Anatomic study on safe insertion of acupuncture needle in Qiuhou (EX-HN7) acupoint / 针刺研究

OBJECTIVE: To explore the anatomical structure of acupuncture point Qiuhou (EX-HN7) area for safe insertion of acupuncture needle. METHODS: A total of 28 orbital specimens of adult corpses (14 men and 14 women) were randomly selected to be observed by anatomical sectioning and layering methods. The acupoint EX-HN7, located at the junction between the 1/4 of the outer boundary and 3/4 of the inner boundary of the infraorbital margin according to the "Standardization of Acupoint Position" implemented by the People's Republic of China, and marked first with a color pen, followed by cutting the head into horizontal sections along the cross line by using a cadaver cutter and measuring the distance between the skin and blood vessels and main nerves with a digimatic caliper. When the anatomic hierarchy was performed, the blood vessels and nerves in the orbit, the morphological characteristics of the structure around the needle body were particularly focused. RESULTS: When an acupuncture needle was vertically inserted into EX-HN7 region, the tissues through which the needle passes are skin, subcutaneous tissue, orbicularis muscle, orbital adipose body, inferior oblique muscle and inferior orbital wall, respectively. When an acupuncture needle was inserted obliquely upward and along the inferior orbital wall to a depth of (26.5±1.7)mm, the needle tip met the posterior ciliary artery; when to a depth of (41.4±1.3)mm, it reached the superior ophthalmic vein. When inserted to a depth of (40.4±1.5)mm, the needle tip may damage the ophthalmic artery and optic nerve. When the acupuncture needle was inserted inferiorly and closely along the orbital inferior wall to a depth of (13.2±1.4)mm, the infraorbital artery in the suborbital sulcus would be hurt. CONCLUSION: It is recommended that when insert vertically into a depth of 12.0 mm in EX-HN7, the acupuncture needle tip should be slightly inclined inward and posterior-upward, and the depth should not exceed 26.0 mm.

Short-term and long-term therapeutic effects of internal heat-type acupuncture needle therapy combined with acupoint injection of O3 for post-stroke shoulder pain / 针刺研究

OBJECTIVE: To observe the short-term and long-term therapeutic effects of internal heat-type acupuncture needle (IHTAN) therapy combined with acupoint injection of O3for post-stroke shoulder pain in apopletic patients. METHODS: Patients with post-stroke shoulder pain were divided into warm needle moxibustion ＋ acupoint injection group (29 cases), acupoint injection group (30 cases) and IHTAN＋acupoint injection group (29 cases) according to the random number table. For acupoint injection, O3 solution (3 mL, 30 µg/mL) was injected into Jianyu (LI15), Jianliao (SJ14), Jianzhen (LI9), Binao (LI14) and Ashi points (4-6 acupoints every time) on the affected side, once every other day for 4 weeks. For warm needle moxibustion, the above mentioned acupoints were stimulated with filiform needles attached with an ignited moxa-stick, once every other day for 4 weeks. For IHTAN, the internal warmth controllable acupuncture needles were inserted into the above mentioned acupoints on the affected side, and then connected to an internal heat acupuncture apparatus for stimulating the acupoints at 42 ℃， 20 min every time, once a week, for 4 weeks. The severity of shoulder pain was assessed by using visual analogue scale (VAS, 0-10 points), the upper limb joint motion function evaluated using Fugl-Meyer assessment scale (FMA, 0－66 points), and the ability of daily living activities (ADL) evaluated using Barthel index (0－100 points) at the ends of the 2nd and 4th week as well as the 6th month after the treatment. If the shoulder pain disappeared or basically disappeared, it was considered to be healed. If the pain was relieved, it was considered to be effective. Otherwise, it was considered to be ineffective. RESULTS: At the ends of the 2nd and 4th week as well as the 6th month after the treatment, the VAS scores of the IHTAN＋acupoint injection group were significantly lower than those of the warm needle moxibustion＋acupoint injection and acupoint injection groups (P0.05). Of the 29, 30 and 29 cases in the warm needle moxibustion＋acupoint injection, acupoint injection and IHTNA＋acupoint injection groups, 1, 0 and 7 cases at the 2nd week, 3, 2 and 12 cases at the 4th week, 4, 2 and 15 cases at the 6th month were cured; 15, 14 and 16 cases at the 2nd week, 17, 17 and 13 cases at the 4th week, and 18, 18 and 12 cases at the 6th month experienced marked improvement; 13, 16 and 6 cases at the 2nd week, 9, 11 and 4 cases at the 4th week, 7, 10 and 2 cases at the 6th month had no apparent changes in their shoulder pain severity, with the total effective rates at the 4th week and 6th month being 68.97% and 75.86%, 63.33% and 66.60%, and 86.21% and 93.10%, respectively. CONCLUSION: The internal heat-type acupuncture needle therapy combined with O3 acupoint injection has obvious short-term and long-term therapeutic effects for post-stroke shoulder pain and is obviously superior to warm needle moxibustion＋ acupoint injection and simple acupoint injection in relieving shoulder pain and improving upper limb motion function.

