Hoku Point Research Articles

Effect of Hoku point massage on postpartum afterpains intensity among multiparous women

Afterpains are high prevalent complaints. They lead to neuro-hormonal stress responses. Hoku point massage is used to relieve afterpains. Objective: determine the effect of Hoku point massage on postpartum afterpains intensity among multiparous women. Material and Methods: A quasi-experimental design was conducted at El-Shatby Maternity Hospital. A purposive sample of 100 women who were meeting the inclusion criteria. The control group was receiving routine hospital care and the experimental group was receiving Hoku point massage. Results: statistically significant difference was found between the control and experimental group regarding socio-demographic and reproductive data as well as physiological stability, as evidenced by vital signs, while there was a highly statically significant difference between the control and experimental groups in the favor of Hoku point massage. Conclusions and recommendations: Hoku point massage was effective in the reduction of postpartum afterpains intensity. multiparous women who receive Hoku point massage showed observable behaviors indicating less afterpains intensity than those who do not receive it. Researchers recommended that strict protocols should be established in maternity care units for a comprehensive and routine assessment of afterpains. Further studies should be conducted to verify the findings of this study.

Comparing the effect of cold and warm stimulation of Hoku point on pain Caused by Removal of External Fixators pin in patients with hand fractures

Comparing the effect of cold and warm stimulation of Hoku point on pain Caused by Removal of External Fixators pin in patients with hand fractures

The Effect of Cryotherapy in the Hoku point on the Severity of Pain of Fistula Catheterization in Patients on Hemodialysis

The Effect of Cryotherapy in the Hoku point on the Severity of Pain of Fistula Catheterization in Patients on Hemodialysis

Effect of LI4 (Hoku point) massage with ice on labor duration during the active phase of labor among women delivering at El Manial University Maternity Hospital

Background Childbirth is one of the most painful experiences for women during their reproductive life. The aim of this study was to assess the effect of large intestine 4 (LI4) massage with ice on labor duration during the active phase of labor. A randomized controlled trial was adopted for this study. Mothers were recruited from the labor unit at El Manial University Maternity Hospital. A total of 200 laboring women were randomly selected after admission to the labor unit according to certain criteria. The sample was divided into two groups (100 each): group A and group B. Women in group A received LI4 massage with ice on their hands and women in group B received routine care. Two tools were developed and filled by the researchers, a structured interview sheet and a partograph, to assess the labor progress and duration. Results We found no statistically significant differences between groups with respect to maternal sociodemographic characteristics. The duration of the active phase (4 cm dilatation to full dilatation) was shorter in the study group compared with the control group. This difference showed a highly significant difference (X=4.5±0.53 compared with 5.39±0.89) (P≤0.05). Conclusion and recommendations The study concluded that LI4 massage with ice on the hands is an easy, cost-effective, and noninvasive technique to reduce the duration of labor.

The Effect of Hoku Point Massage with Ice on Venipuncture Pain in Children with Thalassemia

The Effect of Hoku Point Massage with Ice on Venipuncture Pain in Children with Thalassemia

Complementary and alternative therapies to relieve labor pain: A comparative study between music therapy and Hoku point ice massage

Background & aimPain is a common experience for women during labor. In the present study, we compared the effect of two types of non-pharmacological pain relief methods “music therapy” and “Hoku point ice massage” on the severity of labor pain. MethodsThis prospective, randomized, controlled trial was conducted in Shahrekord, Iran, from September 2013 to June 2014. We randomly assigned 90 primiparous women who expected a normal childbirth into three groups: group “A” received music therapy, group “B” received Hoku point ice massage, and group “C” received usual labor care. At the beginning of the active phase (4 cm cervical dilation) and before and after each intervention (at dilations 4, 6, and 8 cm), the intensities of labor pain were measured using Visual Analogue Scale (VAS). ResultsAt the beginning of the active phase, the mean VAS scores were 5.58 ± 1.29, 5.42 ± 1.31, and 6.13 ± 1.37 in the women in groups “A,” “B,” and “C,” respectively (P > 0.05). After the intervention, the mean pain scores were significantly lower at all of the time points in groups “A” and “B” than in group “C” women (P < 0.05). Although the pain scores showed a more decreasing trend after the intervention in group “A” than that in group “B,” the difference between the two groups was not statistically significant (P > 0.05). ConclusionsMusic therapy and Hoku point ice massage are easily available and inexpensive methods and have a similar effect in relieving labor pain.

