Complementary Therapy Research Unit, Francisco de Miranda University, , Coro, Venezuela.
Acupunct Med. 2014 Feb;32(1):62-9. doi: 10.1136/acupmed-2013-010352. Epub 2013 Nov 6.
Traditional Chinese medicine (TCM) meridians and points run vertically, reflecting their function in the Zhang-Fu system (meridian pattern). However, the trunk's spinal nerves show a traverse orientation, or a 'horizontal pattern'.
The aim of the present work was to evaluate, via a cognitive quasiexperiment, whether the clinical indications of the points on the trunk are associated with their meridian function or with their innervation and visceral-somatic connection.
The points in each dermatome of the trunk were considered crosswise, regardless of their meridians. The clinical indications for each point were differentiated into two mutually exclusive categories: (a) vertical distribution effect (VDE) or 'meridian pattern', when indications were quite different regarding the indications for the other points on the dermatome; and (b) transverse distribution effects (TDE) or 'horizontal pattern', represented by mainly local or segmental indications except for Shu-Mu points. After observing that the proportions between both categories often exceeded 60% in pilot samples, 60% was adopted as the reference value.
A total of 22 dermatomes accommodated 148 points with 809 indications, of which 189 indications (23.4%) exhibited VDE features, whereas 620 (76.6%) exhibited TDE features.
A TDE/VDE ratio of 3 : 1 implies that the clinical indications for the points of any dermatome on the torso are similar, regardless of their meridians, and suggests that most of the indications for trunk points involve a 'horizontal pattern' due to their neurobiological nature. These findings may help in understanding acupuncture's neurobiology and clarify some confusing results of clinical research, for example, excluding sham acupuncture as an inert intervention for future clinical trials.
传统中医(TCM)经络和穴位呈垂直走向,反映了它们在张福系统(经络模式)中的功能。然而,躯干的脊神经呈横切方向,即“水平模式”。
本工作旨在通过认知类实验评估,躯干上穴位的临床指征是否与其经络功能相关,或者与它们的神经支配和内脏-躯体连接相关。
无论其经络如何,都将沿躯干每个皮节的穴位进行横切考虑。每个穴位的临床指征分为两种互斥类别:(a)纵向分布效应(VDE)或“经络模式”,当指征与皮节上其他穴位的指征有很大不同时;(b)横向分布效应(TDE)或“水平模式”,除了输穴外,主要表现为局部或节段性指征。在观察到两种类别之间的比例在试点样本中经常超过 60%后,采用 60%作为参考值。
共有 22 个皮节容纳了 148 个穴位,共有 809 个指征,其中 189 个指征(23.4%)表现出 VDE 特征,而 620 个(76.6%)表现出 TDE 特征。
TDE/VDE 比值为 3:1 意味着躯干任何皮节的穴位的临床指征相似,无论其经络如何,并且表明由于其神经生物学性质,大多数躯干穴位的指征涉及“水平模式”。这些发现可能有助于理解针灸的神经生物学,并澄清一些临床研究中的混淆结果,例如,将假针灸排除为未来临床试验的无效干预。