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Original Paper
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 co-
ordination 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 mod-
ern 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 devi-
ates 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 in-
dications 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.
School of Acupuncture and Moxibustion, Beijing University of Chinese Medicine, Beijing, China.
269
270 MA ET AL
had better effects in the total scores of symptoms, diar- 10. Sanyinjiao SP 6
rhea, and abdominal distention than using SP 15. Zhang Gao et al found that electroacupuncturing SP 6 had a
et al found that needling ST 25 to treat constipation had rapid effect in improving signs and symptoms of acute
better effects in improving colonic transit time, reliev- urinary retention. Cheng et al found that elec-
ing constipation, and better 6-month remote efficacy troacupuncturing SP 6 to treat perimenopausal syn-
than those of the control group by taking lactulose drome has obvious therapeutic effects. Compared with
liquid. oral drug therapy in the control group, acupuncture had
6. Zusanli ST 36 specific effects on symptoms of flushing, insomnia, ir-
Zhang et al found that electroacupuncturing ST 36, ritability, hot feeling in palm and sole, depression, dizzi-
combined with granisetron hydrochloride injection to ness, headache, palpitation, and itchy skin. Zhou et al6
relieve the side effects of chemotherapy and radio- found that electroacupuncturing SP 6 to treat peri-
therapy in malignant tumors, had better therapeutic ef- menopausal syndrome was safe and effective. Ma et al
fect than that of granisetron hydrochloride injection found that electroacupuncturing SP 6 could shorten the
control group. Acupuncture significantly inhibited active period of the first stage of labor, ease labor pain,
nausea and vomiting caused by chemotherapy. Wu et and reduce bleeding during the birth process and 2 hours
al found that electroacupuncturing ST 36 had a defi- after the labor.
nite clinical effect to prevent adverse reaction in the 11. Diji SP 8
stomach and intestine during the process of gastro- Wu et al found that electroacupuncturing SP 8 to treat
scope examination. Zhao et al found that moxibustion primary dysmenorrhea and taking ibuprofen both had
at ST 36 for the common cold was safe and reliable. good analgesic effect, and there was no significant dif-
It not only could reduce the incidence of common cold ference between them in the clinical symptom score, vi-
in the elderly, but also reduce the incidences of it and sual analog score (VAS), and the total effective rate af-
alleviate the symptoms. ter 3 months’ treatment.
7. Shangjuxu ST 37 12. Shenmen HT 7
Lin found that acupuncturing ST 37 and combined sul- Dong et al found that electroacupuncturing HT 7 to treat
fasalazine to treat ulcerous colitis had certain effects in insomnia had a therapeutic effect. It prolonged the to-
improving ulcerative colitis symptoms, signs and the tal sleep time, shortened the time to fall asleep, reduced
points score, the colonic mucosa, and blood integral the times of nights awake, improved sleep quality, re-
state classification. But compared with the effect of tak- duced dreams, as well as significantly improving wake-
ing sulfasalazine in the control group, the difference was up.
not significant. 13. Shaoze SI 1
8. Tiaokou ST 38 Wand et al7 found that electroacupuncturing SI 1 to
Guo et al4 found that taking anti-inflammatory anal- treat insufficient lactation had better effect than that
gesics and electroacupuncturing ST 38 to treat peri- of using LI 1 in the control group. Indications were
arthritis of the shoulder had quick, safe, and stable ef- that SI 1 was a special acupoint for insufficient lac-
fect, and its effect was better than only taking tation.
analgesic drugs. Shao et al found that applying elec- 14. Houxi SI 3
troacupuncture at ST 38 was effective for periarthri- Wu et al8 found that electroacupuncturing SI 3 to treat
tis of the shoulder. The shoulder disorders score stan- acute lumbar sprain had better recent and remote ther-
dards (JOA) was used for results evaluation. Results apeutic effect than that of taking MO (MOBIC) tablets
showed that the effect was better than that of taking in the control group in sedating lumbar pain and im-
diclofenac sodium sustained-release tablets in the proving lumbar activities.
control group. Xuan et al found that electroacupunc- 15. Feishu BL13
turing ST 38 to treat periarthritis of shoulder could re- Zhao et al found that electroacupuncturing BL13 to treat
markably relieve shoulder pain. The recent, remote ef- bronchial asthma (acute attacking stage) had a thera-
ficacy of sedating pain and improving joint function peutic effect. However, compared with the effect of tak-
were significantly better than those taking nuofuding ing theophylline sustained-release tablets, it showed no
tablets in the control group. significant difference.
