MEDICAL ACUPUNCTURE Volume 20, Number 4, 2008 © Mary Ann Ann Liebert, Liebert, Inc. DOI: 10.1089/acu.200 10.1089/acu.2008.0595 8.0595
Original Paper
Clinical Studies on the Indications of 33 Acupoints Zeng-bin Ma, MD, Yuan-yuan Zheng, MD, Liang-xiao Ma, MD, Nan-nan Guo, MD, Chun Li, MD, Yan-ping Wang, MD, Kai Cheng, MD, Huan Yang, MD, Wan-ning Liu, MD, Kim Leo Wi, MD, and Jiang Zhu, MD Editor’s Note: This article is an English reprint from the original Chinese article as it appeared in the Journal Chinese Acupuncture and Moxibustion in June 2008. Permission was granted to reprint this translated article in the journal of Medical Acupuncture. This is part of our cooperative Center Of Excellence effort between the University of Beijing, School of Medicine and Moxibustion, and the journal Medical Acupuncture. This was a large and tedious effort on behalf of our Chinese colleagues to study the actual indications and use of 33 acupuncture points. It reflects a most high level of coordination and effort to gather the data at many university centers and analyze it into the Chinese Compendium of Acu points. Most important question: were the ancient descriptions of these points accurate when analyzed in with our modern technological evaluations? This is what our colleagues set out to accomplish in a most labor-intensive and involved scientific manner. It is interesting to note that the style of this Chinese paper reflects a conception of research that deviates from the “West.” It is important that the reader be willing to accept that scientific methodologies are different and influenced by culture. We should be flexible to appreciate and to respect our Chinese colleagues’ contributions. Of course, there is no room for poor scientific research. All of us would agree. I apologize for any errors and inaccuracies that are a result of the translation effort. Richard C. Niemtzow, MD, PhD, MPH Editor in Chief
ABSTRACT Objectives: To verify the indications of 33 acupoints scientifically and provide definite clinical data for the indications of acupoints (which will be recorded in the Compendium of Acupoints of China). Methods: Randomized controlled clinical trials (RCTs) in multiple centers were performed. Results: Among a total of 52 studies, results of 40 studies showed the acupuncture-moxibustion (acumoxa) groups had better therapeutic effects than those in control groups. Results of 11 studies showed the acumoxa groups had similar therapeutic effects to those in control groups. Results of 1 study showed the control group had better therapeutic effects than that in acumoxa group. Conclusions: Needling a single acupoint to treat diseases and symptoms may have different therapeutic effects. Key Words: Acupuncture, Single Point, Clinical Study
School of Acupuncture and Moxibustion, Beijing University of Chinese Medicine, Beijing, China.
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INTRODUCTION
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Compendium of Acupoints of China was established in 2003 with funding from the State Administration of Traditional Chinese Medicine of China, including 2 parts of compiling the Compendium of Acupoints, and clinical studies on the indications of acupoints. HE PROJECT OF
METHODS Totally, there were 59 studies, which consisted of clinical sub-projects, 52 of them applied multi-center, randomized, and controlled design. Those 52 studies have been conducted for over 4 years; 540 acupuncture physicians and related staff from 116 hospitals in 19 provinces, municipalities, and autonomous regions took part in the 52 studies. The indications of 33 points were studied by randomized controlled trails (RCTs) in multiple centers. Thus, certain definite clinical data for the indications of certain acupoints were provided (which will be recorded in the Compendium of Acupoints of China) . Thirty-three commonly used acupoints and 36 diseases and symptoms were involved in the studies, including 30 meridian acupoints and 3 extraordinary acupoints, covering 12 meridians (except for the Lung Meridian of Hand- Taiyin and the Liver Meridian of Foot- Jueyin). The main contents of those studies follow.