Randomized controlled trial of internal heat-type acupuncture needle therapy in the treatment of post-stroke shoulder pain / 针刺研究

OBJECTIVE: To evaluate the effectiveness and safety of internal heat-type acupuncture needle (IHTAN) the-rapy in the treatment of post-stroke shoulder pain in apopletic patients. METHODS: According to the random number table, 96 patients with post-stroke shoulder pain were divided into IHTAN group and warm needle moxibustion group (n＝48 in each one). Jianyu (LI15), Jianliao (TE14), Jianzhen (SI9), Binao (LI14) and Ashi points (Extra) on the affected side were selected in the two groups. For patients of the IHTAN group, internal warmth controllable acupuncture needles were inserted into the above-mentioned acupoints, and then connected to an internal heat acupuncture apparatus for stimulating the acupoints at 42 ℃， 20 min every time, once a week, for 4 weeks. For patients of the warm needle moxibustion group, the above mentioned acupoints were stimulated with filiform needles attached with an ignited moxa-stick, once every other day, for 4 weeks. If the shoulder pain disappeared or basically disappeared, it was considered to be healed, if the pain was relieved, it was considered to be effective, ot-herwise, it was considered to be ineffective. The incidence of local skin injury including burn, empyrosis, silt blue, hematoma and infection, the heart rate, respiration, blood pressure, oxyhemoglobin saturation, blood routine (hemoglobin level, white blood cell [WBC] count, platelet count), creatase and dipolymer levels were recorded or detected. Additionally, the patients' satisfaction rate about the treatment environment was recorded. RESULTS: Following the treatment, of the 45 and 47 cases in the warm needle moxibustion and IHTAN groups, 5 (11.11%) and 20 (42.55%) were cured, 26(57.78%) and 21(44.68%) experienced marked improvement, and 14 (31.11%) and 6 (12.77%) had no apparent changes in their shoulder pain severity, with the total effective rates being 68.89% and 87.23%, respectively. The curative rate and total effective rate of the IHTAN group were significantly higher than those of the warm needle moxibustion group (P0.05). CONCLUSION: The IHTAN therapy is effective, safe and reliable in the treatment of post-stroke shoulder pain. In terms of the incidence of skin injury and the satisfaction degree of therapeutic environment, the internal heat-type acupuncture needle therapy is obviously superior to the warm needle moxibustion therapy.

Analysis on the origin and development of elements of reinforcing and reducing needling techniques / 针刺研究

Reinforcing and reducing needling manipulations are important factors affecting clinical therapeutic effect. In the present paper, the relevant elements of the reinforcing and reducing techniques of acupuncture needle including the left- and right-ward twirling, gender, needling at the left and right, front and back parts of the body, needling along or against the running course of the meridian, and their origin and development recorded in ancient Chinese medical books were collected and sorted out, followed by analysis on the understandings of Chinese ancient medical practitioners about them. Results show that the right- or left-ward twirling of needles, gender, and needling at the right or left part, the front or the back part of the body of patients are not the core components of the reinforcing and reducing techniques. Of the three stimulus parameters of needling, named amplitude, frequency and duration which are frequently researched at present, only the duration of single twirling (frequency) was highly noted in GAO Wu's book Zhenjiu Juying (A Collection of Gems in Acupuncture and Moxibustion). It is worthy of being studied in the further. Regarding the stimulation intensity of acupuncture involving the identification of reinforcing or reducing manipulations, the factors influencing the patients' feelings of needling intensity of acupuncture should be studied at the same time.

