The objectification of ashi point diagnosis and treatment / 中国针灸

Ashi points play a significant role in the clinical localization and qualitative diagnosis of acupuncture, as well as in selecting acupoints along the meridians and applying tonifying or reducing techniques. This paper introduces the theoretical basis and existing technical methods of objectification of ashi point diagnosis and treatment. It proposes that using sensory quantitative testing to determine the temperature and tenderness thresholds of ashi points could help to identify the pathological characteristics of "cold" "heat" "deficiency" or "excess" of ashi points. In addition, the possibility of objectification of ashi point diagnosis-treatment plan is explored from three perspectives, precision of selection of ashi point therapy, objectification of effect evaluation of ashi point analgesia, and differentiation of the studies on ashi point analgesic mechanism, aiming to provide new research ideas for the modernization of traditional Chinese acupuncture.

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.

Literature review and application experience of needling the Belt Vessel for low back pain / 针灸推拿医学（英文版）

Objective: To explore the feasibility of needling the Belt Vessel (BV) for low back pain. Methods: The relevant literature was systematically reviewed; the relationship between the BV and low back pain was illustrated; the clinical features of BV-related low back pain as well as the key points of acupoint selection in treatment were summarized, and the efficacy of needling the BV for treating low back pain was observed. Results: The BV is closely related to low back pain. The main clinical manifestations of BV-related low back pain include sagging distension in the low back, enlarged abdomen, and pain radiating to the groin. The main acupoints for treating low back pain via needling the BV include Mingmen (GV4), Wushu (GB27) and Ashi points near the transverse process of the third lumbar spine. Needling the BV can swiftly and effectively relieve both the low back pain and associated symptoms. Conclusion: Needling the BV can effectively alleviate the typical BV-related low back pain.

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.

Clinical experience of Professor Shao Jing-ming: a master of acupuncture-moxibustion / 针灸推拿医学（英文版）

Professor Shao Jing-ming had practiced Chinese medicine for more than 80 years with rich clinical experience and exquisite acupuncture techniques. From his clinical experience, Professor Shao's clinical features can be summarized as the followings: attaching importance to the theory of meridians and collaterals, combining pattern identification and disease identification, using fewer acupoints for treatment, and using Ashi point and Hegu (LI 4) to treat goiter. He emphasized the priority and sequence in acupoint-selection and manipulation. In treatment of epilepsy, he proposed to treat it according to the situation and paid great attention to the special function of the extraordinary acupoints. During the onset, it should be managed by calming the mind and controlling the symptoms; during the remission period, acupuncture and drugs should be applied simultaneously to regulate qi-blood and yin-yang, so as to reduce the frequency of attacks. He believed that acupuncture manipulation be one of the key factors in achieving the efficacy. In treatment of the motive diseases, such as convulsions and cramps, acupuncture with static and longer needle-retaining time should be adopted to control the limb movement, to strengthen the stimulation and to obtain a long-term efficacy. Professor Shao Jing-ming's medical records range from internal medicine, external medicine, gynecology and pediatrics, listing various refractory diseases effectively treated by him. Professor Shao was a moral and erudite Chinese medicine master, and his clinical experience is worthy of inheritance and development.

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.

Learning the new by restudying the old: discussion on "consolidating tendons when tendons involved in disorders" / 中国针灸

In order to better understand and implement the treating principle of acupuncture as "consolidating tendons when tendons involved in disorders", the author explored the necessity of this principle in view of "the depth of disorder and depth of needle insertion" through explaining the meanings of it in the classic literature. In combination with the clinical experience, three recognitions were proposed. When treating tendon disorder, the correct recognition of disease is very important. The coordination of points and the distal points enhances the therapeutic effects. Besides, the modern anatomic knowledge is assisted to the selection of acupoints. The study results enrich the connotation of this treating principle, explore the approach to the clinical treatment of the disorders of bones, joints and soft tissues and improve the therapeutic effects.

Clinical Observations on Acupoint Selection at Distant Places and Local Tenderness Points for Treatment of Migraine Without Aura / 上海针灸杂志

Objective To investigate the efficacy of acupoint selection at distant places and local tenderness points in treating migraine without aura.Method Sixty patients were randomly allocated, using a random number table, to two groups, 30 cases each. The treatment group received acupuncture at distant points selected along meridians and local tenderness points and the control group, acupuncture at conventionally selected points. The therapeutic effects were evaluated using the visual analogue scale (VAS) and the short-form McGill Pain Questionnaire (SF-MPQ).Result After treatment, the VAS pain score was lower in the treatment group than in the control group; there was a statistically significant difference (P<0.05). The total efficacy rate was 93.3% in the treatment group and 73.3% in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion Both acupuncture at distant points selected along meridians and local tenderness points and acupuncture at conventionally selected points have a certain therapeutic effect on migraine, but the former produces a better effect than the later and can markedly relieve the pain and improve the quality of life in the patients. The outcome of this study provides a certain reference value for clinical treatment of this disease.

