Clinical Practice Of Acupuncture Research Articles

"To be meridian or collateral" in meridian-collateral differentiation

Identifying the study subject, "to be in meridian or collateral", is the first step of meridian-collateral differentiation. Combined with the ancient literature and clinical practice of acupuncture and moxibustion, the methods of identifying "to be in meridian or collateral" and its values are elaborated. Through analyzing the onset location of symptoms and the body layers of lesions, as well as the palpation and observation in meridian-collateral detection, "to be meridian" or "to be collateral" is identified in disease diagnosis. It may guide the choice of techniques of acupuncture and moxibustion. Identifying "to be meridian or collateral" is crucial in meridian-collateral differentiation, which not only contributes to improving the therapeutic effect of acupuncture and moxibustion, but also to better recognizing diseases and understanding the relevant concepts of techniques of acupuncture and moxibustion in view of acupuncture and moxibustion, and perfecting the system of meridian-collateral differentiation.

Effect of acupuncture on BDNF signaling pathways in several nervous system diseases.

In recent years, the understanding of the mechanisms of acupuncture in the treatment of neurological disorders has deepened, and considerable progress has been made in basic and clinical research on acupuncture, but the relationship between acupuncture treatment mechanisms and brain-derived neurotrophic factor (BDNF) has not yet been elucidated. A wealth of evidence has shown that acupuncture exhibits a dual regulatory function of activating or inhibiting different BDNF pathways. This review focuses on recent research advances on the effect of acupuncture on BDNF and downstream signaling pathways in several neurological disorders. Firstly, the signaling pathways of BDNF and its function in regulating plasticity are outlined. Furthermore, this review discusses explicitly the regulation of BDNF by acupuncture in several nervous system diseases, including neuropathic pain, Parkinson's disease, cerebral ischemia, depression, spinal cord injury, and other diseases. The underlying mechanisms of BDNF regulation by acupuncture are also discussed. This review aims to improve the theoretical system of the mechanism of acupuncture action through further elucidation of the mechanism of acupuncture modulation of BDNF in the treatment of neurological diseases and to provide evidence to support the wide application of acupuncture in clinical practice.

From the body-mind holism to psychosomatic medicine: theory and practice of acupuncture and moxibustion

The traditional life concept of "body-mind holism" in Chinese medicine has drawn a special attention with the development of modern psychosomatic medicine. The "body-mind holism" is valuable in the guidance for clinical acupuncture practice, but, it is only remained on the theoretical significance by the medical masters in the past dynasties. In the paper, based on the understanding of Huangdi Neijing (Yellow Emperor's Internal Classic), the similarities and differences are compared between the body-mind theory and psychosomatic medicine. In association with clinical observation, from three aspects, i.e. body-mind pathogenesis, acupoint detection and observing the mind, and body-mind treatment, the guidance of "body-mind holism" is explored for the clinical diagnosis and treatment of acupuncture and moxibustion; the referents of "body" and "mind" are clarified in views of disease, diagnosis and treatment; and the treatment strategies of acupuncture and moxibustion are discussed in the perspective of "body-mind holism".

Discussion on "sugar needle - comfortable acupuncture and moxibustion"

The cases of feeling comfort during acupuncture and moxibustion treatment in literature were summarized and its biological basis was explored. A simple classification of comfort was made, and the importance of obtaining comfort in acupuncture treatment was pointed out. Considering the pursuit of less pain and harmlessness in modern clinical treatment, sugar needle should be advocated and popularized in current clinical practice of acupuncture and moxibustion.

