Point specificity in acupuncture

Susan Samueli Center for Integrative Medicine, Department of Medicine, School of Medicine, University of California, Irvine CA 92697-4075, USA. .
Chinese Medicine (Impact Factor: 1.49). 02/2012; 7(1):4. DOI: 10.1186/1749-8546-7-4
Source: PubMed


The existence of point specificity in acupuncture is controversial, because many acupuncture studies using this principle to select control points have found that sham acupoints have similar effects to those of verum acupoints. Furthermore, the results of pain-related studies based on visual analogue scales have not supported the concept of point specificity. In contrast, hemodynamic, functional magnetic resonance imaging and neurophysiological studies evaluating the responses to stimulation of multiple points on the body surface have shown that point-specific actions are present. This review article focuses on clinical and laboratory studies supporting the existence of point specificity in acupuncture and also addresses studies that do not support this concept. Further research is needed to elucidate the point-specific actions of acupuncture.

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    • "Clinical studies showed either a large variability in acupoint selection for the same clinical condition [26] or similar effectiveness between sham and verum acupuncture [1,27]. Additionally, a recent review considered the specificity of acupoints as controversial despite some scientific evidence [28]. Although acupoints were commonly considered as small cutaneous region, it was found a large variance on the skin surface area for the exact location of acupoints by CM experts [29]. "
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    ABSTRACT: Analysis of the relationship between the nervous system anatomy and the therapeutic characteristics of all acupuncture points in the channel network may provide new insights on the physiological mechanisms underlying acupuncture stimulation for prevention, treatment, and rehabilitation purposes. This study investigates the association between the similarity of acupoints' dermatomes, traditional actions, and contemporary indications. Channel acupoints had their characteristics annotated from a literature review of four topographic atlases of Chinese medicine and one atlas of human anatomy: initials of the channel's name (n = 14), sequential number in the channel (n = 67), acupoint's name (n = 361), dermatomes related to perpendicular needle insertion (n = 31), traditional actions (n = 848), and contemporary indications (n = 1143). Jaccard's similarity coefficient quantified the similarities between dual acupoints. All dual acupoints were evaluated to generate similarity matrices for each nominal variable. Cross-tables were generated by simultaneous classification of variables into levels of similarity with respect to: dermatomes versus traditional actions, dermatomes versus contemporary indications, and traditional actions versus contemporary indications. Goodman-Kruskal gamma and Rousson gamma*2 were calculated based on cross-tables, bootstrap and permutated samples to evaluate the association and determination coefficient between variables, respectively. Significant associations were observed between levels of similarities of dermatomes and traditional actions (gamma = 0.542; P < 0.001), dermatomes and contemporary indications (gamma = 0.657; P < 0.001), and traditional actions and contemporary indications (gamma = 0.716; P < 0.001). Similarities of dermatomes explained 16% of the variance of traditional actions and 25% of contemporary indications. Traditional actions explained 30% of the variance of contemporary indications. The association between traditional actions and contemporary indications was the highest one (gamma = 0.716, 95% confidence interval (95% CI) = [0.715; 0.719]), followed by the association between dermatomes and contemporary indications (gamma = 0.622, 95% CI = [0.621; 0.623]), and between dermatomes and traditional actions (gamma = 0.446, 95% CI = [0.444; 0.447]), all with P < 0.001. The similarity of dermatomes between dual acupoints partially determined the similarity of traditional actions and contemporary indications, therefore dermatomes partially determine the therapeutic efficacy of acupuncture.
    Full-text · Article · Dec 2013 · Chinese Medicine
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    • "There is debate as to whether the effect of acupuncture depends on the points used [24]. TCM acupuncturists claim that point specificity and the choice of points according to patients' symptoms and signs are vital. "
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    ABSTRACT: Infantile colic is common, but no safe and effective conventional treatment exists. The use of acupuncture has increased despite weak evidence. This practitioner survey explores and discusses how infantile colic is regarded and treated in Traditional Chinese Medicine (TCM). The study is based on personal communication with 24 acupuncturists from nine countries. These acupuncturists specialize in pediatric acupuncture and represent different styles of acupuncture. Their experiences are discussed and related to relevant books and articles. Informants claimed good results when treating infants with colic. The TCM patterns commonly described by informants matched the textbooks to a great extent. The most common syndromes were "stagnation of food" and "Spleen Qi Xu." Regarding treatment, some informants followed the teachers' and the textbook authors' advice on differentiated treatment according to syndrome. The points used most often were LI4, ST36, and Sifeng. Other informants treated all infants alike in one single point, LI4. The results demonstrate the diversity of TCM. The use of acupuncture for infantile colic presents an interesting option, but further research is needed in order to optimize the effects and protect infants from unnecessary or less effective treatment.
    Full-text · Article · Nov 2013 · Evidence-based Complementary and Alternative Medicine
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    • "For instance, GB37 is traditionally applied to treat eye disease for the belief of its correlation with vision; neuroimaging studies also demonstrated specific activation of the visual area in brain by stimulating at it [71, 72]. Similar specificity has also been demonstrated in other points [73–75]. Thus, in previous studies on Deqi, one responsible factor for the paradox that could be posited is that different acupoints with their own unique efficacy could cause efficacy-related brain response which are certainly different in terms of pattern, mode, and intensity and as a result might contribute to the diversity of brain response to acupuncture Deqi. "
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    ABSTRACT: Acupuncture as an oriental natural healing therapy with prolonged history has been extensively utilized in the management of great numbers of disorders. Deqi, a renowned acupuncture needling sensation, is profoundly regarded as the predictor and also the prerequisite of a preferable acupuncture treatment efficacy. Till now, there is still no consistency being reached towards the mechanism of acupuncture Deqi as a result of the discrepancy for publicly acknowledged evidence. Recent visualized research on Deqi using modern technologies has demonstrated possible central mechanism towards it. However, there is a conspicuous paradox underway in the research of cerebral response to acupuncture Deqi. This paper provided a view of up-to-date studies using visualized tools to characterize the brain response to acupuncture Deqi, such as functional magnetic resonance imaging (fMRI) and positron emission tomography/computed tomography (PET/CT). The paradox was extruded to highlight certain reasons from a TCM view. It is hypothesized that acupoints located at different dermal sites, state of participant, and needling manipulation can all contribute to the current paradox. Hence, further studies on acupuncture Deqi should pay more attention to the strategy of experiment design with generalized measurement, valid sham control methods, and more to subjects in diseased condition.
    Full-text · Article · Jul 2013 · Evidence-based Complementary and Alternative Medicine
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