Participants The 33 acupoints included: LI 4, LI 11, LI 15; ST 11, ST 25, ST 36, ST 37, ST 38, ST 40; SP 6, SP 8; HT 7; SI 1, SI 3; BL 13, BL 17, BL 35; KI 6; PC 6; SJ 6; GB 20, GB 24, GB 30, GB 40; CV 3, CV 12, CV 17; GV 14, GV 20, GV 26; Sifeng (EX-UE10), Sishencong (EX-HN1), and Taiyang (EX-HN5). The 36 diseases and symptoms studied in the projects were: the common cold, chronic pharyngitis, asthma in the respiratory system; hyperlipidemia, premature heartbeat, hypertension, shock in the cardiovascular system; adverse reaction in the stomach and intestines, chronic cholecystitis, peptic ulcer, constipation, intestinal irritation syndrome, ulcerous colitis, infantile anorexia and infantile malnutrition in the digestive system; urinary retention, chronic prostate hyperplasia, reducing clinical symptoms, insufficient lactation, lack of contraction of uterus, female urethral syndrome, primary dysmenorrhea and menopause syndrome in the genito-urinary system; goiter, side effects of chemotherapy and radio therapy in malignant tumor in the endocrine and immunity systems; depression due to stroke, insomnia, dysfunction of mobility after cerebral thrombosis, primary sciatica, migraine, central dizziness in psychological and nerve systems; periarthritis of shoulder, acute sprain of lumbar in the motor system, chronic urticaria, toothache, and high fever.
All 52 studies consisted of RCTs in multiple centers with follow-up. Electroacupuncture was applied in the treatment groups of 41 studies; regular acupuncture was applied in the treatment groups of 10 studies; moxibustion was used in the treatment group of 1 study. The studies were conducted in 116 hospitals; 540 acupuncture physicians and related staff were involved. Four controlling methods were applied in the clinical trials, including comparison methods between the acumoxa and drug therapy in 33 studies; comparison method between different points for exploring the specificity of points in 13 studies; placebo-controlled trials in 3 studies; normal controlled trials in 2 studies; and comparison method between acupuncture and transcutaneous electrical stimulation in 1 study.
RESULTS The results of clinical studies for 33 single acupoints were: 1. Heg Hegu LI LI 4 Wang et al1 found that applying electroacupuncture at LI 4 was effective for toothache. Its analgesic effect was immediate, but delay analgesic effect was more obvious. Wang et al 2 found that applying electronic acupuncture at LI 4 could extend the duration of continuous uterine contractions and shorten the average time of intermittence, resulting in less usage dosage of oxytocin. 2. Qu Quch chii LI 11 Song et al 3 found that applying electroacupuncture at LI 11 to treat chronic urticaria had better therapeutic effect than that of control group (using cetirizine) in the number and size of skin rashes, edema, itching, frequency, and duration. Yang et al found that applying electroacupuncture at LI 11 to treat hypertension had better therapeutic effect than that of control group by needling Heyang (BL 55). 3. Ji Jian anyu yu LI 15 Fang et al found that applying electroacupuncture at LI 15 was effective for shoulder omarthritis. The effect was better than that of the control group taking ibuprofen. 4. Qi Qish shee ST 11 He et al found that applying acupuncture at ST 11 to treat goiter had therapeutic effect. There was no significant difference between the acupuncture treatment group and control group (using thyroxine tablets) in thyroid ultrasonography, sTSH, FT 4, and FT 3. Acupuncture showed better effects in swallowing difficulties, throat irritation, fullness and distention of chest, and swelling of the thyroid gland. 5. Ti Tian ansh shu u ST 25 Liu et al found that applying electroacupuncture at ST 25 for diarrhea-predominant irritable bowel syndrome
INDICATIONS OF 33 ACUPOINTS
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had better effects in the total scores of symptoms, diarrhea, and abdominal distention than using SP 15. Zhang et al found that needling ST 25 to treat constipation had better effects in improving colonic transit time, relieving constipation, and better 6-month remote efficacy than those of the control group by taking lactulose liquid. Zusa Zu sanl nlii ST 36 Zhang et al found that electroacupuncturing ST 36, combined with granisetron hydrochloride injection to relieve the side effects of chemotherapy and radiotherapy in malignant tumors, had better therapeutic effect than that of granisetron hydrochloride injection control group. Acupuncture significantly inhibited nausea and vomiting caused by