Re-thinking the acupoint-visceral correlation: evidence from clinical literature and its biological mechanism

The regularity of acupoint-viscera correlation is a basic problem in the study of acupuncture and moxibustion. At present, there are two main theories of the regularities: (1) the law of acupoint effect determined by meridian circulation; (2) segmental dominance of acupoint effect. These two regularities belong to different paradigm systems, they are not complementary relations within the same conceptual system. Based on the evidence of clinical practice of acupuncture and moxibustion, combined with the research on biological mechanisms, this paper analyzed the objectivity and universality of the regularities of acupoint-visceral correlation. The law determined by meridian of acupoint effect does not manifests the universality guiding role in the clinical practice of modern acupuncture and moxibustion, which is obviously divorced from the needs of modern clinical practice. The segmental dominance of acupoint effect has been strongly supported by the clinical practice of modern acupuncture and moxibustion, which is highly consistent with the clinical practice. The regularity of acupoint effect needs to be tested and re-identified in practice.

The translational medicine approach to acupuncture and moxibustion

The idea of translational medicine from "laboratory to bedside" has become more and more popular. The main purpose of translational medicine is to promote basic research to solve practical clinical problems and improve the level of clinical treatment. It is thus a whole new medical paradigm. However, the principle of "bench to bedside" still has some obvious deficiencies in the "bench" ring, whereas the subject of acupuncture and moxibustion is carried out in the "bench" ring relatively more systematic, but also does not achieve bench to bedside regression well. Nevertheless, as a bridge between basic research and clinical practice of acupuncture and moxibustion, translational medicine has constructed a data fusion channel between them. Our basic researchers should cooperate closely with clinical experts, exchange ideas, collide sparks of wisdom, and promote the leap-forward development of acupuncture and moxibustion.

Paradigm transformation from structural meridians to functional meridians：a hypothesis of "the brain controls the meridians"

The "meridian" is the core concept of acupuncture medicine. It can be said that almost all the theories and clinical practice of acupuncture and moxibustion in traditional Chinese medicine are based on this concept. However, up to now, scientists have failed in finding the "meridian" described in Chinese classic textbooks and fall into the dilemma of the meridian essence research. In fact, the meridian is independent of currently known anatomical tissues. Nevertheless, researches obtained highly valuable outcomes of life science through long-term studies, especially the cerebral science endowed the meridian theory with new connotations. The modern meridian theory is composed of new knowledge and traditional meridian knowledge. In the present paper, we put forward a new hypothesis that "the brain controls the meridians", and a new academic paradigm, that is, the meridians research should turn from looking for the structure of meridian to exploring the functions of meridian, which can be realized with the help of brain function.

Acupuncture promotes nerve repair through the benign regulation of mTOR-mediated neuronal autophagy in traumatic brain injury rats.

Recent investigations have already proved the neuroprotective efficacy of acupuncture in clinical practice in the treatment of neurological diseases, such as traumatic brain injury (TBI). Since growing evidence has suggested that neuronal autophagy was involved in multiple stages of TBI, this study aims to clarify the autophagy mediating mechanism underlying the neuroprotective effect of acupuncture in TBI rats. Three experiments were carried out to detect changes in neuronal autophagy and identify the potential molecular mechanism underlying the neuroprotective effect of acupuncture for TBI treatment. Feeney's free-falling epidural impingement method was used to establish the moderate TBI rat model; modified neurological severity scoring (mNSS) was used for neurological recovery evaluation. Nissl and HE staining were used to examine the histopathological changes. Immunofluorescence was used to detect the LC3-positive cell rate. The transmission electron microscope (TEM) was used to investigate the morphology and quantity of autophagosomes. Western blotting was used to determine the protein expressions of LC3, p62, beclin1, mTOR, ULK1, p-mTOR, and p-ULK1. Quantitative real-time polymerase chain reaction (qRT-PCR) was used for gene expressions analysis of LC3 mRNA and p62 mRNA. Co-immunoprecipitation (CO-IP) method was used to identify the protein interaction of mTOR and ULK1. On Day 3 after TBI, acupuncture accelerated the removal of damaged cellular structures by promoting neuronal autophagy; on Day 7 and Day 14 after TBI, acupuncture inhibited neuronal autophagy, preventing excessive autophagy and thus alleviated nerve damage. In addition, the simultaneous treatment with 3-MA or rapamycin at different stages after TBI attenuated the effect of acupuncture. Acupuncture has a benign regulatory effect on neuronal autophagy in different stages of TBI, possibly through the mTOR/ULK1 pathway.

