Overview of researches on central action mechanism of needling Zusanli(ST 36)

The contents about the central action mechanisms of needling Zusanli（ST 36） were sorted by summarizing the relevant literatures published in the past 10 years, and it was found that： by comparing acupuncture at Zusanli（ST 36）, other acupoints or sham points, most studies showed that Zusanli（ST 36） had relatively specific characteristics in the brain function response; studies on the central action mechanisms of Zusanli（ST 36） were mainly focused on sequelae of cerebral apoplexy, pain, gastrointestinal diseases, weight loss and drug addiction withdrawal and so on; acupuncture manipulations, stimulation methods, individual differences, stimulation quantity, and stimulation duration, etc. could also induce different brain function responses; acupuncture at Zusanli（ST 36） had an after-working effect, also called long-term effect, but with poor repeatability. So, it was suggested that the future studies should focus on the factors that affect the clinical efficacies and experimental results, including the compatibility effects of the acupoints, reproducibility of research results, sample size, acupuncture methods, long-term effects and disease entities.

Study of the thermal pain threshold latency of acupoints based on Fei Teng Ba Fa

Objective： By applying moxibustion to the eight confluent points in different periods of time, to observe the changes in thermal pain threshold latency of acupoints based on Fei Teng Ba Fa. Methods： A total of 468 healthy college student volunteers received moxibustion at the eight confluent points in three different periods of time, i.e. Chen （7：00-9：00）, Wu （11：00-13：00） and Xu （19：00-21：00）. The thermal pain threshold latency was adopted to measure the changes in pain threshold of the eight confluent points under different conditions （different periods of time, different genders, different acupoints and different states of the acupoints） based on Fei Teng Ba Fa. Results： Finally, thirty subjects dropped out and 438 subjects were included. The comparison of thermal pain threshold latencies of the eight confluent points in the same opening or closing state based on Fei Teng Ba Fa： latencies of the closing points and adjunct points were significantly different in different periods of time （P〈0.05）, the latencies of the males were significantly longer than those of the females （P〈0.05）; there was no significant difference in the latency between the left and right sides （P〉0.05）; in the female group, there was a significant difference in the latency between the lower-limb points and the upper-limb points （P〈0.05）. The comparison of thermal point threshold latencies of the eight confluent points in different opening or closing state： in the period of Wu （11：00-13：00）, the latencies of the opening points were significantly longer than those of the closing points and adjunct points （P〈0.05）; for men, their opening and closing points had significantly longer thermal pain threshold latencies than their adjunct points （P〈0.05）; despite the gender, the latencies of the upper limb opening and closing points were significantly longer than the latency of the adjunct points （P〈0.05）; in the female group, the latencies of the lower-limb opening points were significantly shorter than those of the lower-limb closing and adjunct points （P〈0.05）. Conclusion： Based on Fei Teng Ba Fa, the pain thresholds of the eight confluent points vary in different periods of time, gender, acupoint location and opening/closing state, which can be taken as the evidence of making time-based acu puncture-moxibustion prescriptions.

Study on the body surface temperature variation patterns of the meridian acupoints related to the physiological status of the uterus

Objective:By observing the body surface temperature changes of different meridian acupoints located at the same or adjacent spinal segments of the uterus during the whole storing and releasing process of the uterus under normal physiological condition by the infrared thermal imaging technology,to explore the specific patterns that the functions of Zang-fu organs are reflected on the biophysical characteristics of acupoints,and to enrich the functional specificity theory of the meridian acupoints,thus to provide a reference for discussing the biophysical characteristics of meridian acupoints associated with the menstrual cycle in healthy female college students.Methods:Ninety healthy subjects were included.Infrared thermal imaging device was used to detect the body surface temperature of the Yuan-Primary points,the Xi-Cleft points,the crossing points,the non-specific points,the unrelated meridian acupoints and the non-meridian non-acupoint points of the three yin meridians of foot located at the same or adjacent spinal cord segment with uterus,during the menstrual phase,the follicular phase,the ovulation phase and the luteal phase.The absolute skin temperature difference between the left and right acupoints with the same name was used as the main outcome indicator.Results:The temperature difference between left and right Diji(SP 8,the Xi-Cleft point of the Spleen Meridian)during the ovulation phase was significantly higher than that during the other 3 phases(all P<0.05).There was no statistically significant difference in the temperature difference between the other meridian acupoints and non-meridian non-acupoint points during the 4 phases(all P>0.05);the absolute temperature difference value of each meridian acupoint was not statistically different from each other in the same phase(all P>0.05).Conclusion:The temperature of Diji(SP 8)specifically reflected the onset of ovulation,and the thermal characteristics of Diji(SP 8)specifically reflected the physiological changes of uterus.The meridian acupoints reflecting the performance of Zang-fu function is not only associated with the spinal cord segment innervating the acupoints,but also associated with the characteristics of the acupoints and the meridians to which the acupoints belong.