9. Fenglong ST 40 16. Geshu BL17
Gan et al found that electroacupuncturing ST 40 to treat Lin et al found that electroacupuncturing BL 17 to treat
hyperlipidemia could improve the overall symptoms the side effects of chemotherapy and radiotherapy in
and reduce LDL. Zhang et al5 found that electro- malignant tumors had therapeutic effects. It reduced the
acupuncturing ST 40 and taking pravastatin both had side effects caused by chemotherapy such as poor qual-
the therapeutic effect of reducing blood fat; the differ- ity of life, physical decline, damage to the blood sys-
ence between them was not significant. tem, and gastrointestinal discomfort.
272 MA ET AL
32. Taiyang EX-HN 5 (overall follow-up effects of the treatment groups were sig-
Zhou et al found that electroacupuncturing EX-HN 5 to nificantly better than the control groups) in the follow-ups,
treat migraine of ascendant hyperactivity of Liver Yang accounting for 48.1%; 5 studies showed that the acupoints
had immediate analgesic effects. Zhao et al13 found that had partly better therapeutic effects than other controlled ther-
electroacupuncturing EX-HN 5 could treat central dizzi- apies in their follow-ups, accounting for 18.5%; 7 studies in-
ness caused by vertebrobasilar arterial blood insuffi- dicated that acupoints had similar therapeutic effects to the
ciency, and improve vertigo symptoms and verte- controlled therapies in their follow-ups, accounting for 25.9%;
brobasilar arterial blood. The effects were better than 1 study indicated that both groups had therapeutic effects
that of electroacupuncturing Ligou (LR 5) in the con- without comparison in its follow-up, accounting for 3.7%; and
trol group. 1 study showed that the treatment group had remote thera-
33. Sifeng EX-UE 10 peutic effects in the follow-up, accounting for 3.7%.
Liang et al14 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, DISCUSSION
subcutaneous fat thickness, weight, and serum albu-
min concentration. Ma et al found that acupuncturing In recent years, the studies of acupoints mainly focus on
EX-UE 10 of Four Hands significantly improved the ap- specificity of acupoints and stimulation techniques of acu-
petite and food intake of children, as well as children with points, as well as single-acupoint studies. More attention was
significantly increased subcutaneous fat, The conditions given to clinical studies of single acupoints. The clinical
of spirit, sleep, abdominal pain, sweat, and hair luster were studies of the above-stated 33 Points Indications, which
also improved in varying degrees. lasted for 4 years, could be considered as new achievements
in the area of single-acupoint studies.
same electroacupuncture stimulating parameters were used 5 trials of herbs control (including 4 trials of mere acupunc-
in an experiment, so that the results of the study could be ture group with oral herbs group, and 1 of acupuncture plus
more objective and precise. However, in the above 33 clin- oral herbs group with mere oral herbs group), and 27 trials
ical studies, the researchers disregarded the influence of of medications control (of those, 17 of mere acupuncture
stimulation volume and method to the clinical effect. It is group with oral medications group, 9 of acupuncture plus
expected that more consideration will be given to those fac- oral medications group with mere oral medications group,
tors to the clinical effect in the future. 1 of acupuncture plus oral medications group with same
medications plus other medications group).
