Birch Stephen
The Stichting for the Study of Traditional East Asian Medicine, Amsterdam, The Netherlands.
J Altern Complement Med. 2003 Feb;9(1):91-103. doi: 10.1089/107555303321222973.
In 1977, Melzack and colleagues examined the possible correspondence of acupuncture points and trigger points for the treatment of pain. They claimed a 71% correspondence between these two classes of points. Their findings have influenced many researchers and practitioners but have not been examined since 1977. The current study explores the claim of a 71% correspondence between these two classes of points through a more extensive examination of the acupuncture literature.
To investigate the claim of a 71% correspondence of acupuncture points and trigger points for the treatment of pain.
The study involved a review of acupuncture texts published since 1977, focusing on five textbooks for the in-depth analyses and a broader range of texts for the more general analyses.
If trigger points correspond to any class of acupuncture points it would have to be to the a shi points rather than the "channel" or "extra" points with which the 1977 study attempted to find correlation. Approximately 35% of recommended acupuncture points in the treatment of pain are distant from the site of the pain, making assumptions about the infrequency of use of distant acupuncture points for pain suspect. Sixty-one percent (61%) of the acupuncture points that the 1977 study examined for the treatment of pain are not recommended at all for the treatment of pain, and 44% are not recommended in the treatment of any problem, while only 19% of the acupuncture points are frequently recommended for pain and 20% for all conditions. For the acupuncture points that corresponded in the 1977 study, the equivalent numbers are: 60% not recommended at all for pain, 47% not recommended for anything, 18% commonly recommended for pain, and 16% commonly recommended for anything.
The claimed 71% correspondence of trigger points to acupuncture points is conceptually not possible. Furthermore, even putting this conceptual problem aside, no more than 40% of the acupuncture points that the 1977 study examined could correlate for the treatment of pain, and more likely, only approximately 18%-19% correlate rather than the 71% that was claimed. However, this study found a probable correspondence of trigger points to a different class of acupuncture points, the a shi points, which appears to be an important finding. Researchers and clinicians who have assumed the conclusions of the 1977 study to be correct will need to reexamine the impact of the current findings on any claims that are dependent on the conclusions of that study.
1977年，梅尔扎克及其同事研究了用于治疗疼痛的穴位与触发点之间可能存在的对应关系。他们宣称这两类点之间的对应率为71%。他们的研究结果影响了许多研究人员和从业者，但自1977年以来尚未得到检验。本研究通过对针灸文献进行更广泛的考察，探讨这两类点之间71%对应率的说法。
调查用于治疗疼痛的穴位与触发点之间71%对应率的说法。
该研究涉及对1977年以来出版的针灸文献进行综述，重点对五本教科书进行深入分析，并对范围更广的文献进行更全面的分析。
如果触发点与任何一类穴位相对应，那也应该是阿是穴，而非1977年的研究所试图寻找相关性的“经穴”或“奇穴”。在治疗疼痛时，约35%推荐的穴位远离疼痛部位，因此关于治疗疼痛时很少使用远部穴位的假设值得怀疑。1977年的研究中所考察的用于治疗疼痛的穴位，有61%根本不被推荐用于治疗疼痛，44%不被推荐用于治疗任何病症，而只有19%的穴位经常被推荐用于治疗疼痛，20%被推荐用于治疗所有病症。对于1977年的研究中相对应的穴位，相应的比例为：60%根本不被推荐用于治疗疼痛，47%不被推荐用于任何病症，18%经常被推荐用于治疗疼痛，16%经常被推荐用于治疗所有病症。
宣称的触发点与穴位之间71%的对应率在概念上是不可能的。此外，即使抛开这个概念性问题不谈，1977年的研究所考察的穴位中，用于治疗疼痛的穴位最多只有40%可能存在相关性，更有可能的是，只有约18%-19%存在相关性，而非宣称的71%。然而，本研究发现触发点与另一类穴位——阿是穴之间可能存在对应关系，这似乎是一个重要发现。那些认为1977年研究结论正确的研究人员和临床医生需要重新审视当前研究结果对任何依赖该研究结论的主张的影响。