The origin, development and mechanisms of special acupuncture needle tools for cutaneous region / 针刺研究

In this paper, we expound the origin and development of special acupuncture needle tools for cutaneous region, and discuss its mechanisms from modern medical theory. By consulting related acupuncture books and literature and in combination with needles used in clinical practice, we conclude that acupuncture needle tools can be divided into skin massage needle (digital pressing, spoon needle, etc.), cutaneous pricking blood needle (shear needle, three-edged needle, plum blossom needle, etc.), subcutaneous shallow puncture needle (intradermal needle, superficial needle, subcutaneous in-dwelling needle), etc. The skin-brain axis is the core of skin stimulation therapy. Mechanical pressure exerted on the skin surface induced by acupuncture stimulation or pressing, microcirculation changes and drug superposition are probably the underlying mechanisms of special skin acupuncture needle tools for treatment of various clinical disorders.

Evolvement of Acupuncture Needle Manipulation Techniques Described in Textbooks of Acupuncture and Moxibustion of Successive Editions / 针刺研究

This paper summarizes the evolvement of the needle manipulation techniques described in the textbooks of Acupuncture and Moxibustion of the past successive 10 editions in Chinese, analyzes the reasons for the evolvement and its impact on clinical treatment, and proposes future developing trends. After analyzing characteristics of needle-manipulation techniques of the well-known Chinese acupuncture specialists, and those described in multi-editions of the textbooks, we found that the currently evoluted contents primarily contain the definition and types of manipulating techniques. However, the reasons for the evolvement and connotation of needle manipulating are probably due to a) undefined descriptions in the history; b) changes in the academic studies and clinical application of acupuncture and moxibustion during the textbook compilation; c) the well-known specialists' and the participated editors' academic thoughts; d) the textbook content setting needs, etc. The evolvement reflects the changed preoccupations of factors affecting clinical efficacy of acupuncture manipulations, and facilitates the implementation of standardized clinical operative procedures. The development of current acupuncture needle manipulation techniques emphasizes the quantification of manual manipulations, fits clinical needs, and pays more attention to the pressing hand during needle insertion.

Application and effect of transfer type anti-acupuncture needle in blood collection of hemodialysis patients / 实用医学杂志

Objective To improve the efficiency of blood collection in hemodialysis patients by inventing and applying new blood collection needles.Methods One hundred and eighty cases of hemodialysis patients were randomly divided into control group 1(CG1),control group 2(CG2),experimental group(EG). Comparison of the three groups in time of blood collection,the number of operation that had the risk of acupuncture injury and the number of the blood samples that had been contaminated. Results There were statistically significant difference (P<0.05)in three groups.The number of times of blood collection in the number of operations that had the risk of acupuncture injury,and the number of the blood sample that had been contaminated. CG1 had the longest blood collection time(12.55 min),EG had the shortest blood collection time(5.09 min);the risk of acupuncture injury was the highest in CG2 and the lowest in the EG.The number of contamination of blood samples and the amount of inaccurate sample in CG1 were the highest,and the lowest in the EG. Conclusions The working efficiency of transfer type anti-acupuncture needle(TTAN)during blood sample collection in hemodialysis patients is signifi-cantly better than that of traditional blood collection method,and it is helpful to reduce the risk of acupuncture injury and the risk of contamination in blood samples,which is worthy of promotion.

The strategy discussions on the acupuncture needles standardization and intellectual property protection / 国际中医中药杂志

In this paper,we analyze the current situation of the national standardization on acupuncture needles and related patents.Through analyzing the international research focus on the acupuncture needle patents,we give some strategic suggestions on the intellectual property protection of acupuncture needles and traditional Chinese medicine.

Analysis of Removal the Non-metallic Foreign Bodies of Superficial Tissue under the Location of Ultrasonic and the Guidance of Acupuncture Needle / 浙江中医药大学学报

[Objective] To analyze the experience and methods of removal the non-metal ic foreign bodies in the superficial tissue under the location of ul-trasonic and the guidance of acupuncture needle. [Method] First find the non-metal ic foreign bodies and observe the trauma around them by ultrasonic scanning, then use needle to puncture and approach the foreign bodies gradual y for location. Remove the foreign bodies according to the guidance of nee-dle in the end. [Result]Total foreign bodies could be removed easily without any remains in these cases, and trauma recovered wel . 33 cases were removed out smoothly the non-metal ic foreign bodies for just one time, and 1 case for two times. [Conclusion] Removal of the superficial non-metal ic foreign bodies under the location of ultrasonic and the guidance of needle is a great method of security,operating simply,being worthy of popularization through comparing with other methods.