Exploration of GAO Shu-zhong's academic thought of acupuncture and moxibustion

This paper summarizes professor GAO Shu-zhong's academic thought of acupuncture and moxibustion. Professor GAO studies classic literature and clarifies the authentic Chinese medicine from the origin. He provides the unique understandings on the theories, e.g "four passes", gaohuang, the flowing rule of nutrient and defensive qi, lung governing management and regulation and moxibustion for sinking of qi. By analyzing the differences in diagnosis and treatment between acupuncture and herbal medication therapies and exploring the syndrome/pattern differentiation, he advocates the rules of disorder differentiation and treatment in clinical practice of acupuncture and moxibustion, creates GAO 's three-promotion theory and summarizes the characteristic diagnostic methods. He proposes novel statement, perfects theoretic system and creates GAO's extra points. He puts forward that the human acupoint system should be reconstructed to compose of two systems, i.e. meridian acupoints and collateral acupoints systems. Professor GAO pays the attention to acupuncture techniques, proposes a trinity needling technique, "pulse diagnosis, acupoint detection and qi differentiation under needle", and applies different needling techniques in treatment accordingly. He thinks highly of moxibustion, especially umbilicus moxibustion therapy, which has been used widely in practice. Besides, professor GAO provides the comprehensive methods flexibly, with acupuncture, moxibustion and herbal medication in combination.

Discussion on Collection of Clinical Questions in International Clinical Practice Guidelines of Acupuncture-Moxibustion.

The clinical questions of acupuncture-moxibustion (Acup-Mox) guidelines are complicated, including not only the curative effect of Acup-Mox intervention measures, but also the operational elements of Acup-Mox. This paper aimed to put forward the idea and process of collecting clinical questions in developing international acupuncture clinical practice guidelines. The experience was collected and the idea of collecting clinical questions of Acup-Mox was formed through expert consultation and discussion in combination with expert opinions. Based on the characteristics of Acup-Mox discipline. This paper put forward the thinking of collecting elements of clinical questions following the intervention-population-outcome-control (I-P-O-C) inquiry process, according to the discipline of Acup-Mox. It was emphasized that in the process of collecting clinical questions, "treatable population" and "alleviable outcome indicators" for a specific Acup-Mox intervention with certain therapeutic effect should be focused on, so as to highlight the pertinence of clinical questions of Acup-Mox guidelines in terms of population and outcome elements.

Acupuncture modulates the frequency-specific functional connectivity density in primary dysmenorrhea.

BackgroundThe study aimed to investigate how acupuncture modulates brain activities across multiple frequency bands to achieve therapeutic effects in PDM.MethodsA total of 47 patients with PDM were randomly assigned to the verum acupuncture group and sham acupuncture group with three menstrual cycles of the acupuncture course. The fMRI scans, visual analog scale (VAS) scores, and other clinical evaluations were assessed at baseline and after three menstrual-cycles treatments. The global functional connectivity density (gFCD) analyses were performed between the pre-and post-acupuncture course of two groups at full-low frequency band, Slow-3 band, Slow-4 band, and Slow-5 band.ResultsAfter the acupuncture treatments, the patients with PDM in the verum acupuncture group showed significantly decreased VAS scores (p < 0.05). The frequency-dependent gFCD alternations were found in the verum acupuncture group, altered regions including DLPFC, somatosensory cortex, anterior cingulate cortex (ACC), middle cingulate cortex (MCC), precuneus, hippocampus, and insula. The sham acupuncture modulated regions including angular gyrus, inferior frontal gyrus, and hippocampus. The gFCD alternation in DLPFC at the Slow-5 band was negatively in the patients with PDM following verum acupuncture, and S2 at the Slow-4 band was positively correlated with VAS scores.ConclusionThese findings supported that verum acupuncture could effectively modulate frequency-dependent gFCD in PDM by influencing abnormal DLPFC at Slow-5 band and hippocampus at the Slow-3 band. The outcome of this study may shed light on enhancing the potency of acupuncture in clinical practice.