Hoku Cryokinetics for the Reduction of Pain during the Active Phase of Labor

Hoku is located on the medial midpoint of the first metacarpal, within 3 - 4 mm of the web of skin between the thumb and forefinger. The study evaluated the effectiveness of the use of ice massage on the energy meridian point, large intestine 4 (Hoku), during contractions to reduce the woman’s perception of labor pain. This one-group, pretest-post test design was instituted among 30 primigravid Cebuano women. The study utilized a 100 mm Visual Analog Scale (VAS) to numerically measure pain levels before and after using ice massage on the left and right hand. Pain response difference being evaluated consisted of four elements: pain before and after ice massage of left hand and pain before and after ice massage of right hand. Results indicated significant pain reduction with a mean difference of 18.93 mm on the left hand and 20.87 cm on the right hand. Hoku Cryokinetics on the left Hoku point highly yield the same analgesic effect with that of the right Hoku point. The study concludes that ice massage on either hand is a cost-efficient, safe, non-invasive, non-pharmacologic and effective method in reducing labor pain. Keywords - Hoku cryokinetics, active phase of labor, reduction of pain, Cebuano Women

Electroacupuncture-induced pressor and chronotropic effects in anesthetized rats

The effects of electroacupuncture (Ea) on circulatory dynamics were investigated in anesthetized rats. The arterial blood pressure (BP) and the heart rate (HR) in response to Ea stimulations at the Tsusanli point (St-36) and the Hoku point (Li-4) were tested by a low frequency Ea (2 Hz; LFEa) and a high frequency Ea (20 Hz; HFEa) with stimulation intensities 20 times the motor threshold. Neither the HR nor the BP was affected when the Tsusanli point was stimulated. Whereas, Ea stimulations at the Hoku point elicit chronotropic and pressor effects. The patterns of pressor responses caused by the LFEa were different from that of an HFEa, i.e., the LFEa elicited a tonic effect, while an HFEa had a phasic one. The HFEa-induced pressor and chronotropic effects were attenuated, while the LFEa induced effects were completely blocked by an intravenous infusion of an alpha-adrenergic blocker (moxisylyte 0.2 mg/min/kg, i.v., for 20 min). A co-infusion with alpha-and beta-adrenergic blockers (propanolol 0.2 mg/min/kg, i.v., for 20 min) completely blocked the HFEa-induced pressor and chronotropic effects. We concluded that Ea stimulations, at the Hoku acupoint, with appropriate stimulation parameters can increase and maintain BP. Furthermore, the LFEa stimulation activates sympathetic vasomotor tone, whereas the HFEa stimulation causes an additional potentiation on the sympathetic drive to the heart.

Depressor effect on blood pressure and flow elicited by electroacupuncture in normal subjects

To clarify the effect of electroacupuncture (Ea) on the activity of the cardiovascular system in normal individuals, hemodynamic parameters including arterial blood pressure (BP), finger blood flow (FBF) and heart rate (HR) as well as paravertebral temperature (PVT) were non-invasively recorded under Ea stimulation. Surface stimulation electrode was placed on the Hoku point (Li-4). Square wave pulses (0.05 ms) were applied from a stimulator with a stimulation frequency of 2 Hz (3 min). The stimulation intensity was five times of sensory threshold. BP and FBF were decreased (68.5±6.0%, P<0.01 and 96.8±1.1%, P<0.01 of control, respectively, n=7) while HR and PVT were increased significantly (115.0±5.1 of control, P<0.05 and 0.054±0.004 degree C, P<0.01, respectively, n=7) during Ea treatment. The results suggested an inhibition in sympathetic outflow, which induced vasodilatation of systemic arteriole and decrease in BP and FBF were elicited by Ea stimulation.

