>Thirty patients in compliance with the diagnostic criteria of neck-type cervical spondylosis were selected. The trigger points, tender points and placebo points were positioned on any of the three available oriented lines. The point-to-point high-frequency real-time dynamic ultrasonic imaging technology was used to scan and position each point and record the changes in ultrasound gradation anatomy and two-dimensional ultrasound in perimysium, two-dimensional and color Doppler ultrasonography and blood flow. The ultrasound characteristics were analyzed.</p><p><b>RESULTS</b>①Regarding the changes in ultrasound gradation anatomy and two-dimensional ultrasound in perimysium, the anatomic gradation at trigger points and tender points was in the sequence as cutaneous layer, subcutaneous fat layer, shallow muscular tissue layer, deep muscular tissue layer and vertebrae. The linear high echo presented in cutaneous layer; the low echo in subcutaneous fat layer; the linear high echo in muscular fasciae; the low echo in muscular layer and the clear linear echo in its perimysium; the high echo and declined posterior echo in vertebrae. Compared with the placebo points, 93.3% of trigger points (28/30) presented enhanced or thickened perimysium echo (<0.05), and 96.7% of tender points (29/30) presented enhanced or thickened perimysium echo (<0.05). The differences were not significant between the trigger points and the tender points (>0.05). ②In the two-dimensional ultrasonography, the clear linear echo presented in perimysium, the enhanced or thickened echo in perimysium of trigger points and tender points. In the color Doppler ultrasonography, the blinking unstable dotted blood flow signal or stable short rod-like blood flow signal presented in the trigger points and tender points. ③Regarding the condition of blood flow, 56.7% of trigger points (17/30) presented Ⅱ degree of color blood flow signal and 83.3% of tender points (25/30) presented Ⅱ degree of color blood flow signal; 0% of placebo points presented Ⅱ degree of color blood flow signal. Compared with the placebo points, the differences in the rate of Ⅱ degree of color blood flow signal were significant statistically at both the trigger points and the tender points (both<0.05). The difference was not significant between the trigger points and tender points (>0.05).</p><p><b>CONCLUSIONS</b>In the high-frequency ultrasound imaging at trigger points and tender points in neck-type cervical spondylosis, the ultrasound imaging characteristics present, which are similar between the trigger points and the tender points. The high-frequency ultrasound imaging is valuable in positioning and quantitative research ofpoints in cervical spondylosis and has a certain significance to guide treatment.</p>

Can Ashi points stimulation have specific effects on shoulder pain? A systematic review of randomized controlled trials / 中国结合医学杂志

<p><b>OBJECTIVE</b>To provide an evidence-based overview regarding the efficacy of Ashi points stimulation for the treatment of shoulder pain.</p><p><b>METHODS</b>A comprehensive search [PubMed, Chinese Biomedical Literature Database, China National Knowledge Infrastructure (CNKI), Chongqing Weipu Database for Chinese Technical Periodicals (VIP) and Wanfang Database] was conducted to identify randomized or quasi-randomized controlled trials that evaluated the effectiveness of Ashi points stimulation for shoulder pain compared with conventional treatment. The methodological quality of the included studies was assessed using the Cochrane risk of bias tool. RevMan 5.0 was used for data synthesis.</p><p><b>RESULTS</b>Nine trials were included. Seven studies assessed the effectiveness of Ashi points stimulation on response rate compared with conventional acupuncture. Their results suggested significant effect in favour of Ashi points stimulation [odds ratio (OR): 5.89, 95% confidence interval (CI): 2.97 to 11.67, P<0.01, heterogeneity: χ(2) =3.81, P=0.70, I (2) =0% ]. One trial compared Ashi points stimulation with drug therapy. The result showed there was a significantly greater recovery rate in group of Ashi points stimulation (OR: 9.58, 95% CI: 2.69 to 34.12). One trial compared comprehensive treatment on the myofascial trigger points (MTrPs) with no treatment and the result was in favor of MTrPs.</p><p><b>CONCLUSIONS</b>Ashi points stimulation might be superior to conventional acupuncture, drug therapy and no treatment for shoulder pain. However, due to the low methodological quality of included studies, a firm conclusion could not be reached until further studies of high quality are available.</p>

Understanding of needle-knife medicine onpoint / 中国针灸

The concept ofpoint and the understanding of modern acupoint research onpoints were analyzed. According to the bowstring mechanics anatomy of needle-knife medicine and mesh theory, it was believedpoint was the warning of mechanical imbalance of bowstring mechanics anatomy.points were mainly distributed in the joint part of bowstring or stress concentration of string; the acupotomy could compensate for the subjectivity and arbitrariness of point selection of, which also emphasized the importance ofpoint anatomy.