The historical source of “Trigger Points”:classical Ashi points

Our research began with a consideration of the etymological origins of the terms Ashi and the Ashi point. We used both original source texts and textual criticism to trace the original meaning of the phrases, ＂take the tender spot as the point＂ and ＂use the Ashi method.＂ Linguistic theory informed our discussion of three similar terms and our analysis of them. We show that Ashi points are in theory similar to regular acupuncture points in terms of their definition and function. Furthermore, we can use the concept of ＂c/i-pathway （Qi./ie）＂ to expand our understanding of the clinical use of Ashi points. Ultimately, the main purpose of our research was to clarify that the classical Ashi point and modern, western concept of the trigger point are in fact quite similar. The two concepts have been described in different languages primarily due to cultural differences.

Regular acupuncture at combined with join valley needling at ashi point for scapulohumeral periarthritis: A randomized controlled trial

Objective:To observe clinical efficacy differences of regular acupuncture at empirical acupoints combined with join valley needling at ashi point compared with simple join valley needling at ashi point for scapulohumeral periarthritis.Methods:Sixty-four patients of scapulohumeral periarthritis were randomly divided into an observation group and a control group,32 cases in each one.Both groups underwent basic rehabilitation training.Patients in the observation group were treated with acupuncture at empirical acupoints combined with join valley needling at ashi point,while the patients of the control group were treated with simple join valley needling at ashi point.Both groups were all treated once a day,6 times a week.Patients were treated for one course which lasted for 4 weeks.The visual analog scale(VAS)score,the Constant-Murley score and the Hamilton Anxiety Scale(HAMA)are compared between the two groups before and after the treatment,and the efficacy was evaluated after the treatment.Telephone investigation was applied as the followed-up after one month of the treatment.Results:The total effective rate in the observation group was 87.5%(28/32),and that in the control group was 71.9%(23/32),and there was statistically significant difference between the two groups(P<0.05).The VAS scores,Constant-Murley scores,and HAMA scores in the patients of the observation group were lower than those of the corresponding indicators in the patients of the control group respectively,and there were statistically significant differences(all P<0.05).Conclusions:Compared with simple join valley needling at ashi point,regular acupuncture at empirical acupoints combined with join valley needling at ashi point can relieve the clinical symptoms of patients with scapulohumeral periarthritis,attenuate pains,ease anxiety and improve daily life activities better.

Clinical Study on Treatment of Myofascial Pain Syndrome with Ashi Points

Objective： To investigate the clinical efficacy of Ashi points in the treatment of myofascial pain syndrome. Method： A hundred and fifty cases were randomized into a treatment group and a control group by the order of visit. The cases in the treatment group were treated with ＂Stuck Needle＂ method in Ashi points plus tuina manipulations. The cases in the control group were treated with external local application of Votalin. The cases in both groups were treated once a day and 10 times made up one course. Results： Among 90 cases in the treatment group, 18 got clinical recovery, 34 got marked effect, 34 got certain effect, the marked effective rate was 57.8% and the total effective rate was 94.4%; while among 60 cases in the control group, 1 got clinical recovery, 18 got marked effect, 15 got certain effect, the marked effective rate was 31.7% and the total effective rate was 73.3%. Statistical management showed P〈0.01, indicating a significantly better effect in the treatment group. In addition, ＂Stuck Needle＂ method in Ashi points plus tuina manipulations can effectively improve local pain, tenderness, muscle spasm and motion range of joints, and can obtain significantly better effect for muscle spasm and motion range of joints. Conclusion： This therapy is safe, reliable and effective, and therefore worth spreading for clinical application.