Study on the acupoints belonging to the three yin meridians of foot reflecting the variation pattern of uterine qi and blood in women with moderate constitution

Objective:To observe the blood perfusion volume variation pattern in the body surface microcirculation at the Yuan-Primary and the Xi-Cleft points during the menstrual cycle in female college students with moderate constitution under normal physiological state of the uterus;to explore the specific laws of the body surface microcirculation at the Yuan-Primary and Xi-Cleft points in response to the uterine qi and blood changes under normal physiological conditions,and to provide the experimental basis for the specificity of acupoints reflecting the uterine function.Methods:Forty-three healthy and moderate constitution female college students with regular menstrual cycles,without dysmenorrhea and not yet giving birth were recruited.Bilateral Yuan-Primary points[Taichong(LR 3),Taibai(SP 3)and Taixi(KI 3)]and Xi-Cleft points[Zhongdu(LR 6),Diji(SP 8)and Shuiquan(KI 5)],belonging to the three yin meridians of foot and adjacent to the spinal cord segment of the uterus,were selected as the detection acupoints;the crossing point of the three yin meridians of foot[Sanyinjiao(SP 6)],the uterus-related meridian acupoint[Xuehai(SP 10)],the uterus-non-related meridian acupoint[Xuanzhong(GB 39)],and the non-meridian non-acupoint point were selected as the control points.The laser speckle blood flow imaging technique was used to monitor the blood perfusion volume in skin microcirculation at the above points at the menstrual,follicular,ovulatory,and luteal phases of the subjects.Results:The blood perfusion volume in the body surface microcirculation at the right Zhongdu(LR 6)at the ovulatory phase was higher than that at the menstrual,follicular and luteal phases(all P<0.05);there was no significant difference in the microcirculation blood perfusion volume at the other points among different phases(all P>0.05).Conclusion:The blood perfusion volume in the body surface microcirculation at Zhongdu(LR 6),the Xi-Cleft point of the Liver Meridian,shows a specific response to qi and blood changes in the uterus of women with moderate constitution.

Research advances in the brain mechanisms of acupuncture effects based on the BOLD-fMRI technology

By summarizing the recent literatures on brain mechanisms with acupuncture intervention based on blood oxygenation level-dependent(BOLD)-functional magnetic resonance imaging(fMRI),the BOLD-fMRI examination and analysis methods,the points to be acupunctured,the corresponding meridian activation regions,the specific intensity range,functions and indications of the acupoints,the manifestation of'bi-directional regulation'characteristics,fMRI performance of chronergy,laterality and needling qi of acupuncture were reviewed to provide the ideas for future research in this area.

BASIC STUD Peculiar Phenomena During Resistance Detection of Acupoints

Studying on resistance specificity of human acupoints is one of the major subjects in the research on acupoint specificity. Even since a long time ago, many methods have been put forward in the detection of acupoint resistance specificity. From the vertical lengthways of the acupoint structure, the methods and means are put forward to detect the acupoint resistance in a series of studies. In the studies, some peculiar phenomena are found out in the detection of the acupoint resistance, and some phenomena are interrelated with the volume conductor characteristics of the human body, and some phenomena might be interrelated with the detecting methods and means. By the summary and analysis of those peculiar phenomena, references are offered to the relevant researchers engaged in the detection of the acupoint resistance.