Afferent nerve characteristics during acupuncture stimulation

A number of studies have provided evidence that acupuncture or acupuncture-like stimulation increases pain threshold in humans. According to traditional Chinese theory, there is a specific point called meridian point to treat a specific symptom. For example, if a needle was inserted into Ho-Ku point, and this point was stimulated electrically or manually, oro-facial pain, especially tooth pain, is fairly diminished. To clarify peripheral mechanisms of acupuncture effects and to reveal the nature of meridian points scientifically, characteristics of afferent nerve information evoked by acupuncture stimulation were investigated in Wistar albino rats. The magnitude of the jaw opening reflex induced by stimulation of the lower incisor tooth pulp was estimated as an indicator of the acupuncture effect. Acupuncture needling was given at one meridian point of Ho-Ku and two nonmeridian points in the forepaw. Compound action potentials of ulnar, median and radial nerves elicited by electroacupuncture stimulation (0.1 ms duration at 45 Hz for 15 min) were recorded from the brachial plexus. Electroacupuncture stimulation applied to the Ho-Ku point showed a greater suppressive effect than that to the two nonmeridian points. The threshold current intensity for producing the compound action potentials was the lowest at Ho-Ku. There was a significant correlation between the amplitude of A-beta fibers in the compound action potentials elicited by electroacupuncture stimulation and the degree of suppression of the jaw opening reflex. The results of the present study are in good agreement with the traditional view that stimulation of the meridian point is an important factor for obtaining excellent acupuncture effects. Moreover, we propose that A-beta component plays a leading role in producing acupuncture effects (A-beta theory). Activation of A-delta or C components may play a supplemental role in detecting the magnitude of the A-beta activities, and relate to the “Tokki”, which is reported to be dull, warm or tingling sensation. At the central terminal site of the primary nociceptive afferent, three inhibitory mechanisms were observed in the spinal trigeminal nucleus.

Inhibitory Effects of Electroacupuncture on Stress Responses Evoked by Tooth-Pulp Stimulation in Rats

The mechanism of electroacupuncture (EA) on the stress responses induced by tooth-pulp stimulation was investigated in anesthetized adult female Sprague–Dawley rats. The Hoku point in the Chinese meridian was used for acupuncture stimulation. Constant rectangular current (1 mA) pulses of 5-ms duration were delivered at 3 Hz through a pair of needles for 15 min. As for stress response indexes, we have monitored changes in arterial blood pressure and the levels of blood catecholamines, corticosterone, and ACTH. Arterial blood pressure was increased by high frequency stimulation (0.1 mA, 0.5 ms, 100 Hz for 15 s) of tooth-pulp in the control condition. After EA, we did not observe the same responses of the arterial blood pressure changes with the same stimuli. The tooth-pulp stimulation increased the concentrations of plasma norepinephrine (NE), epinephrine (E), dopamine (DA), corticosterone, and ACTH significantly from the levels of those before stress. After treatment with EA, the stress-induced increase in NE, DA, corticosterone, and ACTH but not the rise in E, were inhibited. When naloxone, an opioid antagonist, was administered intraperitoneally before EA, the effects of EA on stress responses were reduced. In this study, it can be suggested that EA has not only an analgesic effect but also suppressive effects on the stress responses primarily through the mediation of an endogenous opioid.

