SnchezAraujoMax

1,2
,
LuckertBarelaAnaJ
2
1
ComplementaryTherapyResearchUnit,
FranciscodeMirandaUniversity,Coro,Venezuela.
2
InstitutodeInvestigacindeSaludyTeraputica.
Caracas,Venezuela.
OnDermatomes,
Meridians&Points:
ApunctureforTCM
model?
Introduction
After TCM
statements,trunks
channels and
acupointsrun
verticallyalongthe
body.
02/11/2009 2 Acupuntura/AcupunctureBarcelona,2009.
Introduction
The Clinicalmission
ofagivenacupoint
ormeridianwould
dependspecifically
onthe
corresponding
ZangFu
AneventualMeridian
derivedeffect (MDE)
ofthepuncture.
.
02/11/2009 3 Acupuntura/AcupunctureBarcelona,2009.
Introduction
Incontrast,the
trunksanatomy
insteadshows
anhorizontal
distribution of
thesomato
visceral
innervation.
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02/11/2009 Acupuntura/AcupunctureBarcelona,2009.
Introduction
That
neurobiological
bodyarchitecture
woulddetermines
thatstructures
innervatedbythe
samespinal
segmenttendto
behaveasawhole.
BOSSYJ.etal.Neuroanatomie,HaugVerlag,Paris,2001
Introduction
Thus,acupoints pertainingtoagiven
dermatomemayhavesimilareffects
or indications,dependingontheir
somaticvisceralsubstrate.
AneventualNeurobiologyderivedeffect,
(NBE)ofanypuncture.
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Objective:Evaluatingbothvisions
throughacognitivestrategy.
Objective:Evaluatingbothvisions
throughacognitivestrategy.
Torespondthequestion:
"Would acupointsclinicaleffectsdepend,either
ontheirmeridiansclinicalvocationorontheir
viscerosomaticsubstrateandinnervations?
Nullhypothesis:
Acupointsclinicalbehaviourwilldependontheir
effectonenergyflowinagreementwithTCM"
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Material&methods:
Asimple'experiment' wasperformed:
Frominformationobtainedthroughasearch
onemblematicChinesetextsweperformed:
Assessmentofclinicalindicationsof acupoints
locatedontrunksdermatomes
Assessmentoftheprevalenceoflocalor
systemic effectsforbothacupointsand
dermatomes
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Chinesetexts
02/11/2009 9 Acupuntura/AcupunctureBarcelona,2009.
Twoprestigiousatlas
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Material&Methods
Allclinicalindicationsoreffectsavailable for
eachpointofthetrunk werearbitrarily
separatedintotwocategories:
a. Systemic orextrasegmentaleffects
takenasMeridianderivedeffects(MDE).
b. Segmental orlocalindications
consideredasNeurobiologyderived
effects(NBE).
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Spinalsegment&Acupuncture
02/11/2009 12 Acupuntura/AcupunctureBarcelona,2009.
Assumptions
Assumptions
A.Foragivenpoint:
1. PredominanceofMDE>NBE over
80%,asconsistentwithMTC
statements;conversely,
2. PrevalenceofNBE>MDE>80%,as
compatiblewithaneurobiology
derivedeffect.
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Assumptions
Assumptions
B.Foragivendermatome:
1. PrevalenceofMDE>NBE indications
over80%ofitspoints,wouldvalidate
theTCMenergymodel;conversely,
2. PredominanceofNBE>MDE>80%,
wouldsupporttheneurobiological
approach.
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Procedures
1. Weperformedacomprehensivesearchof
acupointspertainingtothe22trunks
dermatomes.
2. Aftergroupingthemwithin22tableswecarried
outacomprehensivesearchofclinical
indications orpotentialeffectsforeachpoint.
3. Whichwerethen,independently,classifiedas
eitherSystemic(Meridianderived)effector
segmental (Neurobiologyderived)effect.
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Procedure
Inordertomakeiteasyandsimple
Systemiceffects wereshowninred
boldletters.