chemotherapy. Wu et al found that electroacupuncturing ST 36 had a definite clinical effect to prevent adverse reaction in the stomach and intestine during the process of gastroscope examination. Zhao et al found that moxibustion at ST 36 for the common cold was safe and reliable. It not only could reduce the incidence of common cold in the elderly, but also reduce the incidences of it and alleviate the symptoms. Shan Sh angj gjux uxu u ST 37 Lin found that acupuncturing ST 37 and combined sulfasalazine to treat ulcerous colitis had certain effects in improving ulcerative colitis symptoms, signs and the points score, the colonic mucosa, and blood integral state classification. classification. But compared with the effect of taking sulfasalazine in the control group, the difference was not significant. Tiao Ti aoko kou u ST 38 Guo et al4 found that taking anti-inflammatory analgesics and electroacupuncturing ST 38 to treat periarthritis of the shoulder had quick, safe, and stable effect, and its effect was better than only taking analgesic drugs. Shao et al found that applying electroacupuncture at ST 38 was effective for periarthritis of the shoulder. The shoulder disorders score standards (JOA) was used for results evaluation. Results showed that the effect was better than that of taking diclofenac sodium sustained-release tablets in the control group. Xuan et al found that electroacupuncturing ST 38 to treat periarthritis of shoulder could remarkably relieve shoulder pain. The recent, remote efficacy of sedating pain and improving joint function were significantly better than those taking nuofuding tablets in the control group. Feng Fe nglo long ng ST ST 40 Gan et al found that electroacupuncturing ST 40 to treat hyperlipidemia could improve the overall symptoms and reduce LDL. Zhang et al 5 found that electroacupuncturing ST 40 and taking pravastatin both had the therapeutic effect of reducing blood fat; the difference between them was not significant.
271 10. Sanyin Sanyinjia jiao o SP SP 6 Gao et al found that electroacupuncturing SP 6 had a rapid effect in improving signs and symptoms of acute urinary retention. Cheng et al found that electroacupuncturing SP 6 to treat perimenopausal syndrome has obvious therapeutic effects. Compared with oral drug therapy in the control group, acupuncture had specific effects on symptoms of flushing, insomnia, irritability, hot feeling in palm and sole, depression, dizziness, headache, palpitation, and itchy skin. Zhou et al 6 found that electroacupuncturing SP 6 to treat perimenopausal syndrome was safe and effective. Ma et al found that electroacupuncturing SP 6 could shorten the active period of the first stage of labor, ease labor pain, and reduce bleeding during the birth process and 2 hours after the labor. 11.. Di 11 Diji ji SP 8 Wu et al found that electroacupuncturing SP 8 to treat primary dysmenorrhea and taking ibuprofen both had good analgesic effect, and there was no significant difference between them in the clinical symptom score, visual analog score (VAS), and the total effective rate after 3 months’ treatment. 12.. Sh 12 Shen enme men n HT 7 Dong et al found that electroacupuncturing HT 7 to treat insomnia had a therapeutic effect. It prolonged the total sleep time, shortened the time to fall asleep, reduced the times of nights awake, improved sleep quality, reduced dreams, as well as significantly improving improving wakeup. 13.. Sh 13 Shao aoze ze SI 1 Wand et al 7 found that electroacupuncturing SI 1 to treat insufficient lactation had better effect than that of using LI 1 in the control group. Indications were that SI 1 was a special acupoint for insufficient lactation. 14.. Ho 14 Houx uxii SI 3 Wu et al8 found that electroacupuncturing SI 3 to treat acute lumbar sprain had better recent and remote therapeutic effect than that of taking MO (MOBIC) tablets in the control group in sedating lumbar pain and improving lumbar activities. 15.. Fe 15 Feis ishu hu BL1 BL13 3 Zhao et al found that electroacupuncturi electroacupuncturing ng BL13 to treat bronchial asthma (acute attacking stage) had a therapeutic effect. However, compared with the effect of taking theophylline sustained-release tablets, it showed no significant difference. 16.. Ge 16 Gesh shu u BL BL17 17 Lin et al found that electroacupuncturing BL 17 to treat the side effects of chemotherapy and radiotherapy in malignant tumors had therapeutic effects. It reduced the side effects caused by chemotherapy such as poor quality of life, physical decline, damage to the blood system, and gastrointestinal discomfort.