Neural Responses of Acupuncture for Treating Functional Dyspepsia: An fMRI Study.

Different acupoints exhibiting similar therapeutic effects are a common phenomenon in acupuncture clinical practice. However, the mechanism underlying this phenomenon remains unclear. This study aimed to investigate the similarities and differences in cerebral activities elicited through stimulation of CV12 and ST36, the two most commonly used acupoints, in the treatment of gastrointestinal diseases, so as to partly explore the mechanism of the different acupoints with similar effects. Thirty-eight eligible functional dyspepsia (FD) patients were randomly assigned into either group A (CV12 group) or group B (ST36 group). Each patient received five acupuncture treatments per week for 4 weeks. The Symptom Index of Dyspepsia (SID), Nepean Dyspepsia Symptom Index (NDSI), and Nepean Dyspepsia Life Quality Index (NDLQI) were used to assess treatment efficacy. Functional MRI (fMRI) scans were performed to detect cerebral activity changes at baseline and at the end of the treatment. The results demonstrated that (1) improvements in NDSI, SID, and NDLQI were found in both group A and group B (p < 0.05). However, there were no significant differences in the improvements of the SID, NDSI, and NDLQI scores between group A and group B (p > 0.05); (2) all FD patients showed significantly increased amplitude of low-frequency fluctuation (ALFF) in the left postcentral gyrus after acupuncture treatment, and the changes of ALFF in the left postcentral gyrus were significantly related to the improvements of SID scores (r = 0.358, p = 0.041); and (3) needling at CV12 significantly decreased the resting-state functional connectivity (rsFC) between the left postcentral gyrus and angular gyrus, caudate, middle frontal gyrus (MFG), and cerebellum, while needling at ST36 significantly increased the rsFC between the left postcentral gyrus with the precuneus, superior frontal gyrus (SFG), and MFG. The results indicated that CV12 and ST36 shared similar therapeutic effects for dyspepsia, with common modulation on the activity of the postcentral gyrus in FD patients. However, the modulatory pattern on the functional connectivity of the postcentral gyrus was different. Namely, stimulation of CV12 primarily involved the postcentral gyrus–reward network, while stimulation of ST36 primarily involved the postcentral gyrus–default mode network circuitry.

Dissemination of Acupuncture-Moxibustion Clinical Practice Guidelines among Clinical Practitioners: A Systematic Review of Quality Assessment Studies.

Acupuncture clinical practice guidelines are authoritative medical recommendations developed by evaluating and integrating acupuncture-related evidence. However, their synthesis and dissemination are not integrated, and clinical practitioners require more credible effective evidence. The study aim was to systematically review problems disseminating acupuncture clinical practice guidelines to clinical practitioners, to facilitate evidence dissemination. This systematic review included searches of PubMed, EBSCO, Web of Science, and four major Chinese electronic databases (CNKI, VIP, Wanfang Database, and SinoMed) from inception to October 26, 2021. Two independent reviewers screened the literature, extracted information, and evaluated the quality of included studies. A systematic review was subsequently performed. Eleven studies were reviewed: nine (81.8%) cross-sectional surveys and two (18.2%) systematic reviews. The evaluated clinical practice guidelines differed across studies; seven studies (63.6%) evaluated guidelines for a specific disease, one (9.1%) evaluated guidelines for acupuncture therapies (e.g., moxibustion and fire acupuncture), one (9.1%) evaluated US acupuncture guidelines and recommendations, and two (18.2%) did not describe the guideline content. The included studies used different evaluation indicators. Guideline dissemination problems included lack of guideline standardization, unclear target population, mismatch between guidelines and application environment, lack of reliable health economics evaluation, poor quality content of the recommendations, lack of linkage between recommendations and evidence, and disassociation of recommendations from clinical practice et al. The development and publishing of credible acupuncture clinical practice guidelines is urgently needed to improve the usability of guidelines and standardize and disseminate tools for analysing information to clinical practitioners and to help the domestic and international acupuncture community to apply evidence to practice. Recommendations for promoting the dissemination of acupuncture clinical practice guidelines are to define clinical events suitable for the target population, to develop recommendations relevant to clinical practice, to improve the evidence evaluation index system, and to further standardize the method and process of formulating guidelines.