Clinical Study Methods on the Indications (4) The acupoint controlled trials are divided into 4 cate-
of 33 Acupoints gories, A. Acupoint treatment group to correlative acupoint
control group trails; B. Acupoint treatment group to non-cor-
(1) All the clinical studies involved randomized, con- relative acupoint control group trials; C. Acupoint treatment
trolled, clinical trials in multiple centers. Previous studies group to non-points control group trials; and D. Acupoint-
on acupoints mostly studied the coordination of several acu- group plus single acupoint treatment group to acupoint-group
points, while single-acupoint clinical studies were relatively control group. Acupoint treatment group to correlative acu-
fewer, and the related literature was mostly about case stud- point control group trials refers to the comparison of effi-
ies. Meanwhile, most single-acupoint clinical studies did not ciency of 2 acupoints which are commonly used in treatment
have control groups and occurred as randomized, controlled of the same disease (2 studies used this method). Acupoint
clinical trials in multiple centers; thus, the results couldnot treatment group to acupoint non-correlative control group tri-
be proven reliable. The above clinical studies on 33 points als refers to the comparison of efficiency of 2 acupoints; the
all took randomized, controlled clinical trials in multiple acupoint treatment group is commonly used in treatment of
centers, processed the data scientifically, and attained reli- the disease, while the acupoint in the control group is seldom
able results. However, according to previous clinical study used in treatment of the disease (10 studies used this method).
literature, clinical studies of acupoints need to be system- Acupoint treatment group to non-points control group trials
atized, such as clinical studies on the expansion of the in- refers to the comparison of efficiency of 2 acupoints; the ori-
dications of single acupoints, regularities of the indications, entation of the 2 acupoints have different meanings. The non-
and mechanisms of the related efficacy. acupoints in the control group trial (neither on the meridian,
(2) Most previous clinical studies of acupoints were de- nor an extraordinary point, nor an Ah Shi point) compares the
signed informally and there were no strict diagnostic crite- real acupoints either located in the meridian or is an extraor-
ria, participating criteria, exclusion criteria, and standards of dinary point. There was 1 study that employed this method.
evaluation—-which made the studies lacking in scientific This kind of trials proves the specificity of acupoint in treat-
evidence. The above clinical studies on 33 points primarily ment of the certain disease. Acupoint-group plus single-acu-
used nationally or internationally recognized standards point treatment group to acupoint-group control group trial (1
which enhanced the reliability of the conclusion. study used this method) suggested that the single point and
point-group had joint satisfactory effect for a certain disease.
Control Design (5) There was 1 study that applied transcutaneous elec-
trical stimulation in the control group.
Nearly half of the previous studies of acupoints em- According to the present clinical study of acupoints, the
ployed controls, which affects the credibility of the conclu- process of acupuncture is a visible procedural treatment;
sion. In our studies, a total of 52 items adopted parallel however, to implement a control experiment properly is dif-
controls and the control designs had 4 categories: blank con- ficult, and it is different from placebo control in which pa-
trol, placebo control, acupoint and drug control, acupoint tients could clearly know whether they received acupunc-
and acupoint control. ture treatment. Hence, if we want to comply with the
(1) The trials of blank control were an acupuncture group principle of the blind method, we would face many opera-
and a blank group. There are 2 such studies. tional difficulties. It is necessary to continuously develop
(2) The trials of placebo-control composed of consolation the methodology to overcome the difficulties in the future.
acupuncture (electroacupuncture group and transcutaneous
electrical stimulation in the control group in 1 study, elec-
Clinical Effects
troacupuncture group and the consolation electroacupunc-
ture control group in another study), and consolation mox- The clinical studies on 33 points achieved mostly posi-
ibustion (moxibustion group and sham moxibustion control tive results. Only 1 study showed the effects of acupuncture
group in 1 study), excluding the acupuncture consolation to be inferior to the drug control group. One study showed
role to prove the validity of the acupoints. that acupuncture did not attain the treatment effect. Perhaps
(3) In acupoint and drug control trials, there were 2 cat- it was due to the acupoints in those studies were usually ef-
egories: herbs control and medications control. There were fective, verified by the past clinical practice. The results of
INDICATIONS OF 33 ACUPOINTS 275
those clinical studies proved the effectiveness of the 33 acu- Acupuncture. Shanghai Journal of Acupuncture and Moxi-
points on the one hand; conversely, it also proved the su- bustion. 2005;24(8):17–18.
periority of acupuncture therapy to certain diseases. 4. Guo C-q, Zhang F-m, Sha Y, et al. Randomized controlled tri-
als of acupuncture at Tiaokou ST 38 for treatment of peri-
arthritis of shoulder. Chinese Acupuncture & Moxibustion.