Surgical Treatment for Intra-Thoracic Migration of Acupuncture Needles

The aim of this study was to introduce the experience of diagnosis and treatment for patients with migrated acupuncture needle to pleural cavity and or lung parenchyma. We had treated 5 patients who had acupuncture needles in their thoracic cavity from January 2000 to September 2009. The mean age was 55.8 yr old. All patients suffered from the sequelae of the cerebrovascular accident and had been treated with acupuncture. They had drowsiness and hemiplegic or quadriplegic motor activity. Fever and dyspnea were main symptoms when referred to us. Diagnosis was made by the chest radiography and chest computed tomography which revealed straight metallic materials in their thoracic cavity. The needles were removed via thoracotomy or thoracoscopic procedures. Pleural decortications were also needed in four patients. Thoracoscopic surgery was successfully performed in two patients. After the removal all patients became symptomless. Although we experienced only five patients who have migrated acupuncture needles in thoracic cavity, we suggest that thoracoscopic removal of the needle with or without pleural decortication is the most optimal modality of treatment in those patients.

Avoiding direct contact between fingers and needle shaft in removing acupuncture needles with alcohol cotton-Assessment of risk reduction using a fluorescent agent- / 全日本鍼灸学会雑誌

[Objective]Using cotton to cover needle shafts when removing acupuncture needles is recommended in order to prevent blood contamination. However, the effect of risk reduction has not been confirmed by experimental studies. We, therefore, observed spreads of fluorescent agent, assumed as blood, with or without alcohol cotton to avoid direct contact between fingers and needle shaft. <BR>[Methods]Subjects were two blind acupuncturists and two acupuncture students. We asked them to insert acupuncture needles to people who played a role of a patient. Of the five acupoints needled, we put the fluorescent agent to one point, and asked the subjects to remove the needles. After all the needles were removed, we took photographs of all points needled and the subjects'hands in order to assess the spread of the fluorescent agent. 'We performed two sessions. In Session A, the subjects used alcohol cotton to cover a needle shaft so that their fingers did not contact the needles directly. In Session B, they did not use alcohol cotton. The subjects were not told that we used the fluorescent agent.<BR>[Results](1) In the forearm of those who were needled, adhesion of the fluorescent agent was not seen in three out of four subjects, in Session A. (2) In two of the four subjects who inserted the needles, the adhesion area of the fluorescent agent in the needle-supporting hands was smaller in Session A compared with Session B. (3) In three of the four subjects who inserted the needles, the adhesion area of the fluorescent agent in the needle-stimulating hands was smaller in Session A compared with Session B.<BR>[Conclusion]It is suggested that covering needle shaft with alcohol cotton during needle withdrawal suppresses the spread of blood contamination.

Report on a Meeting to Develop an Acupuncture Needle Standard for WFAS in Suzhou, China (September 16, 2010) / 全日本鍼灸学会雑誌

A WFAS meeting for a standard for acupuncture needles was held in Suzhou, China on September 16, 2010. A delegate from the Department of International Affairs of JSAM accompanied by three experts from an acupuncture needle manufacture (Seirin Corporation) attended the meeting with the purpose of requesting modifications of the draft. <BR>Suggestions from Japan included;(1) clearly define type of needle as 'Sterile filiform acupuncture needles for single-use', (2) not to limit the materials used for the needle body, (3) not to define upper/lower limitations in the size of the needle, (4) add some tests to guarantee safety such as limits for acidity or alkalinity and limits for extractable metals and an endotoxin test, (5) elimination of unnecessary tests regarding needles including hardness, puncture performance, strength, (6) change the term 'normative'in the quality testing method to 'informative'. <BR>According to the suggestions from Japan, modifications in the 'Scope'(defining type of needle as 'filiform') and in the 'Material'section (any kind of materials in accordance with ISO/TS 15510:2007) were annexed to the resolution. However, there is still a need to continue requesting modification of other issues to develop a better draft of the WFAS standard, which will be submitted to an ISO/TC 249 meeting in the near future.

Comments on the Thickness of Abdominal Acupuncture Needles / 针刺研究

In the present paper,the authors make a summary about the development of acupuncture needles in Chinese ancient times recorded in the literature,and have a discussion on the effect of the thickness of acupuncture needles on clinical the-rapeutic efficacy in accordance with modern medical theories,the development of its clinical application and by combining their own experience in acupuncture practice. They conclude that the thickness of the abdominal needle is a negligible factor influencing the therapeutic efficacy of the reinforcing-reducing manipulations. In the treatment of deficiency pattern disorders,a thinner acupuncture needle is suitable,while for excess syndrome,a thicker acupuncture needle is recommended. In the light of the patient's constitution and different state of clinical conditions,a flexible application of the acupuncture needle with different diameters is highly recommended in clinical practice. In this way,the clinical therapeutic effect would be improved much.