Investigation of international demand for Clinical Practice Guidelines of Acupuncture and moxibustion: A cross-sectional study

This study aims to get the medical management of acupuncture and moxibustion in the countries and regions where the society members of World Federation of Acupuncture-Moxibustion Societies (WFAS) are located, including the educational background of acupuncture and moxibustion practitioners and the local clinical practice of acupuncture and moxibustion, and the demands of the content and evidence types of Clinical Practice Guidelines (CPGs) of acupuncture and moxibustion in accordance with WFAS standards, so as to provide requirements and reference principles for the development of CPGs of acupuncture and moxibustion in accordance with WFAS standards. The convenient sampling method was used to collect the questionnaires, and the WFAS secretariat distributed the questionnaires to 294 contacts of society members from 70 countries and regions in the form of Questionnaire Star four times in April 2020, July 2020, March 2021, and April 2021 respectively. They were then distributed to individual members of acupuncture-moxibustion societies by the contacts. The study content involved the basic information of respondents, including their nationality, occupation, educational background of acupuncture and moxibustion, their local clinical practice and medical management of acupuncture and moxibustion, as well as their demand for CPGs of acupuncture and moxibustion, etc. After the questionnaires were collected, the data were analyzed and described by quantitative research method. In all, 302 respondents from 37 countries of six continents responded. The 302 respondents were members of the WFAS society members. (1) Basic information of respondents. They all had acupuncture and moxibustion learning experience, among which, 76.5% (231/302) had the education background of acupuncture and moxibustion professional college training, and 88.4% (267/302) had experience of acupuncture and moxibustion clinical practice. Acupuncturists or traditional Chinese medicine doctors accounted for 63.9% (193/302), western medicine doctors, nurses, and pharmacists accounted for 18.2% (55/302), and researchers and teachers accounted for 6.3% (19/302). (2) Local clinical practice and medical management of acupuncture and moxibustion. The level of clinical practice of acupuncture and moxibustion varies greatly among the regions where the WFAS society members lived. Among them, more countries in Europe have not included acupuncture and moxibustion in medical insurance than those in other continents (x2=26.049, P < 0.01), and more countries have not included acupuncture and moxibustion in public hospital treatment system than those in other continents (x2=113.488, P < 0.01). (3) Demand for CPGs of acupuncture and moxibustion. A total of 93.0% (281/302) respondents believed that WFAS CPGs of acupuncture and moxibustion would be helpful for their local practice. The order of their demand and concern for WFAS CPGs was: acupuncture manipulation > latest progress of acupuncture treatment > choice of acupuncture therapies > safety of acupuncture and moxibustion > combination of acupuncture and other programs. A total of 87.4% (264/302) respondents believed that ancient classics could guide clinical practice, and the ancient literature should be used as evidence for the development of guidelines. The respondents are those future practitioners of CPGs of acupuncture and moxibustion conforming to WFAS standards. Commonly they have clinical practice experience and professional education background. They believe that guidelines will be of help to the clinical practice of acupuncture and moxibustion, hope that WFAS CPGs would recommend effective guidelines for acupuncture manipulation and provide the latest progress in acupuncture treatment and so on, and they believe that classical ancient books can guide their clinical practice. It indicates the necessity and feasibility of formulating the WFAS CPGs of acupuncture and moxibustion. In view of the results of this study, it is suggested that the formulation process of WFAS CPGs of acupuncture and moxibustion should take into account the clinical practice level of acupuncture and moxibustion in each region, as well as its legislation and management situation of acupuncture and moxibustion, so as to meet the needs of users as much as possible.