Clinical observation of acupuncture bloodletting at Ashi points on local swelling and pain after snakebite

Objective:To evaluate the clinical therapeutic effect of acupuncture bloodletting therapy on local swelling and pain of snakebite in the patients bitten by snakes.Methods:A total of 106 patients with trimeresurus stejnegeri bite were randomly divided into two groups,a conventional treatment group and a conventional treatment combined with bloodletting therapy group,53 cases in each one.In the conventional treatment group,the convention treatment of western medicine was adopted.In the conventional treatment combined with bloodletting therapy group,on the base of the conventional treatment,bloodletting therapy was applied at Ashi points selected at the tender points around the wound.The intervention and observation were performed not less than 7 days in two groups.Before and after treatment,swelling and pain degrees were measured and remission time of both the limb swelling and pain were recorded in the patients.Results:Compared with the values on day 1 of treatment,swelling degree and visual analogue scale(VAS) score of the upper and lower limbs were all lower on day 3 and day 7 of treatment in the patients of the two groups(all P <0.05).Compared with the conventional treatment group,swelling degree and VAS score of the upper and lower limbs were all lower in the values of the conventional treatment combined with bloodletting therapy group on day 3 and day 7 of treatment respectively(all P <0.05).The remission time of either limb swelling or pain in the patients of the conventional treatment combined with bloodletting therapy group was shorter than the conventional treatment group respectively(both P <0.05).Conclusion:Acupuncture bloodletting therapy can effectively relieve the local swelling and pain caused by snakebite,promote the recovery of limb function,shorten the treatment course and improve the clinical therapeutic effect.

Can Ashi Points Stimulation Have Specific Effects on Shoulder Pain? A Systematic Review of Randomized Controlled Trials

Objective： To provide an evidence-based overview regarding the efficacy of Ashi points stimulation for the treatment of shoulder pain. Methods： 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. Results： 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： x 2=3.81, P=0.70, 12=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. Conclusions： 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.

Clinical Observation on Ashi Point Injection of Ozone for Tennis Elbow

Tennis elbow (lateral epicondylitis ) is the asepticinflammation on the attachment point of tendons ofthe forearm extensor muscles. It is a common-encountered disease with main symptoms of pain,tenderness and weakness in holding objects. Theauthor treated 75 cases of tennis elbow by ozoneacupoint injection. It was reported as follows.

Distributed Simulation of Non-Point Source Pollution in Ashi River Basin

In order to get a thorough understanding of non-point source pollution,it is essential to examine its temporal and spatial distribution. A physically-based distributed model,Soil and Water Assessment Tool( SWAT),was used in this research,to quantitatively estimate the NPS load and analyze the temporal and spatial distributions of NPS pollution in Ashi River Basin. The results indicated that SWAT was suitable to simulate stream-flow and water quality in Ashi River Basin. Total Nitrogen which was contributed by NPS( NPS-TN) accounted for 32. 47%-62. 61%,and Total Phosphorus which was contributed by NPS( NPS-TP)accounted for 22. 30%- 57. 85% of the total load respectively. In inter-annual timescale,both NPS-TN and NPS-TP were influenced by stream-flow and fertilizer. However,when compared with fertilizer,NPS pollution was more directly affected by stream-flow. In annual timescale,NPS-TN and NPS-TP mainly occurred in flood season( from May to September). In the aspect of space,spatial differences of NPS-TN and NPS-TP were extremely significant. The spatial variations of NPS pollution were mainly influenced by land use,precipitation,soil and slope.

Analysis of the Relationship between Landuse and Non-point Source Pollution in Ashi River Basin

Landuse is one of the most influential factors of non-point source pollution. Based on the three-year landuse data( 2000,2005 and 2008),Arc GIS and Fragstat were used to analyze the landuse type and the change of landscape pattern. The relationships between landuse and non-point source-total nitrogen( NPS-TN) and nonpoint source-total phosphorus( NPS-TP) were discussed with the methods of spatially statistical analysis,landscape pattern analysis and principal component analysis. The study results conveyed that agricultural land and forestland,which accounted for over 92% of the study area,were the major landuse type of Ashi River Basin.Meanwhile,the NPS pollution had close connections with landuse type and landscape pattern. When it comes to landuse type,the export risks of NPS-TN and NPS-TP were agricultural land > urban land > grassland > forestland. As for landscape pattern,NPS-TN and NPS-TP were positively related to SHDI and SHEI, while negatively connected with LPI,AI and COHESION. Therefore,the study could reach the conclusion that the more fragmented and complicated the landscape patterns were,the more serious the NPS pollution was.

