WSAVA 2001 - Information Technology to Select Effective Acupoints for Therapy

Information Technology to Select Effective Acupoints for Therapy

Phil Rogers Ireland

SUMMARY

From over 55 textbooks and hundreds of clinical articles, data on acupoints used in specific conditions were assembled in a database. A summary of the database (�Acupuncture Formulas: Top Ten Points for Common Conditions�) is at [homepage.eircom.net/~progers/ad2.htm]. I will demonstrate the database in action.

To access data for the most used acupoints for treatment of a specific symptom, see the �Keyword and Fast Find Page� at [homepage.eircom.net/~progers/ff.htm]. Introductory pages are at [homepage.eircom.net /~progers/adtop.htm] and [homepage.eircom.net/~progers/ad1.htm]. Those unfamiliar with acupoint names or locations will find them at [homepage.eircom.net/~progers/pt.htm]. Acupoints for genitourinary and related conditions are covered in more depth at [homepage.eircom.net/~progers/gu1.htm].

INTRODUCTION

Change is the most fundamental principle of traditional Chinese medicine (TCM): nothing stays the same. Even in the same subject, causes and manifestations of disease change with time. Therefore, as great chefs avoid cookbooks, great acupuncturists avoid standardized (�Cookbook�) AP. Instead, based on their clinical findings at each session, they select and vary the acupoints used between sessions. However, well-based Cookbook AP is helpful for beginners and is effective in simple AP-responsive conditions in humans and animals. For background data, see the author's papers on AP [homepage.eircom.net/~progers/rogpubco.htm], especially those in the references at the end of this paper.

Mastery of acupuncture (AP) takes decades of study of the fundamental principles of TCM. Acutherapy is no panacea. It can work only if the correct points and procedures are used, and only if the adaptive-homeostatic mechanisms of the recipient can respond adequately. Adaptation is the key to health, happiness, and life itself. These data are given in good faith; they and the related files are for use by trained acupuncturists. In spite of our best efforts, imperfection, suffering, and death are as much everyday realities as beauty, health, and life. The Law of Change (day-night, life-death, joy-sorrow, pleasure-pain) is absolute and inflexible. Within that Law, even Masters must fail! Their loved ones (parents, children, friends) and their animals must suffer dis-ease and must die sometime. Death is the ultimate failure to adapt. C'est la vie. The author cannot guarantee the success of these prescriptions, nor be held responsible legally, morally, or in any other way, for any consequences arising from use or misuse of these data, or data in related articles.

Appendix 1

This page [homepage.eircom.net/~progers/ad1.htm] describes the structure of the acupoints database, basic Laws of selecting effective acupoints, and how to evaluate the likelihood that points in any given output may or may not be effective. Before using the Acupoint Formulas, readers should know the details in Appendix 1 which lists the acupoint conventions (coding systems) used, and has hyperlinks to the Channel Points, Renmai (CV) Points, Dumai (GV) Points, New Points (N), Strange Points (Z), Hand Points (H) and Other Points (O). Appendix 1 also lists details of the Structure and Headings of the Point's Index, the 12 main Laws of Point Selection and advises users on considerations before making the final selection of Points.

Twelve Basic Laws of Point Selection

Successful AP therapy depends on the selection of effective points. There is wide scope for creativity in point selection; very few Masters select exactly the same combination of points in any given case, but all Masters observe one, or several, of the following �Laws�:

1. Eight Principles, Six Levels, Six Level Variant (Mirror Technique), Five Phase Theory, Points for Specific TCM Syndromes [See �Practical Dictionary of Chinese Medicine� (Wiseman and Feng, 1998, Paradigm Publications, Brookline, Mass, USA, 945pp)].

2. Points according to the innervation.

3. AhShi (tender) points (trigger, myalgic, fibrositic, motor, REPP points).

4. Local points or points locally on nearest Channels.

5. Distant points on Channels controlling problem area.

6. Combine local and distant points or Yin and Yang points (e.g., Yuan (Source) point of the problem part, organ or Channel and the Luo (Passage) point of its linked Channel).

7. Points �Fore and Aft�, �Above and Below�, �Left and Right�, �Circling the Dragon� (encircling the problem area).

8. Extra-Channel Points well known for their symptomatic effects.

9. Back and Abdomen combination: SHU (BL Reflex) + MU (Front Alarm) or points near the SHU and MU.

10. XI (Cleft) point of affected organ/Channel in acute diseases.

11. Scar / neural therapy to improve electrical conductivity of scars and soft tissue injury by needling, injection, laser, physiotherapy etc.