Vibration-induced finger flexion reflex and inhibitory effect of acupuncture on this reflex in cervical spinal cord injury patients

The vibration-induced finger flexion reflex (VFR) and the inhibitory effect of acupuncture on this reflex were studied in five cervical spinal cord injury patients (C-SCIs). VFR, which is a tonic finger flexion reflex induced by vibratory stimulation on the finger tip, was induced before and after acupuncture was carried out on the same hand. A stainless steel needle was inserted to the Hoku point. As in healthy subjects, VFR was performed and it was significantly inhibited by acupuncture in the C-SCIs; mean maximum VFR was 204.2 ± S.E. 68.6 g before and 119.8 ± S.E. 42.2 g after acupuncture. The present results suggest that at least part of the reflex center for VFR is located in the spinal cord and that part of VFR inhibition by acupuncture may be mediated via the spinal cord.

O-25-11 - The effects of naloxone on HPA function in depression

The effects of electroacupuncture (Ea) on circulatory dynamics were investigated in anesthetized rats. The arterial blood pressure (BP) and the heart rate (HR) in response to Ea stimulations at the Tsusanli point (St-36) and the Hoku point (Li-4) were tested by a low frequency Ea (2 Hz; LFEa) and a high frequency Ea (20 Hz; HFEa) with stimulation intensities 20 times the motor threshold. Neither the HR nor the BP was affected when the Tsusanli point was stimulated. Whereas, Ea stimulations at the Hoku point elicit chronotropic and pressor effects. The patterns of pressor responses caused by the LFEa were different from that of an HFEa, i.e., the LFEa elicited a tonic effect, while an HFEa had a phasic one. The HFEa-induced pressor and chronotropic effects were attenuated, while the LFEa induced effects were completely blocked by an intravenous infusion of an alpha-adrenergic blocker (moxisylyte 0.2 mg/min/kg, i.v., for 20 min). A co-infusion with alpha-and beta-adrenergic blockers (propanolol 0.2 mg/min/kg, i.v., for 20 min) completely blocked the HFEa-induced pressor and chronotropic effects. We concluded that Ea stimulations, at the Hoku acupoint, with appropriate stimulation parameters can increase and maintain BP. Furthermore, the LFEa stimulation activates sympathetic vasomotor tone, whereas the HFEa stimulation causes an additional potentiation on the sympathetic drive to the heart.

Effect of acupuncture at the Hoku point on vibration-induced finger flexion reflex in man: comparison between press needle technique, electroacupuncture, and in-situ technique.

Effects of press needle technique (PN), electroacupuncture (EA), or in-situ technique (IS) on vibration-induced finger flexion reflex (VFR) were examined in 31 healthy adults. VFR, which is tonic finger flexion evoked by vibration applied to the finger tip, was induced by vibrating the volar side of the middle finger tip before and after acupuncture. Acupuncture was applied to the Hoku point on both sides. The three techniques, each studied on separate days, inhibited VFR and there was no significant difference in VFR inhibition among the three techniques (percentage of pre-acupuncture VFR was 71.5 +/- SE 2.2% after PN, 72.6 +/- SE 2.4% after EA, and 75.6 +/- SE 2.8% after IS). The results suggest that afferent signals from muscles contracting due to electrical stimulation had no significant effect on the reflex arcs of VFR; and that the intradermal stimulation by acupuncture played a significant role in VFR inhibition.

Rat hypothalamic arcuate neuron response in electroacupuncture-induced analgesia

Electroacupuncture (EA) effects on activity of arcuate neurons of the hypothalamus (ARH) and on magnitude of the digastric electromyogram (dEMG) in the jaw opening reflex were investigated, in both p-chlorophenylalanine pretreated and normal Wistar rats. EA stimulation (300–500 μA, 5 msec pulses, for 15 min) was delivered unilaterally to a meridian Ho-Ku point of anesthetized rats at 3, 45 and 100 Hz. In control animals, EA stimulation at 3, 45 or 100 Hz induced long-lasting suppression of the magnitude of the dEMG activity and changed the spontaneous firing rate of most of the ARH neurons: the rate either increased (type I) or decreased (type II). After low-frequency stimulation, there were significantly more type I neurons than type II, after high-frequency stimulation, there were significantly more type II neurons than type I. In serotonin-depleted rats, however, high-frequency stimulation suppressed dEMG activity only slightly and induced a smaller proportion of type II neurons.