272 17.. Huiy 17 Huiyan ang g BL 35 35 9 Cen et al found that electroacupuncturing BL 35 to treat female urethral syndrome had better therapeutic effects than that of Huantiao (GB 30) or Shenshu (BL 23) in the control group in improving the I-PSS symptom score, emiction and urodynamic aspects. Better effects were found after 5 continuous sessions. 18.. Zh 18 Zhao aoha haii KI KI 6 Luo et al found that electroacupuncturing KI 6 to treat chronic pharyngitis was as effective as that of taking compound caoshanhu buccal tablet. Both improved the clinical symptoms of chronic pharyngitis. 19.. Ne 19 Neig igua uan n PC 6 Wang et al found that applying electroacupuncture at PC 6 for 10 continuous days may reduce the frequency of premature heartbeats, and had better therapeutic effects than that of Xuanzhong(GB 39) in the control group. Liu et al found that electroacupuncturing PC 6 relieved vomiting, throat discomfort, and other major reactions caused by gastroscopy. Acupuncture was simple, well-tolerated in patients, and a safe and effective natural therapy. Wang et al found that electroacupuncturing PC 6 to treat adverse reactions of the stomach and intestine was safe and effective. 20.. Zh 20 Zhig igou ou SJ 6 Zhang et al found that electroacupuncturi electroacupuncturing ng SJ 6 to treat constipation due to Qi deficiency had significant therapeutic effects in improving defecation intervals and time, degree of bowel and feces traits, and abnormal colonic transit tests. 21.. Fe 21 Feng ngch chii GB 20 Chen et al found that acupuncturing GB 20 had rapid effects on hypertension (first or second stages). There was significant differences in the effects of reducing blood pressure between the acupuncture treatment group and the control group. The control group, in taking (the Western medicine) metoprolol had better therapeutic effects. 22.. Ri 22 Riyu yuee GB GB 24 24 Li et al found that acupuncturing GB 24 to treat chronic cholecystitis had better therapeutic effects than that of the Kunlun (BL 60) in the control group in relieving pain and tenderness in the gallbladder. 23.. Hu 23 Huan anti tiao ao GB 30 30 Wang et al found that electroacupuncturing GB 30 to treat primary sciatica had a definite clinical efficacy in easing pain and relieving clinical symptoms. 24.. Qi 24 Qiux uxu u GB GB 40 40 Jia et al found that electroacupuncturing GB 40 to treat migraine had immediate analgesic effects; significantly better than Tianshu (ST 25) in the control group. 25.. Da 25 Dazh zhui ui GV 14 14 10 Xiao et al found that acupuncturing DU 14 to treat high fever could lower body temperature; its effect was better than that of the antipyretic control group.