Low-frequency fluctuation amplitude analysis of resting-state fMRI for functional brain response differences between acupuncture and moxibustion at Zusanli(ST 36) in patient with functional dyspepsia

Objective： To compare and analyze functional brain response characteristics by applying acupuncture or moxibustion to Zusanli（ST 36） in patients with functional dyspepsia（FD） and investigate the differences of central action mechanism resulting from acupuncture or moxibustion.Methods： A total of eligible 24 FD cases were divided into two blood-oxygen-level dependent（BOLD） sequences for functional magnetic resonance imaging（fMRI） scan. The amplitude of low frequency fluctuation（ALFF） analyses were conducted on the data of location phase, structure phase, resting state before acupuncture/moxibustion, working state during acupuncture/moxibustion and resting state after acupuncture/moxibustion using Data Processing Assistant for Resting-State fMRI（DPARSF） software.Results： Acupuncture and moxibustion produced significant differences in functional brain response. The working state during acupuncture/moxibustion mainly decreased ALFF values in the right supramarginal gyrus, right superior parietal lobule, right frontal gyrus, upper right occipital lobe, right precuneus and right cingulate gyrus. At the same time, it increased ALFF values in the left cerebellum, right caudate nucleus, right cerebellum and left inferior gyrus. The differences during the resting state after acupuncture/moxibustion were significantly smaller than the working state in intensity and size. It mainly resulted in decrease in ALFF values in the right postcentral gyrus and right supramarginal gyrus and increase in ALFF values in the left precuneus, orbital part of inferior frontal gyrus and right cerebellar peduncles.Conclusion： Needling and moxibustion at Zusanli（ST 36） can produce significant differences in immediate functional brain response.

Effect of herbal cake-partitioned moxibustion on MEK1/2 and ERK1/2 expressions of gastric tissues in rats with spleen deficiency syndrome

Objective： To observe the effect of herbal cake-partitioned moxibustion on the expressions of mitogen-activated protein kinase （MEK：1/2） and extracellular regulatory protein kinase （ERK：1/2） in gastric tissues of rats with spleen deficiency syndrome, and to explore the possible mechanisms of herbal cake-partitioned moxibustion in treating spleen deficiency syndrome. Methods： Sixty Sprague-Dawley （SD） rats were randomly divided into a blank control group （group A）, a model group （group B）, a ranitidine group （group C）, and a herbal cake-partitioned moxibustion group （group D） by random digit, 15 rats in each group. Rat models of spleen deficiency syndrome were made by intragastric administration of 4℃ 200% concentrated Da Huang （Radix et Rhizoma Rhei）. After successful modeling, the rats in group C were treated with 25 mg/（kg.bw） ranitidine by intragastric adminstration and rats in group D were treated with herbal cake-partitioned moxibustion at Zusanli （ST 36） and Zhongwan （CV 12）, for 8 d. Excepted for rats in group A, all the other rats were treated with indomethacin at 5 mg/（kg.bw） at 8：00 a.m. on the second day after finishing all the intervention and sacrificed 7 h later to isolate the stomach. Histopathological changes of the gastric tissues were observed under light microscope after hematoxylin-eosin （HE） staining. The protein expressions of MEK：1/2 and ERK：1/2 in the gastric tissues were detected by immunohistochemistry. Results： After intervention, the gastric mucosal injury in group B was significantly severer than that in group A, with large breakage and ablating; the damage of gastric mucosa was decreased in group C compared with group B; the gastric mucosal surface remained relatively complete, and the status of breakage and ablating was significantly improved. After intervention, compared with group A, the protein expressions of MEK：1/2 and ERK：12 in gastric tissues of the other groups were significantly higher （P〈0.01）. Compared with group B, the protein expressions of MEK：1/2 and ERK：1/2 in group C and D were significantly higher （all P〈0.01）. Compared with group C, the protein expressions of MEK：1/2 and ERK：1/2 in group D were significantly higher （P〈0.01）. Conclusion： Herbal cake-partitioned moxibustion promotes the repair of gastric mucosa in rats with spleen deficiency syndrome, via improving protein expressions of MEK：1/2 and ERK：1/2 in gastric tissues, as well as activating MEK/ERK signaling pathway.