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>

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.

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.

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>

Therapeutic Observation of Pricking Anti-Ashi Points with Fire Needles for Acute Lumbar Sprain / 上海针灸杂志

Objective To observe the clinical efficacy of pricking anti-Ashi points with fire needles in treating acute lumbar sprain.Method Seventy-six patients with acute lumbar sprain were randomized into a treatment group and a control group, 38 cases in each group. The treatment group was intervened by pricking anti-Ashi points with fire needles, while the control group was by warm needling. The Visual Analogue Scale (VAS) and Roland-Morris Dysfunction Questionnaire (RMDQ) were adopted to evaluate lumbar pain and dysfunction after 1-day and 5-day treatment, and the clinical efficacies were compared between the two groups.Result Respectively after the first treatment session and 5 treatment sessions, the VAS and RMDQ scores were significantly changed in both groups (P<0.01). Respectively after the first treatment session and 5 treatment sessions, the VAS and RMDQ scores in the treatment group were significantly different from that in the control group (P<0.05). The total effective rate and recovery rate were respectively 94.7% and 63.2% in the treatment group, versus 86.8% and 42.1% in the control group, and the differences were statistically significant (P<0.01).Conclusion Pricking anti-Ashi points with fire needles is an effective method in treating acute lumbar sprain, and it can produce a significant real-time analgesic effect.

Observations on the Efficacy of Acupuncture plus Ashi Point Pricking Bloodletting in Treating Acute Gouty Arthritis / 上海针灸杂志

Objective To investigate the clinical efficacy of acupuncture plus ashi point pricking bloodletting in treating acute gouty arthritis.Methods Seventy patients with acute gouty arthritis were randomly allocated to a treatment group of 38 cases and a control group of 32 cases. The treatment group received acupuncture plus ashi point pricking bloodletting and the control group, routine medication. Blood uric acid and C reaction protein contents were measured in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Results There were statistically significant differences in blood uric acid and C reaction protein contents after one and two courses of treatment compared with before treatment in the two groups (P<0.01). After two courses of treatment, there was a statistically significant difference in comparing C reaction protein contents between the two groups (P<0.05). The total efficacy rate was 84.2% in the treatment group and 81.3% in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion Acupuncture plus ashi point pricking bloodletting is an effective way to treat acute gouty arthritis.

Therapeutic Observation of Triple Needling plus Centro-square Needling for Hemifacial Spasm / 上海针灸杂志

Objective To observe the clinical efficacy of triple needling and centro-square needling in treating hemifacial spasm. Method Sixty-eight patients with facial spasm were randomized into a treatment group and a control group, 34 in each group. The treatment group was intervened by centro-square needling at topical Ashi points and triple needling at Yifeng (TE 17) on the affected side; the control group was intervened by regular acupuncture. The two groups were treated once a day, 10 times as a treatment course, for 3 courses in total. Cohen Albert grading scale was adopted to evaluate the spasm intensity before and after the intervention, and the clinical efficacies were then compared.Result After intervention, there was a significant difference in comparing the spasm intensity between the two groups (P<0.05). The significant improvement rate was 88.2% in the treatment group versus 50.0% in the control group, and the difference was statistically significant (P<0.05).Conclusion Triple needling plus centro-square needling is an effective method in treating hemifacial spasm. This method uses less points, but it produces a high efficacy, strong pertinence, and is easy-to-operate.

Therapeutic observation of superficial needling for hemifacial spasm / 针灸推拿医学（英文版）

Objective:To observe the therapeutic efficacy of superficial needling in treating hemifacial spasm. Methods:Eighty patients with facial spasm were randomized into two groups by the random number table, 40 cases in each group. The observation group was intervened by superficial needling at local Ashi points and wrist-ankle acupuncture at the Upper 1, Upper 2 and Upper 3 points; while the control group was by ordinary acupuncture. For both groups, the treatment was given once a day, 7 times as a treatment course, and the therapeutic efficacy was evaluated after 3 courses. Results:The total effective rate and recovery rate were respectively 97.5% and 57.5% in the observation group versus 85.0% and 37.5% in the control group, and the differences were statistically significant (P Conclusion:Superficial needling can produce a more significant efficacy in treating hemifacial spasm than ordinary acupuncture.