Letsseeanexample:
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AcupointsindicationsonT2
DERMATOME
ACUPOINTS INDICATIONS MDE NBE
PU 1 Zhonfu
Cough, asthma, Chest and
shoulder pain, lung congestion
0 5
BP20 Zhourong
Chest and hypochondria
Congestion, cough.
0 3
ES15 Wuyi
Cough, asthma, chest
congestion and pain, mastitis
0 5
T2
RN25 Shencang Cough, asthma, chest pain,
0 3
VC19
Zigong of Chest
Cough, asthma, chest pain.
0 3
VU12 Fengmen
Cold flu*, cough, fever,
headache*, cervical stifness,
dorsalgia.
3 2
VU41 Fufen
Neck, dorsal and shoulder
rigidness. arm numbness
0 4
02/11/2009 Acupuntura/AcupunctureBarcelona,2009.
*RedLettersindicateMeridianDerivedEffect.
AcupointsindicationsonT2(Cont)
DERMATOME
ACUPOINTS INDICATIONS MDE NBE
VU12 Fengmen
Cold flu*, cough, fever*,
headache*, cervical stifness,
dorsalgia.
3 3
VU41 Fufen
Neck, dorsal and shoulder stiffness,
arm numbness.
0 4
T2
ID 9 Jianzhen
Omalgia, pain and motor
dysfunction of upper limb.
0 3
ID10 Naoshu Shoulder and upper arm pain.
0 2
ID12 Bingfeng
Escapulobrachial pain, parestesia
and weakness of the arm, chest
pain, cough and distension of
hipocondria*.
1 5
ID 13 Quyuan
Weakness and pruritus* of
shoulder and arm.
Total:
1
8
2
39
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*MeridianDerivedEffect.
Total:(47)7%83%
Results
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Results:
On22dermatomes
148points
Totalindications
N=902
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POINTS ON DERMATOMES
Dermatom
e
N Points %totalNBE
T1 11
70,90
T2 11
83,00
T3 8
83,80
T4 8
82,50
T5 7
81,80
T6 9
82,90
T7 9
94,30
T8 5
82,10
T9 9
89,10
T10 10
90,90
T11 12
92,20
T12 13
100,00
L1 9
93,10
L2 3
78,60
L3 9
86,80
L4 3
100,00
L5 2
95,00
S1 3
96,70
S2 2
95,80
S3 2
86,20
S5 3
96,40
TOTAL 148
89,64
Results:
MDE criteria:+
n =94(10,4%)
NBE criteria:+
n =808
(89.6%)
P<0.001
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POINTS ON DERMATOMES
Dermatom
e
N Points %totalNBE
T1 11
70,90
T2 11
83,00
T3 8
83,80
T4 8
82,50
T5 7
81,80
T6 9
82,90
T7 9
94,30
T8 5
82,10
T9 9
89,10
T10 10
90,90
T11 12
92,20
T12 13
100,00
L1 9
93,10
L2 3
78,60
L3 9
86,80
L4 3
100,00
L5 2
95,00
S1 3
96,70
S2 2
95,80
S3 2
86,20
S5 3
96,40
TOTAL 148
89,64
Thatmeansthat:
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ContrarytoMTC
postulates,
acupointseffects
forany
dermatomeare
remarkablyakin,
regardlessoftheir
meridianmission.
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Thatmeansthat:
Therefore,acupoints
effectderives
fromtheir
underlyingneural
andsomato
visceral
substratum.
Therefore,acupoints
effectderives
fromtheir
underlyingneural
andsomato
visceral
substratum.
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So,NBsubstrate
emergesas
determinantfactor
foracupuncture
actionmechanisms
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Conclusions:
Thesefindings:
1. Maycontributetoourunderstandingof
acupuncturesneurobiology
2. Couldclarifysomeconfusingresultsof
acupuncturesclinicaltrials
3. Excludingbythewayshamacupunctureas
suitableplaceboforfuturestudies.
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Muchas gracias!
Thanks,alot!
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