The efficacy of acupuncture treatment on pain and ability with osteoarthritis of the knee-Examination of the curative effect by the depth of an acupuncture needle- / 全日本鍼灸学会雑誌

[Objective]To evaluate the efficacy of the different depth of acupuncture on the motor function and the pain with osteoarthritis of the knee. <BR>[Design]Single blind randomized controlled trial.<BR>[Method]Subjects were randomly allocated to one of two groups. Acupuncture needles were inserted about 3mm in the superficial acupuncture group and 10 to 20 mm in the deep acupuncture group. Subjects in both groups received the treatments for ten minutes on ten tender points. Acupuncture sessions were performed once a week for 8 weeks and without treatment 4 weeks.<BR>[Outcome Measures]Pain intensity (visual analogue scale :VAS) , Objective evaluation of the motor function (Timed Up &Go test, 20m walking time, Time of going up and down stairs) and QOL (Western Ontario and MacMaster Universities osteoarthritis index :WOMAC).<BR>All measurements were recorded at baseline, 4th, 8th and 11thweek.<BR>[Result]Motor function improved significantly only in the superficial acupuncture group(P<0.05). The degree of pain decreased significantly in both groups (P<0.05). <BR>[Conclusion]Superficial acupuncture provided the improvements on pain and motor function and contributed to the QOL improvement. Therefore the superficial acupuncture would be suggested to be one of the most effective method for the acupuncture treatment of OA of the knee.

Study on the traditional Chinese medicine theory of floating acupuncture therapy / 中华中医药杂志

The emerging oating acupuncture therapy is one of the most innovative acupuncture therapy recently,with an exact e cacy to treat clinical pain.However,from current research of oating acupuncture therapy,several major misunderstandings and confusions exist.Studying from the perspective of 'Acupuncture needle reaches disease location',this paper integrates traditional Chinese medicine theory,and aims to promoting the development of the traditional Chinese medicine theory of oating acupuncture therapy.

Study on Acupuncture Needles Insulated by Coating Films / 全日本鍼灸学会雑誌

To develop an insulated acupuncture needle with low resistance that causes little pain, insulated needles for acupuncture were prepared by electrodeposition of acrylic coatings such as acrylic/fluorine, acrylic/melamine, acrylic/urethane, and acrylic/epoxy resins. Wettability of these needles and resistance to insertion into muscle model (PVA Hydro-gel, Oil dispersed hydro-gel, and Pig muscle) and human tissue were investigated. Wettability of these coating films was estimated from contact angles of water droplets on the film coating. Resistance to insertion of these needles into Hydro-gel gradually increased with increases in their contact angles. Oil dispersed hydro-gel and Pig muscle showed inverse results. When these needles were inserted into human tissue, the acrylic/fluorine coated needle showed the least resistance and patients felt almost no pain.

Gold Allergy to a Permanent Gold Acupuncture Needle

A 68-year-old female had slightly elevated, dusky erythematous nodules on the right infraorbital and the right temple area. Topical, intralesional corticosteroids and oral antihistamines provided temporary but incomplete improvement. Follow up biopsy, four months after the first visit revealed a tiny gold acupuncture needle lodged at the center of the nodule. Subsequent skull series revealed seven more linear radiopaque densities on the corresponding sites to the skin nodules. A patch test and an intradermal test with gold chloride showed strongly positive reactions. Removal of the embedded needles led to disappearance of the cutaneous nodules and itching sensation in seven days.

An experimental study on movement of broken acupuncture needles / 全日本鍼灸学会雑誌

An accidental break of an acupuncture needle is one of the most serious complication in acupuncture.<br>A German Shepherd weighed 25kg was anesthetized with pentobarbital.<br>Then, unused 7 needles of 1.0, 1.5, 2.0, 2.5, 3.0, 3.5 and 4.0cm long each were inserted at 7 acupuncture points.<br>The movement of broken acupuncture needles were observed by X-ray for 72 days and pathological examination of tissue surrounding broken needles was also done.<br>While broken needles inserted nearby the joints were found moving much around, others inserted in the region of straight bones stayed almost.<br>The dog was dissected 72 days after the preparation. Three broken needles were found just beneath the muscular fascia and two broken needles were in the subcutaneous tissue. Another broken needle in the lumbar region was penetrated into the lumbar spinal cord and the other needle in the region of neck was lost.<br>Pathological examination showed chronic inflammatory changes such as cellular infiltration and muscle fiber necrosis in the lumbar spinal cord and the thigh region, but little changes in the other four regions.