阿是穴四花刺法治疗神经根型颈椎病颈肩肢痛症的随机对照研究

目的:探究阿是穴四花刺法治疗神经根型颈椎病颈肩肢痛症的临床疗效。方法:本研究纳入2021年6月至2023年12月于四川省中西医结合医院、四川省第二中医医院门诊就诊且符合纳入标准的神经根型颈椎病患者,共计370例。采用随机对照研究方法,将患者随机分为对照组和治疗组,每组185例。治疗组接受阿是穴四花刺法治疗,对照组接受常规针刺法治疗,分别在治疗前、治疗后第1、2、3、7、14天进行评定,并观察其疼痛强度、疼痛频度、疼痛持续时间、压痛、生活质量评分的变化,以判断疗效。结果:治疗后,两组患者在VAS评分、SF-MPQ评分、疼痛频度评分、疼痛持续时间评分、压痛评分、生活质量评分方面都有显著改善。与对照组相比,治疗组的疼痛频度更早得到改善,其余各项指标在相同时间节点改善程度更高(P<0.05)。结论:阿是穴四花刺法治疗神经根型颈椎病颈肩肢痛症具有肯定疗效,相比常规针刺法治疗其起效更快,疗效更好,在提高患者生活质量方面也表现出优势,是治疗神经根型颈椎病颈肩肢痛症的理想方法。

阿是穴理论初探

阿是穴理论是以阿是穴为核心的中医经典理论,临床上重视阿是穴的应用却常忽视其理论内涵。通过梳理古代文献及现代理论,总结阿是穴理论作为腧穴定位方法及针灸治疗选穴原则的内涵。比较阿是穴理论与激痛点理论、浮针医学理论、针刀医学理论,发现这些理论与阿是穴理论本同末异,是对阿是穴理论的继承与发展。认为阿是穴是阿是穴理论的核心,阿是穴具有动态取治的性质,并提出阿是穴治未病的思考。

针灸治疗急性肾绞痛临床选穴组方规律研究

【目的】通过数据挖掘技术分析临床针灸治疗急性肾绞痛选穴组方的规律。【方法】检索中国知网期刊全文数据库(CNKI)、万方学术期刊全文数据库(Wanfang)、维普中文科技期刊数据库(VIP)、PubMed数据库已经公开发表并收录的关于针灸治疗急性肾绞痛的临床文献,通过严格筛选,采用Microsoft Excel、SPSS 26.0、IBM SPSS Modeler 15.0软件以及其中的Apriori算法对纳入文献进行信息挖掘与分析。【结果】纳入110篇关于针灸治疗急性肾绞痛的临床文献,统计针灸处方共110条,涉及使用腧穴共59个,其中,肾俞、阿是穴和三阴交的使用频次最高;常用经脉为足太阳膀胱经、足太阴脾经、足阳明胃经;腧穴主要分布在下肢与腰背部;从选用穴位类型来看,五输穴、背俞穴、下合穴为首选;双穴组合配伍中,肾俞、阿是穴组合支持度最高;三穴组合配伍中,肾俞、三阴交、阿是穴组合支持度最高;核心腧穴组合是肾俞与阿是穴组合。【结论】针灸治疗急性肾绞痛的腧穴选择和组方是有规律可循的,所总结的选穴和组方规律能够为其临床治疗和科学研究提供参考。

皮肤针治疗带状疱疹后遗神经痛研究进展

带状疱疹后遗神经痛(postherpetic neuralgia,PHN)病位在皮部,主要累及肝、脾二脏,久则及肾。其发生涉及内、外两个因素,内因有年老体弱、素体亏虚、正气不足、情志内伤、饮食不节等,外因则与外感火毒湿热时邪有关。其病机有虚实两种,实为肝经湿热火毒蕴积与血气搏结,造成局部气血凝滞,经脉瘀阻不通,脏腑气机不畅则痛;虚为正气虚弱,无力抗邪,外感火毒之邪后,余邪未尽日久化火,耗伤阴血,阴血亏虚不能濡养肌肤经脉,不荣则痛。故该病治疗需要兼顾内外虚实,以扶正祛邪、理气活血、通络止痛为主。皮肤针治疗PHN可因势利导、诱邪外出,既能活血祛瘀、通络止痛,又可振奋经气、调节脏腑,常用治疗方法有:皮肤针放血、皮肤针联合普通针刺、皮肤针联合灸法、皮肤针联合中药、皮肤针联合西药等。皮肤针治疗PHN,临床叩刺部位选择主要为局部叩刺,其次是阿是穴、夹脊穴的穴位叩刺。目前,皮肤针治疗PHN的临床研究仍存在以下问题:观察的样本量较小,缺乏多中心、大样本研究;疗效评价以观察性指标为主,缺乏实验室指标观察,实验结果主观性较强,缺乏客观真实性;临床应用型研究多,基础理论型研究少;PHN易复发,病程迁延时间长,部分临床研究仅关注近期疗效,缺少后期随访;治疗主要以缓解疼痛为主,缺乏对患者的心理疏导。建议加强皮肤针治疗PHN的基础研究,注重客观疗效标准,同时注意后期随访及心理疏导,设计更为严谨的科研方案。