Initiation mechanisms of acupuncture effect:a literature review of basic studies

Objective:To summarize the research status of the changes in local microenvironment of acupoints caused by acupuncture,provide theoretical guidance for the initiation mechanisms of local acupuncture effect at acupoints.Methods:Using acupuncture,acupoint as key words to search China National Knowledge Infrastructure(CNKI),Wanfang Academic Journal Full-text Database(Wanfang),Chongqing VIP Database(CQVIP),PubMed and other databases,the representative articles were selected for review.Results:Acupuncture could excite afferent nerves,activate cells,and promote the release of chemical substances like neuropeptide,hormone,cytokines,etc.in the local site of acupoints.Besides,it may cause mechanical deformation of connective tissues,and change chemical ions as well as ion channels.Conclusion:The microenvironment changes around acupoints are crucial to acupuncture effect;the concept of'acupoints network'can be used to objectively describe the local changes around the acupoints after acupuncture.

Influence of different-distance mild moxibustion at Zusanli(ST 36) on functional brain imaging in healthy population

Objective： To explore the beneficial regulatory effect of mild moxibustion from different distances at Zusanli（ST 36） of healthy population on the functions of temperature-related brain regions. Methods： In 20 recruited healthy subjects, the change of the temperature-related brain regions induced by mild moxibustion from different distances at Zusanli（ST 36） was observed by functional magnetic resonance imaging（fM RI）. Results： In comparison of the values in amplitude of low-frequency fluctuation（fA LFF） during and before moxibustion, it has been found that in moxibustion of 2 cm distance, fA LFF value increased in the brain regions of the left anterior cingulated cortex and lateral surrounding cerebral regions, and fA LFF value decreased in the cerebral regions of the peripheral cortex of the calcarine fissure; in moxibustion of 3 cm distance, fA LFF value increased in the brain regions of the right and medial side and paracingulated gyrus, and fA LFF value decreased in the cerebral zone of the left middle temporal gyrus; in moxibustion of 4 cm distance, fA LFF value increased in the brain regions of the right and medial and paracingulated gyrus; and in moxibustion of 5 cm distance, fA LFF value increased in the brain regions of the left hippocampus. In comparison of the value of regional homogeneity（ReH o）, it has been found that in moxibustion of 2 cm distance, ReH o value increased in the cerebral zone of the posterior lobe of the right cerebellum, and ReH o value decreased in the cerebral zone of the right occipital lobe; in moxibustion of 3 cm distance, ReH o value increased in the brain regions of the left cerebellar posterior lobe and left frontal lobe, and ReH o value decreased in the cerebral zone of the right inferior temporal gyrus; in moxibustion of 4 cm distance, ReH o value increased in the brain regions of the right superior frontal gyrus and ReH o value decreased in the brain regions of the right parietal lobe and angular gyrus; in moxibustion of 5 cm distance, ReH o value increased in the cerebral zone of the right frontal lobe and ReH o value decreased in the cerebral zone of the right brainstem. Conclusion： In moxibustion of 3 cm distance, the changes in the brain regions basically conform to the transmission route of body trunk temperature.

Study on metabolic intensity value changes of points on the face using thermal chromatography technology

Objective： To observe the changes of metabolic intensity value of points on the face before and after needling bilateral Hegu （LI 4） in healthy people and provide scientific basis for association between Hegu （LI 4） and face/mouth. Methods： A total of 45 healthy college students were selected in this study. Using medical thermography and Pennes bio-heat transfer model, the infrared thermograph images on the face before and after needling bilateral Hegu （LI 4） were collected to observe the distribution of metabolic intensity value on the face before acupuncture and changes in these values after needling bilateral Hegu （LI 4）. Results： Before acupuncture, Cuanzhu （BL 2） had the maximal metabolic intensity value. Its mean value was （0.71±0.23） W. Quanliao （SI 28） had the minimal metabolic intensity value. There were no left-right statistical significances in metabolic intensity values. After needling bilateral Hegu （LI 4）, the metabolic intensity values of most points on the face were increased. Kouheliao （LI 19） obtained the maximal increase： 0.35 W on average; and Yangbai （GB 24） obtained the minimal increase： 0.08 W on average. Conclusion： Points on both sides in healthy people have good symmetry in metabolic intensity value. After needling bilateral Hegu （LI 4）, the metabolic intensity values of points on the face were increased, especially points around the lips, which accords with the pathway of the Large Intestine Meridian on the head and face. This provided some scientific foundation for the association between Hegu （LI 4） and face/mouth.