12. Tianying point�under the ulcer base, into the cyst etc. Always seek the Ahshi (tender) points, especially Trigger Points!

Final Selection of Points

Experienced acutherapists seldom work with fixed-point selections. At a given session, they treat what they see, or feel, or sense, at that time. In later sessions they may vary, or alternate, the points. Frequent overuse of a point may create scarring or reduce its efficacy for subsequent use. If you use this �Cookbook� in your selection of points, be aware of the following:

1. High point scores (ratings), with multiple authors, indicate the most commonly used (important?) points. If the first point listed has a score < 0.40, this indicates poor agreement between authors and may indicate a prescription of doubtful value.

2. The first 4�6 points in each prescription list are the most frequently cited points. Additional points may be added from those remaining, if other symptoms indicate a need for them.

3. Prescriptions with fewer than two authors, or with little variation in point scores, may be of doubtful value!

4. The most common prescription for local or organ problems is: local points + AhShi points + distant points.

5. When needling, always provoke Deqi (needle sensation). Expect poor results if poor needle sensation is reported!

6. The number of needles per session should normally be < 12 (use as few as possible).

7. Alternate prescriptions if in doubt or if result is not satisfactory after 1�2 sessions.

8. Research workers seeking �non-active� points for placebo or control groups of subjects should not use any point listed in these prescriptions. As �active� points, they should consider points in the Top Ten of each list.

Structure of the Point Index for Body Organs, Parts and Functions

The common formulas in Appendix 2 are sorted by their codings (Lesion Codes) to follow a regional sequence as follows: 01xxxx Emergencies/First Aid; 02xxxx Head, its organs/functions; 03xxxx Neck, thyroid; 04xxxx Thoracic limb; 05xxxx Thorax, its organs/functions; 06xxxx Abdomen, its organs and functions; 07xxxx Pelvic limb; 08xxxx Skin and hair; 09xxxx General, immunity

Headings of the Points Index in Appendix 2

In the headings below, entries with a star* are new data from a recent review of Acupuncture in Genitourinary and related Conditions (qq).

Appendix 2

This page [homepage.eircom.net/~progers/ad2.htm] contains the Acupoint Formulas. It gives the �Top Ten Points� for major body functions, organs and parts. The format of each formula has 12 columns:

Column 1	2	3	4	5	6	7	8	9	10	11	12
Lesion Code, Area, problem or condition	Refs/Pts/Rating	1	2	3	4	5	6	7	8	9	10
010100 emergencies	39/168/.964	GV26	KI01	ST36	PC06	A_01	LI04	PC09	GV20	LU11	LI11
		0.851	0.824	0.521	0.500	0.497	0.441	0.391	0.362	0.338	0.319
...	...	...	...	...	...	...	...	...	...	...	...
090700 analgesia, pain control (general)	23/78/.957	LI04	ST36	LI11	TH05	OT05	SP06	LV03	GB34	A_22	GB38
		0.482	0.436	0.355	0.341	0.341	0.314	0.273	0.264	0.227	0.209

The values in the columns above are:

Column 1	2	3-7	8-12
Lesion Code, Area, problem or condition	Refs/Pts/Rating	Points 1-5	Points 6-10
The Lesion Code used in the database (�010100� in the example above), and the Area, problem or condition (�emergencies� in the example above).	Refs/Pts/Rating�the number of references (Refs), number of points (Pts) and the maximum possible score (Rating) for that condition in the database. In the example above, there were 39 references which cited points for �emergencies.� Between them, they cited 168 possible points, and the rating for any point maximum score was .964 (i.e. 96.4%).	Point 1 gives GV26 as the First (best) Point (score .851, or 85.1%).	Point 10 gives LI11 as the Tenth Best Point (score .319, or 31.9%).

The Keyword and Fast Find Page at [homepage.eircom.net/~progers/ff.htm] allows users to view the Keyword List and select a word (organ, body part, lesion or symptom) from it, or to Fast Find a Formula using the first letter of the search word of interest to access that part of the Keyword List. The Database is Copyright but colleagues are welcome to use the data in clinical practice. The author is in discussion with a developer of TCM Software to upgrade the package to include modern graphics, client files, accounts management, and basic information on TCM.

CONCLUSIONS

Having seen a demonstration of how to search the database, colleagues may be interested to access the data live on the WWW for use in their clinical practices. These data are useful for beginners and as a means of self-testing one's knowledge of acupoint selection for many common conditions in humans. They can be used successfully in animals by the transposition method (Rogers 2001).

REFERENCES are AVAILABLE ON REQUEST