浮针结合艾灸循经筋阿是穴治疗膝骨性关节炎的疗效研究

目的分析在膝骨性关节炎(KOA)患者中应用浮针结合艾灸循经筋阿是穴治疗对关节疼痛及功能的影响。方法选取2021年10月至2023年9月广东医科大学附属第二医院疼痛科、骨科及康复科收治的KOA患者70例,随机分为试验组和常规组,每组35例。试验组采用浮针结合艾灸循经筋阿是穴治疗,常规组单纯采用艾灸循经筋阿是穴治疗。治疗前后及随访1个月时,对两组患者膝痛水平[视觉模拟评分法(VAS)]、膝功能恢复状况[膝关节功能量表(HSS)]及炎性指标[白细胞计数(WBC)、血沉(ESR)、C反应蛋白(CRP)、血小板与淋巴细胞比值(PLR)、中性粒细胞与淋巴细胞比率(NLR)]进行比较。结果试验组总有效率为94.29%,高于常规组的77.14%(P<0.05);两组患者VAS评分、WBC、ESR、CRP、PLR及NLR水平较治疗前下降(P<0.05),与常规组相比,试验组更低;治疗后,两组HSS评分升高,且试验组高于常规组(P<0.05)。结论浮针结合艾灸循经筋阿是穴治疗KOA患者,明显减轻疼痛程度,减少膝关节的炎症反应,且不良反应较少。

超声引导下阿是穴埋线治疗腰臀部肌筋膜疼痛综合征的临床研究

目的:采用超声剪切波弹性成像技术(SWE)评价超声引导下埋线阿是穴治疗腰臀部肌筋膜疼痛综合征(MPS)的临床疗效。方法:将120例腰臀部MPS患者随机分为埋线组和针刺组各60例,均用超声对腰臀部阿是穴进行体表定位,并分别于超声引导下行埋线治疗与针刺治疗,针刺组3次/周,埋线组2次/周,治疗2周。比较2组治疗前、末次治疗后及随访1周后阿是穴的杨氏模量值、腰臀部疼痛评分(VAS)及腰部功能评分(JOA)。结果:末次治疗后,2组阿是穴杨氏模量值、VAS评分均低于治疗前(均P<0.05),JOA评分均高于治疗前(均P<0.05);随访1周后,埋线组阿是穴杨氏模量值、VAS评分均低于针刺组(均P<0.05),埋线组JOA评分高于针刺组(P<0.05)。结论:超声引导下阿是穴埋线可降低腰臀部MPS患者腰痛程度、改善腰部功能,效果明显,其机制可能与延长局部刺激时间、降低阿是穴杨氏模量值及恢复局部组织形态有关。

针刺阿是穴治疗退行性膝骨关节病30例疗效观察

目的:观察针刺阿是穴治疗退行性膝骨关节病的临床疗效。方法:随机将60例退行性膝骨关节病患者分为半导体激光组(对照组)及针刺组(观察组),每组30例。对照组给予阿是穴半导体激光定点治疗;观察组给予阿是穴针刺疗法。观察两组治疗前后的WOMAC评分以及Lysholm评分,并评价临床疗效。结果:治疗后观察组的WOMAC评分以及Lysholm评分均优于对照组(P<0.05),观察组的临床总有效率高于对照组(P<0.05)。结论:针刺作用于阿是穴治疗退行性膝骨关节病疗效肯定,可有效缓解患者膝关节疼痛、僵硬、活动受限等症状,具有一定安全性。在改善疼痛方面,针刺较半导体激光治疗更具优势。临床可根据实际条件,探索针刺联合半导体激光治疗方案,以提高临床疗效。