MA ET AL 26.. Baih 26 Baihui ui GV 20 20 Tang et al found that applying acupuncture at GV 20 by using a penetrating technique, plus conventional Western medicine to treat dysfunction of mobility after cerebral thrombosis, had better therapeutic effects than the conventional Western medicine control group in total effects, Fugl-Meyer score, neurological impairment score, and ADL score. Zhang et al found that acupuncturing GV 20, plus conventional treatment to treat depression due to stroke, had better therapeutic effects than that of the stroke conventional treatment control group in overall effects and improving physical and mental anxiety. Zhao et al 11 found that acupuncturing GV 20 to treat depression due to stroke was as effective as that of taking difenidol. 27.. Re 27 Renz nzho hong ng GV GV 26 Fu et al found that electroacupuncturing GV 26, plus Western medicine to treat mild or moderate shock, had better therapeutic effects than that of Western medicine. Zhao et al found that acupuncturing GV 26 to treat acute lumbar sprain had better therapeutic effects. 28.. Zh 28 Zhon ongj gjii CV CV 3 Liu et al found that electroacupuncturing CV 3 to treat benign prostatic hyperplasia had significant therapeutic effects in improving the prostate symptom score, quality of life index, number of nocturia, urinary line status, lower symptoms, biggest urine flow, residual urine volume, and prostate volume. 29.. Zh 29 Zhon ongw gwan an CV CV 12 Niu et al12 found that acupuncturing CV 12 had therapeutic effects in treating peptic ulcer. Compared with the comprehensive and gastroscopy efficacy of the cimetidine control group, results showed no statistical difference. However, in the initial stage of treatment, the effect of acupuncturing CV 12 in improving stomach pain was superior to that of the cimetidine control group. The effects of the acupuncture group in improving chest pains and late GI symptoms was better than that of the cimetidine control group. 30.. Ta 30 Tanz nzho hong ng CV CV 17 Chen et al found that electroacupuncturing RN 17 to treat insufficient lactation had therapeutic effects in improving maternal breast filling, lactation, neonatal weight, reducing the times of artificial feeding and capacity, etc. Compared to the effects of the control group with milk-producing decoction, there was no significant difference. 31. Sis Sishen hencon cong g EX-HN EX-HN 1 Liu et al found that the efficiency of acupuncturing EXHN 1 to treat insomnia was 94.2%; PSG monitoring indicators and the SPIEGEL Scale score showed more improvement than the Sweet Dream Capsule drug group. Zhang et al found that acupuncturing EX-HN 1 to treat insomnia was effective; during treatment, it had significant effects on relieving insomnia and improving the quality of sleep.
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INDICATIONS OF 33 ACUPOINTS 32. Taiyan Taiyang g EX-H EX-HN N 5 Zhou et al found that electroacupuncturing EX-HN 5 to treat migraine of ascendant hyperactivity of Liver Yang had immediate analgesic effects. Zhao et al 13 found that electroacupuncturing electroacupunctur ing EX-HN 5 could treat central dizziness caused by vertebrobasilar arterial blood insufficiency, and improve vertigo symptoms and vertebrobasilar arterial blood. The effects were better than that of electroacupuncturing Ligou (LR 5) in the control group. 33. Sif Sifeng eng EXEX-UE UE 10 14 Liang et al found that acupuncturing EX-UE 10 of Four Hands to treat infantile malnutrition had certain effects in the signs and symptoms of malnutrition, loss of appetite, subcutaneous fat thickness, weight, and serum albumin concentration. Ma et al found that acupuncturing EX-UE 10 of Four Hands significantly improved the appetite and food intake of children, as well as children with significantly increased subcutaneous fat, The conditions of spirit, sleep, abdominal pain, sweat, and hair luster were also improved in varying degrees.
(overall follow-up effects of the treatment groups were significantly better than the control groups) in the follow-ups, accounting for 48.1%; 5 studies showed that the acupoints had partly better therapeutic effects than other controlled therapies in their follow-ups, accounting for 18.5%; 7 studies indicated that acupoints had similar therapeutic effects to the controlled therapies in their follow-ups, accounting for 25.9%; 1 study indicated that both groups had therapeutic effects without comparison in its follow-up, accounting for 3.7%; and 1 study showed that the treatment group had remote therapeutic effects in the follow-up, accounting for 3.7%.
