| Objective:The present investigation tries to objectify the location of the Zusanli(ST36)acupoint co mparing the senstitive and anatomical location;study the "sensitive point" of Zusanli(ST36)with respect to its basic characteristics:sensitivity and shape,the sensitivity includes mechanical pain and thermalpain,the shape includes toughness and shape.Sensitivity and shape variables both have objective and subjective parameters,this study compares these two aspects in order to validate the variables(sensitivity,shape)and measuring tools(roughness meter,dynamometer).Study the relationship between the“intrinsic state”of acupoints(sensitivity,fo rm)and the body mass index(BMI).The study search for recognize behavioral tendencies in the whole sanple and according to the body mass index(BMI).Following this results propose norms or generalized patterns that can be applied to the entire population in relation to the sensitivity,location and morphology of the acupoint.Study the relationshp between the"intrinsic state" of acupoints(sensitivity,form)and the eight principles.All this asssesments are necessary to objectively explore the location and properties of acupoints.This study is the first step in validating the assessment tools.Method:According to the standard anatomic acupoint location and mechanical pain,the location of Zusanli(ST36)acupoint is daterminated in 101 patients.Objective and subjective measurements on acupoint sensitivity(mechanical pain,thermal pain)and morphological characteristics(toughness,shape)are conducted;a fterwards comparisons between subjective and objective variables of these indicators(sensitivity,morphological characteristics)were carried out.All measurements and assessments were performed in the right and left lower limbs.The sensitivity evaluates mechanical pain and thermal pain,and both variables have an objective and subjective aspect;the morphological characteristics evaluated are toughness and shape,and each variable has an objective and subjective aspect.Finally,the above results are compared with the clinical manifestations,which are based on the eight princples.The statistical analysis of this study is based on the whole sample and body mass index(BMI)grouping.Results:I.Acupoint location:The location of the more sensitive point in Zusanli(ST36)area and the anatomical reference shows statistically significant similarities with the measurement of the three inch(3?)(p<0.05)but not with middle finger measure(p>0.05);II.Clinical manifestations of acupoints:The subjective(S)consistency of Zusanli(ST36)in general at the right side was soft(67.5%)and at the left side was hard(56.6%)(p<0.05);the subjective(S)shape of Zusanli(ST36)in general at the right side was concave(67.5%)and at the left side was convex(56.6%)(p<0.05);the subjective(S)sensitivity for mechanical pain was:on the right side 56.8%of the patiants had lower sensitivity,35.8%had higher sensitivity and 7.4%had the same sensitivity on both sides;for the left side 37.9%had lower sensitivity,54.7%showed high sensitivity and 7.4%showed the same sensitivity on both sides(p<0.05);the subjective morpholo gy(S)of Zusanli(ST36)showed to be related to the subjective sensitivity(S)(p<0.05).The objective measuring for mechanical pain sensitivity(O)of Zusanli showed to be related to the objective measuring for thermal pain sensitivity(O)(p<0.05).The temperature differences between before and after the application of a thermal stimulus present three trends:the temperature increases after the stimulus,the temperature decreases after the stimulus and the temperature remains after the stimulus,these differences showed to be statistically significant(p<0.05).III.Acupoint clinical measuring instruments:The subjective morphology(S)of Zusanli(ST36)showed to be related to the objective morphology(O)(p<0.05),the study could not establish a satisfactory pattern between roughness meter parameters and the subjective morphology of the accupoint so is not possible compare the predicted characteristics from roughness meter variables with the exert force;the subjective sensitivity(S)of Zusanli(ST36)shown to be related to objective sensitivity(O)(p<0.05).? The influence of Bagang syndrome and BMI on the clinical manifestations of acupoints:The differential diagnosis of the eight principles based on the hot nature of the pathology shows statistically significant similarities with the mechanical pain sensitivity(p<0.05).These results are based on the total sample.By grouping the population according to the body mass index statistically significant association(p<0.05)was only observed between the differential diagnosis of the eight principles based on the external nature of the pathology and individuals with a BMI<18.5Kg/m2(tow body mass index).There was no statistical significance diference between BMI groups in aspects like acupoint sensitivity,shape and location.V.The relationship between the 3 cun body size and the estimated bone mass:Was found that there is statistically significant correlation(p<0.05)between the three inches measured on the hand(location parameter for Zusanli point)and the presumed bone mass.Conclusions:I.Acupoint location:a.Only 3 cun measure is relate to the anatomical and sensitive position of the acupoint,this study do not find statistical evidence for related middle finger measure with the anatomical and sensitive position of the acupoint ?.Clinical manifestations of acupoints:a.Zusanli sensitive area on the right side tend to be softer than on the left,while those on the left tend to be tougher;the shaped on Zusanli sensitive area on the right side tend to be concave,while those on the left tend to be convex;b.Painful sensitivity tends to be greater on the left side;c.Subjective sensitivity and subjective morphology are related in such a way that soft ac upoints are less sensitive and hard ones are more sensitive,the sensitivity of acupoints with concave shaped tend to be low,while that with convex shaped tend to be high;d.The sensitivity time for heat and painful mechanical sensitivity are strongly related;e.The investigation results point out that Zusanli acupoint(ST36)has tree different ways to react to heat stimulation:absorb heat(high temperature),reflect heat(low temperature)or the absorption and reflection of heat is balanced(no temperature change)?.Acupoint clinical measuring instruments:a.The values of R displayed by the roughness meter can predict some of the morphological characteristics of the acupoint(R value can be biased to toughness or shape),but the numerical information obtained in the present research is not enought to generate a digital constant that can be introduce in the roughness meter system to directly provide acupoint morphological parameters;b.The subjective and objective mechanical pain sensitivity are comparable,so the use of the dynamometer is effective for the prediction of mechanical pain sensitivity;?.The influence of Bagang syndrome and BMI on the clinical manifestations of acupoints:a.Mechanical pain sensitivity is related to the diagnosis of eight principles with respect to cold and heat pathology;b.The diagnosis of low weight according to the BMI is related to the diagnosis of eight diagnosis principles,specifically with superficial syndromes.The results of this study do not prove the relationship between BMI grouping and acupoint sensitivity,shape and location;V.The relationship between the 3 cun body size and the estimated bone mass:a.3 cun and "bone mass" are related,so meridian dimensions and bone mass have a specific relation. |
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