督脉至阳穴埋针治疗强直性脊柱炎临床观察

目的观察督脉至阳穴埋针治疗强直性脊柱炎(AS)的临床效果。方法将永春县中医院、德化县中医院就诊的60例AS患者随机分为两组,观察组30例给予督脉至阳穴或至阳穴附近阿是穴埋针治疗,对照组30例给予华佗夹脊穴普通针刺治疗。治疗1个月后,观察治疗前后主要症状、体征及相关指标的情况。结果通过治疗,两组患者各临床症状、体征及相关指标均有显著改善(P<0.05),观察组在晨僵时间、疼痛NRS评分、关节活动度改善方面较对照组更加明显(P<0.05)。结论督脉至阳穴或至阳穴附近阿是穴埋针治疗能有效改善AS患者晨僵,减缓疼痛,增加胸廓活动度,提高患者生活质量,降低血沉(ESR)、C反应蛋白(CRP)等炎症指标水平,效果确切、持久,患者依从性好。

阿是穴形成及其镇痛机制探讨

阿是穴是最原始的针灸取穴法则,在砭刺时代曾居主导地位。在临床诊断治疗中均有广泛应用价值。阿是穴既具有"以痛为输"的特点,又强调"体表投射"的特异性,其形成的病理机制是局部炎症作用和整体神经体表投射的综合结果。针刺阿是穴实现镇痛的生物学机理也是多因素、多途径的综合作用效应。其中,神经-体液调节是目前研究较多也是承认较广的方面,而诸如基因、心理等因素的作用虽然研究尚少,但显然已成为了今后研究的一大方向。

论阿是穴与穴位特异性

中医理论认为,阿是穴是体表具有按之快然或疼痛等特点的位点。从理论上来说,阿是穴包含有具有特异性的经穴和其它常用穴;从功能上来讲,阿是穴实际上与现代医学的牵涉痛的体表部位类似。因此,阿是穴乃是在反映病邪和治疗疾病等两大穴位功能方面具有明显特异性的穴位,本文就此进行了论述。

火针对急性期带状疱疹皮损的影响

【目的】评价在带状疱疹急性期的针灸治疗中火针治疗对疱疹皮损的影响。【方法】采用多中心、随机、对照的方法,将87例带状疱疹患者随机分为电针组、电针+火针组、西药组,电针组予电针阿是穴、夹脊穴、支沟穴、后溪穴治疗,电针+火针组予电针阿是穴、夹脊穴、支沟穴、后溪穴治疗,并以火针点刺水疱疹;西药组予盐酸伐昔洛韦、维生素B1口服,以10 d为1个疗程,共计1个疗程。观察3组患者的止疱时间、结痂时间、脱痂时间、带状疱疹综合疗效评分。【结果】电针组、电针+火针组较西药组能更好地改善带状疱疹总体症状(P<0.05或P<0.01);电针治疗能加速疱疹痂结、痂皮脱落,且电针配合火针疗法较单纯电针法疗效更显著,均优于西药疗法(P<0.05)。【结论】带状疱疹急性期在电针的基础上加用火针治疗有加速疱疹痂结、痂皮脱落的作用。

艾灸循经筋阿是穴治疗膝骨性关节炎的临床研究

目的:观察艾灸循经筋对膝骨性关节炎的临床疗效。方法:采用随机原则将膝骨关节炎患者分为传统经穴组和循经筋规律性阿是穴组,共76例患者,连续治疗4周。治疗前后分别进行VAS评分和WOMAC生活评价。结果:患者治疗前、后疼痛积分及生活评价差异比较,有显著性差异(P<0.05)。循经筋阿是穴组的临床疗效更佳,尤其对膝关节屈伸功能的改善最为显著。结论:艾灸对膝骨关节炎止痛效果良好,且循经筋阿是穴灸法疗效更佳。