Summary of the 33 Points
Points
(1) In the 52 studies, results of 40 studies showed the acumoxa groups had better therapeutic effects than those in control groups. Results of 11 studies showed the acumoxa groups had similar therapeutic effects to those in control groups. Results of 1 study showed the control group had better therapeutic effects than the acumoxa group. (2) There were 28 acupoints studied in comparison with the drugs (including ST 38 and GV 20). The results of 12 acupoints studies indicated that the effect of acumoxa groups was superior to that of drug control groups. Seven acupoints studies had similar effects in 2 groups. Nine acupoints studies indicated that acupuncture treatment could strengthen the role of drug therapy. One acupoint study indicated that the effect of the drug control group was superior to that of the acumoxa group. One acupoint study showed that the effect of acupuncture treatment was not obvious. There were 13 acupoints studied in comparison with the other acupoints. Results indicated that 13 acupoints had specific therapeutic effects on some diseases and symptoms. There were 3 acupoints studied in comparison with the placebo control group. Results indicated that the 3 acupoints had therapeutic effects, except for conciliative effects. Two acupoints were studied in comparison with blank control group. Results indicated that the 2 acupoints had therapeutic effects on the diseases and symptoms. One acupoint was studied in comparison with transcutaneous electrical stimulation. The result indicated that eletroacupuncture had a better effect. (3) There were 27 studies with follow-ups, accounting for 51.9%. The remainder of 25 studies were: no follow-ups, accounting for 48.1%; 13 studies of 27 had good effects
The single-point clinical studies involved commonly used 33 acupoints, including 30 Meridian acupoints and 3 Extraordinary acupoints, covering 12 Meridians (with the exception of the Lung Meridian of Hand- Taiyin and the Liver Meridian of Foot- Jueyin). Among the 33 points, 20 are acupoints located on the Yang meridians–60.7%; 4 are points located on the Yin meridians—12.1%; 6 acupoints are located on Conception Vessel and Governor Vessel—18.2%; 3 Extraordinary acupoints—9.0%. Within the 33 acupoints, 26 of them are specific points (no repeat count), including 6 Five-Shu points, 1 Yuan-Primary point, 2 Luo-Connecting points, 5 Front-Mu points, 1 Back-Shu point, 1 Xi-Cleft point, 1 Lower He-Sea point, 1 Eight Influential point, 1 Eight Confluence point, 7 Crossing points. The selection of points in those studies still showed that the main attention of clinical acupuncture studies was devoted to specific points, which is similar to the past. Since the clinical study of the scope of the acupoints remains relatively narrow, the study on more acupoints needs to be further expanded.
DISCUSSION In recent years, the studies of acupoints mainly focus on specificity of acupoints and stimulation techniques of acupoints, as well as single-acupoint studies. More attention was given to clinical studies of single acupoints. The clinical studies of the above-stated 33 Points Indications, which lasted for 4 years, could be considered as new achievements in the area of single-acupoint studies.
Critiques The previous clinical studies on indications of single acupoints used less electroacupuncture stimulation methods, but more manual acupuncture. They rarely described the reinforcing or reducing methods, which made the other studies hard to follow. Therefore, the experiments could not be adequately repeated. In the 52 studies, 41 of them were treated with electroacupuncture; 10 of them were treated with manual acupuncture. One study was treated with moxibustion. The
274 same electroacupuncture stimulating parameters were used in an experiment, so that the results of the study could be more objective and precise. However, in the above 33 clinical studies, the researchers disregarded the influence of stimulation volume and method to the clinical effect. It is expected that more consideration will be given to those factors to the clinical effect in the future.
Clinical Study Methods on the Indications of 33 Acupoints (1) All the clinical studies involved randomized, controlled, clinical trials in multiple centers. Previous studies on acupoints mostly studied the coordination of several acupoints, while single-acupoint clinical studies were relatively fewer, and the related literature was mostly about case studies. Meanwhile, most single-acupoint clinical studies did not have control groups and occurred as randomized, controlled clinical trials in multiple centers; thus, the results couldnot be proven reliable. The above clinical studies on 33 points all took randomized, controlled clinical trials in multiple centers, processed the data scientifically, and attained reliable results. However, according to previous clinical study literature, clinical studies of acupoints need to be systematized, such as clinical studies on the expansion of the indications of single acupoints, regularities of the indications, and mechanisms of the related efficacy. (2) Most previous clinical studies of acupoints were designed informally and there were no strict diagnostic criteria, participating criteria, exclusion criteria, and standards of evaluation—-which made the studies lacking in scientific evidence. The above clinical studies on 33 points primarily used nationally or internationally recognized standards which enhanced the reliability of the conclusion.