Clinical Follow-up 2006;26(8):544–546.
Follow-up descriptions were fewer than reported in pre- 5. Zhang H-x, Huang G-f, Zhang T-fa, et al. Clinical effective-
vious studies; thus, the remote effects of acupuncture were ness of electroacupuncture at Fenglong Point in the treatment
of hyperlipidemia. Chinese Journal of Rehabilitation. 2006;
not clear. The 51.9% of the above clinical studies on the in-
2l(6):372–373.
dications of 33 acupoints conducted follow-ups with a se-
6. Zhou J, Qin Z-y, Li Wei-li, et al. Clinical observation on ther-
ries of follow-up data. Hence, the remote effects of acupunc- apeutic effect of electroacupuncture at Sanyinjiao SP 6 on peri-
ture could be scientifically tested. menopausal syndrome. Chinese Acupuncture & Moxibustion.
Clinical studies on the indications of 33 acupoints demon- 2006;26(9):617–620.
strated that acupuncturing single acupoints to treat diseases 7. Wang Hong-c, An J-m, Han Y, et al. Multicentral randomized
and symptoms had therapeutic effects during a period of ob- controlled studies on acupuncture at Shaoze SI 1 for treatment
servation. This largest-scale single-acupoints clinical stud- of postpartm hypolactation. Chinese Acupuncture & Moxi-
ies revealed progress in the study of acupoints in accordance bustion. 2007;27(2):85–88.
with their multi-center, randomized, and controlled designs. 8. Wu Y-c, Zhang B-m, Wang C-m, et al. Observation on short-
Compared with the past clinical studies of single acupoints, term and long-term therapeutic effects of electroacupuncture
at Houxi SI 3 on acute lumbar sprain. Chinese Acupuncture &
these clinical studies were more standardized. At the same
Moxibustion. 2007;27(1):3–5.
time, prior studies trained a group of acupuncture clinical
9. Cen J, Chen Y-l, Ha L-p, et al. Clinical study on specificity
study personnel—-laying the foundation for the future clin- of Acupoint Huiyang in treating unstable bladder. Shanghai
ical studies of acupoints. It was expected that it would Journal of Traditional Chinese Medicine. 2007;41(2):38–40.
strengthen and expand the clinical study of single-acupoints, 10. Xiao L, Jianc G-l, Xinc J, et al. Effects of acupuncture in the
and fully integrate with evidence-based medicine and clin- treatment of common cold combined with high fever. Chinese
ical epidemiology methods. Thus, the Chinese acupuncture General Practice. 2007;10(8):493–495.
studies would be internationally recognized and would pro- 11. Zhao H, Zhao W-l. Clinical study on post stroke depression
mote the internationalization of Chinese acupuncture and ac- by Acupuncturing Baihui Point DU20. Chinese Traditional
celerate new progress. Chinese Medicine. 2007;25(2):275–276.
12. Niu H-y, Yang M, Qiang B-q, et al. Multi-central randomized
controlled trials of acupuncture at Zhongwan CV 12 for treat-
ment of peptic ulcer. Chinese Acupuncture & Moxibustion.
ACKNOWLEDGEMENTS 2007;27(2):89–92.
13. Zhao H, Liu Z-s, Yang T. Clinical study on treatment of ver-
This work was supported by the study project of Com- tebral-basilar insufficiency with electro-acupuncture on
pendium of Acupoints of China, State Administration of Tra- TAIYANG. Journal of Clinical Acupuncture. 2005;21(10):
ditional Chinese Medicine of China (Grant No. 27, in 2003), 8–9.
and China National Basic Research Program (Program 973, 14. Liang F-r, Xia X-h, Peng X-h, et al. A Multi-central random-
Grant 2006CB504503). ized 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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