Moncayo Roy, Rudisch Ansgar, Kremser Christian, Moncayo Helga
WOMED, Innsbruck, Austria.
BMC Musculoskelet Disord. 2007 Apr 10;8:33. doi: 10.1186/1471-2474-8-33.
A conceptual model of lateral muscular tension in patients presenting thyroid associated ophthalmopathy (TAO) has been recently described. Clinical improvement has been achieved by using acupuncture on points belonging to the so-called extraordinary meridians. The aim of this study was to characterize the anatomical structures related to these acupuncture points by means of 3D MRI image rendering relying on external markers.
The investigation was carried out the index case patient of the lateral tension model. A licensed medical acupuncture practitioner located the following acupuncture points: 1) Yin qiao mai meridian (medial ankle): Kidney 3, Kidney 6, the plantar Kidney 6 (Nan jing description); 2) Yang qiao mai meridian (lateral ankle): Bladder 62, Bladder 59, Bladder 61, and the plantar Bladder 62 (Nan jing description); 3) Dai mai meridian (wait): Liver 13, Gall bladder 26, Gall bladder 27, Gall bladder 28, and Gall bladder 29. The points were marked by taping a nitro-glycerin capsule on the skin. Imaging was done on a Siemens Magnetom Avanto MR scanner using an array head and body coil. Mainly T1-weighted imaging sequences, as routinely used for patient exams, were used to obtain multi-slice images. The image data were rendered in 3D modus using dedicated software (Leonardo, Siemens).
Points of the Dai mai meridian--at the level of the waist--corresponded to the obliquus externus abdominis and the obliquus internus abdominis. Points of the Yin qiao mai meridian--at the medial side of the ankle--corresponded to tendinous structures of the flexor digitorum longus as well as to muscular structures of the abductor hallucis on the foot sole. Points of the Yang qiao mai meridian--at the lateral side of the ankle--corresponded to tendinous structures of the peroneus brevis, the peroneous longus, and the lateral surface of the calcaneus and close to the foot sole to the abductor digiti minimi.
This non-invasive MRI investigation has revealed the anatomical relations of acupuncture points belonging to 3 of the so-called extraordinary meridians. We conclude that the clinically developed "WOMED concept of lateral tension" is related to tendino-muscular structures.
最近有人描述了甲状腺相关性眼病（TAO）患者外侧肌肉张力的概念模型。通过针刺所谓奇经上的穴位已实现了临床改善。本研究的目的是借助基于外部标记的3D MRI图像重建来描述与这些穴位相关的解剖结构。
对外侧张力模型的索引病例患者进行了研究。一位持牌医学针灸师定位了以下穴位：1）阴跷脉（内踝）：肾3、肾6、足底肾6（《难经》描述）；2）阳跷脉（外踝）：膀胱62、膀胱59、膀胱61以及足底膀胱62（《难经》描述）；3）带脉（腰部）：肝13、胆26、胆27、胆28和胆29。通过在皮肤上粘贴硝酸甘油胶囊来标记这些穴位。使用阵列头体线圈在西门子Magnetom Avanto MR扫描仪上进行成像。主要使用通常用于患者检查的T1加权成像序列来获取多层图像。使用专用软件（Leonardo，西门子）以3D模式重建图像数据。
带脉在腰部水平的穴位对应于腹外斜肌和腹内斜肌。阴跷脉在内踝侧的穴位对应于趾长屈肌的腱性结构以及足底拇展肌的肌肉结构。阳跷脉在外踝侧的穴位对应于腓骨短肌、腓骨长肌的腱性结构以及跟骨外侧表面，在足底附近对应于小趾展肌。
这项非侵入性MRI研究揭示了属于3条所谓奇经的穴位的解剖关系。我们得出结论，临床开发的“外侧张力WOMED概念”与腱性肌肉结构有关。