Electroacupuncture increases ipsilaterally tooth pain threshold in man.

The effect of electroacupuncture stimulation applied to a unilateral Ho-ku point on the human tooth pain thresholds was studied by electrically stimulating bilateral canines. In six of ten subjects tested, the tooth pain threshold was elevated ipsilaterally but was unchanged contralaterally during and after the electroacupuncture. In the remaining four, neither the ipsilateral nor the contralateral canine showed any change in the pain threshold by the electroacupuncture. The ipsilateral increase of the tooth pain threshold may be explained by a mechanism by which electroacupuncture stimulation of one Ho-ku point causes various pain suppression centers to release ipsilaterally endogenous opioids.

Extrasegmental transcutaneous electrical nerve stimulation and mechanical vibratory stimulation as compared to placebo for the relief of acute oro-facial pain

The present paper describes the pain reducing effect of high and low frequency transcutaneous electrical nerve stimulation (TENS) and 100 Hz mechanical vibratory stimulation as compared to placebo stimulation of the HoKu point in 50 patients suffering acute oro-facial pain. Ten of the 30 patients receiving actual stimulation reported pain reduction during treatment. In the placebo group of 20 patients, 4 of the subjects experienced pain relief during the trial. The findings in the present study showed that extrasegmental superficial stimulation of the HoKu point alters pain intensity in the patients studied to only a minor degree. The number of patients reporting pain alleviation and the magnitude of pain reduction in the groups receiving actual stimulation was comparable to that observed in earlier studies using intrasegmental placebo stimulation.

Sympathetic vasomotor changes induced by manual and electrical acupuncture of the hoku point visualized by thermography

Considerable evidence implicates sympathetic neural activity in acupuncture analgesia. However, the exact nature of these effects has not been specified in detail, and many experimental findings are contradictory. This study evaluated in normal conditions the specific sympathetic effects of both manual and electrical acupuncture applied to the same hand (Hoku) point. Thermographie measures of superficial skin temperature were used to assess sympathetic vasomotor tone in the face, hand and foot of 19 normal subjects. Baseline assessment, manual acupuncture and electrical acupuncture were performed in 3 separate sessions in a well controlled, 23°C environment. Superficial skin temperature decreased slowly in the control condition. Both manual and electrical acupuncture produced a generalized long-lasting warming effect, indicating reduced sympathetic activity (sympatholytic effect). In addition, electrical acupuncture induced a localized short-term cooling effect, indicating a transient segmental increase in sympathetic activity (sympathomimetic effect).

Sympathetic effects of manual and electrical acupuncture of hoku and tsusanli points as evidenced by thermography

Sympathetic effects of manual and electrical acupuncture of hoku and tsusanli points as evidenced by thermography

Characteristic of analgesia induced by noncatecholic phenylethylamines in mice

Using hot plate method, analgesia induced by noncatecholic phenylethylamines, phenethylamine, phenylethanolamine and amphetamine, was inhibited by naloxone, reserpine, apomorphine and p-chlorophenylalanine, while potentiated by haloperidol. These results suggest that phenylethylamines induced analgesia involves central dopaminergic and serotonergic neurons and endogenous opioid peptides. The blockade of dopaminergic neurons enhanced and the inhibition of serotonergic neuron activity or the stimulation of dopaminergic neurons attenuated the phenylethylamines induced analgesia. Using rat hind paw pressing or tail flick test, analgesia induced by electroacupuncture in which Hoku points were electrically stimulated through stainless steel needles was enhanced by phenylethylamines, haloperidol while attenuated by naloxone, reserpine, apomorphine and p-chlorophenylalanine. Thus the analgegic characteristic of phenylethylamines closely resembles that of electroacupuncture.