Analysis of Similarities and Differences of the Twelve Jing-Well Acupoints for Emergency

The twelve Jing-Well acupoints are located at the tips of the limbs,with strong stimulation andintense needling sensation,and play important roles in the treatment of various critical diseases.The twelve Jing-Well acupoints share similarities and have specificities in the treatment of critical and severe diseases.The similarities of the twelve Jing-Well acupoints are supposed to open the orifices and remove blockage,clear away heat,resolve swelling,dissolve toxin and remove blood stasis.The Jing-Well acupoints locate at the different positions also have their specific effects for emergencies.Shaoshang(LU 11)is supposed to clean and benefit the throat.Shangyang(LI 1)is supposed to clear away heat and purge Fu organs.Lidui(ST 45)is supposed to expel fire and stop fear.Yinbai(SP 1)is supposed to stop bleeding and correct collapse.Shaochong(HT 9)is supposed to clear away heat from the heart and get rid of vexation.Shaoze(SI 1)is supposed to dredge the breast collateral.Zhiyin(BL 67)is supposed to promote birth and smoothen delivery.Yongquan(KI 1)is supposed to nourish yin and suppress yang.Zhongchong(PC 9)is supposed to benefit the orifice and brighten the eyes.Guanchong(TE 1)is supposed to clean and promote the triple energizer.Zuqiaoyin(GB 44)is supposed to induce menstruation and stop pain.Dadun(LR 1)is supposed to clear away the liver fire and relieve hernia.It is advisable to identify the similarities and differences and apply different stimulating modes in order to guide the clinical practice and enhance the emergency effect.

Study on the angle of needling Yamen (GV 15) in atlanto-axial dislocation patients

Objective: To compare the risk angle and safety angle of n eedli ng Ya me n (GV 15) betwee n the atla nto-axial dislocati on (AAD) patients and healthy subjects. Methods: A total of 177 AAD patients diagnosed and treated at the Center of Upper Cervical Vertebra of Beijing Chin a-Japa n Frie ndship Hospital betwee n January 2010 and January 2018 were in eluded in the AAD group. Ano ther 207 healthy subjects were included in the normal group. There were totally 191 males and 193 females. The MRI sean was performed for the cervical vertebrae to measure the risk angle and safety angle of acup un cture at Ya me n (GV 15) on the sagittal image. Results: In the AAD group, the risk angle was (13.14±3.99)° and the relative safety angle was (10.31±3.23)° for the perpendicular needling, while the oblique needling risk angle was (9.09±3.09)° for the male;the risk angle was (12.12±2.74)° and the relative safety angle was (10.56±2.09)° for the perpendicular needling, while the oblique needling risk angle was (9.70±2.95)° for the female. In the normal group, the risk angle was (7.89±1.59)° and the relative safety angle was (10.21±3.55)° for the perpendicular needling, while the oblique needling risk angle was (16.07±1.77)° for the male;the risk angle was (6.93±1.45)° and the relative safety angle was (10.70±2.94)° for the perpendicular needling, while the oblique needling risk angle was (14.89±2.18)° for the female. The perpendicular needling risk angles for the males and females in the AAD group were larger than those in the normal group, and the differences were statistically significant (both P<0.01);for the inner-group comparison, there was no sigrHficant difference in the perpendicular needling risk angle between the male and the female in the AAD group (P>0.05);however, the perpendicular needling risk angle for the male was larger than the female, and the differenee was statistically significant in the normal group (P<0.01). There were no sign讦icant differences in the relative safety angle for both the male and the female between the AAD group and the normal group (both P>0.05). For the inner-group comparison, there was no sign讦icant differenee in the relative safety angle between the male and the female (P>0.05). The oblique needling risk angles for both the males and females were smaller in the AAD group than those in the normal group, and the differences were statistically sign讦icant (both P<0.01);the oblique needling risk angle for the male was not significantly different from that for the female in the AAD group (P>0.05);in the normal group, the oblique needling risk angle for the male was larger than that for the female, and the differenee was statistically significant (P<0.01). Conclusion: Un der the AAD condition, the risk angle and safety angle of acup un cture at Ya me n (GV 15) cha nge significantly, perpe ndicular n eedli ng should be better if performed slightly lower tha n the horiz on tai di recti on, and the oblique needling should be safer across the occipital foramen toward the occipital bone.