Control Design Nearly half of the previous studies of acupoints employed controls, which affects the credibility of the conclusion. In our studies, a total of 52 items adopted parallel controls and the control designs had 4 categories: blank control, placebo control, acupoint and drug control, acupoint and acupoint control. (1) The trials of blank control were an acupuncture group and a blank group. There are 2 such studies. (2) The trials of placebo-control composed of consolation acupuncture (electroacupuncture group and transcutaneous electrical stimulation in the control group in 1 study, electroacupuncture group and the consolation electroacupuncture control group in another study), and consolation moxibustion (moxibustion group and sham moxibustion control group in 1 study), excluding the acupuncture consolation role to prove the validity of the acupoints. (3) In acupoint and drug control trials, there were 2 categories: herbs control and medications control. There were
MA ET AL 5 trials of herbs control (including 4 trials of mere acupuncture group with oral herbs group, and 1 of acupuncture plus oral herbs group with mere oral herbs group), and 27 trials of medications control (of those, 17 of mere acupuncture group with oral medications group, 9 of acupuncture plus oral medications group with mere oral medications group, 1 of acupuncture plus oral medications group with same medications plus other medications group). (4) The acupoint controlled trials are divided into 4 categories, A. Acupoint treatment group to correlative acupoint control group trails; B. Acupoint treatment group to non-correlative acupoint control group trials; C. Acupoint treatment group to non-points control group trials; and D. Acupointgroup plus single acupoint treatment group to acupoint-group control group. Acupoint treatment group to correlative acupoint control group trials refers to the comparison of efficiency of 2 acupoints which are commonly used in treatment of the same disease (2 studies used this method). Acupoint treatment group to acupoint non-correlative control group trials refers to the comparison of efficiency of 2 acupoints; the acupoint treatment group is commonly used in treatment of the disease, while the acupoint in the control group is seldom used in treatment of the disease (10 studies used this method). Acupoint treatment group to non-points control group trials refers to the comparison of efficiency of 2 acupoints; the orientation of the 2 acupoints have different meanings. The nonacupoints in the control group trial (neither on the meridian, nor an extraordinary point, nor an Ah Shi point) compares the real acupoints either located in the meridian or is an extraordinary point. There was 1 study that employed this method. This kind of trials proves the specificity of acupoint in treatment of the certain disease. Acupoint-group plus single-acupoint treatment group to acupoint-group control group trial (1 study used this method) suggested that the single point and point-group had joint satisfactory effect for a certain disease. (5) There was 1 study that applied transcutaneous electrical stimulation in the control group. According to the present clinical study of acupoints, the process of acupuncture is a visible procedural treatment; however, to implement a control experiment properly is difficult, and it is different from placebo control in which patients could clearly know whether they received acupuncture treatment. Hence, if we want to comply with the principle of the blind method, we would face many operational difficulties. It is necessary to continuously develop the methodology to overcome the difficulties in the future.
Clinical Effects The clinical studies on 33 points achieved mostly positive results. Only 1 study showed the effects of acupuncture to be inferior to the drug control group. One study showed that acupuncture did not attain the treatment effect. Perhaps it was due to the acupoints in those studies were usually effective, verified by the past clinical practice. The results of
INDICATIONS OF 33 ACUPOINTS those clinical studies proved the effectiveness of the 33 acupoints on the one hand; conversely, it also proved the superiority of acupuncture therapy to certain diseases.
Clinical Follow-up Follow-up descriptions were fewer than reported in previous studies; thus, the remote effects of acupuncture were not clear. The 51.9% of the above clinical studies on the indications of 33 acupoints conducted follow-ups with a series of follow-up data. Hence, the remote effects of acupuncture could be scientifically tested. Clinical studies on the indications of 33 acupoints demonstrated that acupuncturing single acupoints to treat diseases and symptoms had therapeutic effects during a period of observation. This largest-scale single-acupoints clinical studies revealed progress in the study of acupoints in accordance with their multi-center, randomized, and controlled designs. Compared with the past clinical studies of single acupoints, these clinical studies were more standardized. At the same time, prior studies trained a group of acupuncture clinical study personnel—-laying the foundation for the future clinical studies of acupoints. It was expected that it would strengthen and expand the clinical study of single-acupoints, and fully integrate with evidence-based medicine and clinical epidemiology methods. Thus, the Chinese acupuncture studies would be internationally recognized and would promote the internationalization of Chinese acupuncture and accelerate new progress.