A Protocol of a Guideline to Establish the Evidence Ecosystem of Acupuncture.

This is a protocol for developing a guideline to establish the evidence ecosystem of acupuncture. It describes all steps that will be followed in line with the World Health Organization Handbook for Guideline Development and the Reporting Items for practice Guidelines in Healthcare (RIGHT). The key steps included guideline protocol development, guideline registration, systematic review of acupuncture evidence issues, systematic review of methods for establishing evidence ecosystem, survey of acupuncture stakeholders regarding potential acupuncture evidence issues, development of potential items for guidelines, Delphi method for guideline item development, consensus meeting, drafting guideline, peer review, approval, and publishing. This future guideline will help to establish evidence ecosystem of acupuncture, which will facilitate the application of acupuncture in clinical practice.

The effects of acupuncture on psychological symptoms in patients with insomnia: study protocol for a randomized controlled trial

BackgroundInsomnia is a common sleep-related condition that includes dissatisfaction with sleep quality, difficulty in initiating or maintaining sleep, and early morning waking. Insomnia can affect daytime functioning by causing fatigue, depression, and anxiety. Medications are the most common method for the management of insomnia but can cause adverse effects, including psychological and physical dependence, residual daytime sedation, and cognitive impairment. Acupuncture is a common traditional Chinese therapy. It has been used in the treatment of insomnia, depression, and anxiety in China. However, there are no high-quality studies focusing on acupuncture for insomnia, especially for depression and anxiety due to insomnia. Therefore, we have designed a randomized controlled trial (RCT) involving a placebo control to ensure blinding of participants to investigate the effects of acupuncture on insomnia in improving sleep quality and psychosocial symptoms.MethodsWe have designed a single-center, parallel-group, single-blinded RCT. A total of 252 participants who meet the eligibility criteria will be randomly allocated into a manual acupuncture group or sham acupuncture group in a 1:1 ratio. All participants will receive 24 sessions of acupuncture (30 min per session, three sessions per week for 8 weeks). Participants will be assessed using the Pittsburgh Sleep Quality Index score, self-assessment anxiety scale, self-assessment depression scale, and Medical Outcomes Study 36-Item Short-Form Health Survey at baseline and 8 weeks. All analyses will be based on an intention-to-treat principle. The results will be published in an international peer-reviewed journal.DiscussionThe results of this study are expected to clarify the effects of acupuncture on sleep quality and psychosocial symptoms in patients with insomnia. This will contribute to the clinical practice of acupuncture in the management of insomnia.Trial registrationChinese Clinical Trail Registry ChiCTR2100049172. Registered on 24 July 2021.

Problems in randomized controlled trial on acupuncture and moxibustion for migraine in the development of international standard of Guideline for Clinical Practice of Acupuncture and Moxibustion: Migraine

Regarding the development of international standard of Guideline for Clinical Practice of Acupuncture and Moxibustion: Migraine, the existing problems of the design and methodology of randomized controlled trial (RCT) on acupuncture and moxibustion for migraine were summarized in views of participant, intervention, control, outcome and study design. Four directions need to be further explored, (1) research of adolescent migraine, special subtype of migraine and migraine in a special population; (2) research of the immediate analgesic effect of acupuncture and moxibuation at the attack stage of migraine and the therapeutic effect of migraine at each stage; (3) research on safety and health economics; (4) clinical trial registration of acupuncture and moxibustion. In study, the target population should be further determined and specialized, the diagnosis criteria of western medicine and traditional Chinese medicine be generalized and concentrated, the staging and type division of disease be accurate, the intervention procedure be integrated, the control design be rationalized, the outcomes be validated, and the description of randomization and blinding be clarified.

