Does Modern Research Concerning Chinese Medicine Acupoints Relate to Original Prescriptions? If Not, Why Not?

Abstract

Objective: Huang Fu Mi's Zhen Jiu Jia Yi Jing (ZJJYJ) is regarded as the earliest text (282 ce) on differential diagnosis and clinical acumoxa therapy in Chinese Medicine. Are contemporary manual acupuncture practices consistent with those reported in the ZJJYJ? The aim of this research was to investigate if modern manual acupuncture uses reported in research are consistent with classical practices reported in the ZJJYJ. Materials and Methods: A database search of human research studies from 1995 to 2016 was performed for all 270 acupoints for all 8 leg/body channels. The clinical foci of these modern publications were compared with acupoint clinical indications documented in the Song Dynasty Chinese edition (1077) of the ZJJYJ and the sole English translation (translated and compiled by Yang and Chace in 1994) of The Systematic Classic of Acupuncture and Moxibustion. Results: Of 2149 articles in English, 63 met the search criteria. These articles predominately reported acupoints on the lower leg, back, chest, and head. Correlations between the acupoints used in modern research and those used in the ZJJYJ were minimal. Clinical indications from the ZJJYJ typically involved symptoms relating to pain, swelling, fever, seizures, hallucinatory states, dysentery, malaria, and tuberculosis, which are now treated pharmacologically. However, one-third of modern studies were functional magnetic resonance imaging (fMRI) investigations of neurophysiologic effects of manual acupuncture on the human brain. Conclusions: While, superficially, the ZJJYJ might seem irrelevant in modern manual acupuncture practices, well-documented physical effects (e.g., pain relief) of manual acupuncture do provide measurable outcomes for use in fMRI research. Therefore, the classical text does provide a guide for future research on influential acupoints on the leg and body channels.

Keywords: Ruling Points; The Systematic Classic of Acupuncture and Moxibustion; Zhen Jiu Jia Yi Jing; clinical symptom clusters; fMRI; research publications review.

FIG. 1.

Adapted PRISMA [Preferred Reporting Items for Systematic Reviews and Meta-Analyses] flowchart of studies screened and assessed for eligibility. AMED, Allied and Complementary Medicine, TENS, transcutaneal electrical nerve stimulation, EA, electroacupuncture.

FIG. 2.

Shows for each channel which acupoints had research publications that met the inclusion criteria (dark gray shading) or not (light gray shading); no publications are not shaded.

FIG. 3.

A comparison in the number of clinical studies (dark gray) versus experimental studies (light gray) between the channels.