ACKNOWLEDGEMENTS This work was supported by the study project of Com pendium of Acupoints of China , State Administration of Traditional Chinese Medicine of China (Grant No. 27, in 2003), and China National Basic Research Program (Program 973, Grant 2006CB504503).
275 Acupuncture. Shanghai Journal of Acupuncture and Moxibustion . 2005;24(8):17–18. 4. Guo C-q, Zhang Zhang F-m, Sha Y, et al. Randomized Randomized controlled trials of acupuncture at Tiaokou ST 38 for treatment of periarthritis of shoulder. Chinese Acupuncture & Moxibustion . 2006;26(8):544–546. 5. Zhang H-x, Huang Huang G-f, Zhang Zhang T-fa, et al. Clinical Clinical effectiveeffectiveness of electroacupuncture at Fenglong Point in the treatment of hyperlipidemia. Chinese Journal of Rehabilitation . 2006; 2l(6):372–373. 6. Zhou J, Qin Z-y, Li Wei-li, et et al. Clinical Clinical observation observation on therapeutic effect of electroacupuncture at Sanyinjiao SP 6 on perimenopausal syndrome. Chinese Acupuncture & Moxibustion . 2006;26(9):617–620. 7. Wang Hong-c, Hong-c, An J-m, Han Han Y, et al. Multicent Multicentral ral randomized randomized controlled studies on acupuncture at Shaoze SI 1 for treatment of postpartm hypolactation. Chinese Acupuncture & Moxibustion . 2007;27(2):85–88. 8. Wu Y-c, Zhang Zhang B-m, Wang Wang C-m, et al. Observation Observation on shortshortterm and long-term therapeutic effects of electroacupuncture at Houxi SI 3 on acute lumbar sprain. Chinese Acupuncture & Moxibustion . 2007;27(1):3–5. 9. Cen J, Chen Y-l, Y-l, Ha L-p, et al. Clinical Clinical study on specificity specificity of Acupoint Huiyang in treating unstable bladder. Shanghai Journal of Traditional Chinese Medicine. 2007;41(2):38–40. 10. Xiao L, Jianc Jianc G-l, Xinc J, et al. Effects of acupuncture acupuncture in in the treatment of common cold combined with high fever. Chinese General Practice . 2007;10(8):493–495. 11. Zhao H, Zhao Zhao W-l. Clinical Clinical study on post post stroke depression depression by Acupuncturing Baihui Point DU20. Chinese Traditional Chinese Medicine . 2007;25(2):275–276. 12. Niu H-y, Yang Yang M, Qiang B-q, et al. al. Multi-central Multi-central randomized controlled trials of acupuncture at Zhongwan CV 12 for treatment of peptic ulcer. Chinese Acupuncture & Moxibustion . 2007;27(2):89–92. 13. Zhao H, Liu Z-s, Yang T. Clinical Clinical study study on treatment treatment of vertebral-basilar insufficiency with electro-acupuncture on TAIYANG. Journal of Clinical Acupuncture. 2005;21(10): 8–9. 14. Liang F-r, Xia Xia X-h, Peng X-h, et al. A Multi-central Multi-central randomrandomized controlled study on acupuncturing at Sifeng (EX-UE 10) for treatment of infantile malnutrition. Chinese Acupuncture & Moxibustion . 2006;26(1):3–7.
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Address correspondence to: Professor Jiang Zhu, MD School of Acupuncture and Moxibustion Beijing University of Chinese Medicine 11 Bei San Huan Dong Lu Beijing 100029, PR China E-mail:
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