Analysis of Acupoint Selection and Combinations in Acupuncture Treatment of Asthma Based on Data Mining

Objective: Asthma is a highly prevalent respiratory disease that remains difficult to control. Acupuncture, as an important alternative therapeutic modality in preventing and treating asthma, is widely used in the world due to its promising efficacy and safety. Although acupoint selection and combinations are critical to therapeutic effects of acupuncture, its fundamental rules for asthma have not been fully understood. Thus, using data mining, the present study aimed to discover the most effective acupoints and combinations in the acupuncture treatment of asthma. Methods: Controlled clinical trials (CCTs) of acupuncture treatment for asthma were searched and retrieved from databases including Chinese National Knowledge Infrastructure (CNKI), Wanfang, and PubMed. Data regarding the main acupoints prescribed in these clinical trials was collected and quantified. A network analysis was performed to uncover the interconnections between the acupoints. Additionally, hierarchical clustering analysis and association rule mining were conducted to discover the potential acupoint combinations. Results: A total of 183 CCTs were retrieved. Feishu (BL13), Dingchuan (EX-B1), Dazhui (GV14), Shengshu (BL23), Pishu (BL20), and Fengmen (BL12) appeared to be the most frequently used acupoints for asthma. While the Bladder Meridian of Foot Taiyang, the Governor Vessel, and the Conception Vessel, compared to other meridians, were found to be the more commonly selected meridians. In the acupoint interconnection network, Feishu (BL13), Fengmen (BL12), Dingchuan (EX-B1), and Dazhui (GV14) were defined as key node acupoints. Moreover, acupoint clustering analysis revealed the treatment principle of “facilitating the flow of the lung Qi, tonifying spleen and kidney, and treating both the symptoms and root causes.” Association rule mining analysis demonstrated that the combination of Pishu, Shenshu, Feishu, and Dingchuan, as well as that of Feishu, Dazhui, and Fengmen were potential acupoint combinations that should be selected with priority in asthma treatment. Conclusion: Based on a data mining analysis of published CCTs, this study provides valuable information regarding the selection of the most effective acupoints and combinations for clinical acupuncture practice and experimental study aimed at the prevention and treatment of asthma.

A “4D” systemic view on meridian essence: Substantial, functional, chronological and cultural attributes

The term Jingluo, translated as meridian or channel, is a core component of traditional Chinese medicine (TCM) and has played a fundamental role in guiding the clinical practice of acupuncture for thousands of years. However, the essence of the meridian remains elusive and is a source of both confusion and debate for researchers. In this study, a “4D” systemic view on the essence of the meridian, namely substantial, functional, chronological, and cultural dimensions, was proposed based on a review of the ancient medical classics, recent research developments, and results from clinical practice. Previous studies have primarily focused on the substantial dimension of the meridian system, with scant interpretation about its functional domain. Neither systemic data nor evaluations have been adequately documented. Additionally, a limited but increasing number of studies have focused on the chronological and cultural dimensions. More investigations that embody the holistic concept of TCM and integrate the systemic modes and advanced techniques with dominant diseases of TCM need to be performed to obtain a more comprehensive understanding of the essence of meridians. The goal of this study is to yield useful information in understanding the essence of meridians and provide a reference and perspective for further research.

Tracing origin and development of "Fenglong (ST 40) for phlegm": examination and verification

From the perspective of academic history, the background and evolution of "Fenglong (ST 40) for phlegm" were systematically summarized. As a result, it was found that in the early period, Fenglong (ST 40) was used for "tangible phlegm" of respiratory tract, but in the later generations, due to the comprehensive effects of various factors, the phlegm treated by Fenglong (ST 40) was generalized. In modern clinical practice of acupuncture and moxibustion, Fenglong (ST 40) is widely used for phlegm-related diseases. In addition, the knowledge content represented by "Fenglong (ST 40) for phlegm" showed evolution and change in academic heritage of previous dynasties. It is necessary for modern acupuncture researchers to systematically sort out, test and discriminate the habitual knowledge in combination with the background of traditional Chinese medicine, so as to promote the contemporary inheritance and application of traditional acupuncture theory and knowledge.