| Objective:Acupuncture was originating from China and has lived thousands of years. Nowadays acupuncture had started to be accepted in the scientific group. A lot of researches have been done, including the research on the accuracy of acupuncture points. The accuracy of these acupuncture points is very influential on the success of acupuncture therapy.At present, there are three methods of acupuncture point location commonly used in clinics. These include bone proportional measurement, finger measurement and anatomical landmarks.The level of difficulty will increase when locating acupuncture points in abdomen area, which is lack of anatomical landmarks. Moreover, the shape of abdomen is easily changed in a person who has a thick fat layer and loose abdominal skin. The reference measurements are important when locating acupuncture points that are not situated near anatomical landmarks.The aim of this research is to find the more accurate measurement to locate the abdominal acupuncture point.Methods:Research SampleThe subjects were Indonesian adult persons, the age is between20-40years old and the height is between150-180cm. All subjects had normal body, no handicap and no deformity. The amount of the subjects were300persons, divided into3groups:100persons with underweight criteria (BMI<18,5kg/m2),100persons with normal weight (BMI18,5-24,9kg/m2) and100persons with overweight criteria (BMI>25kg/m2).Data collection technique:Every person was taken his/her data of name, age, sex, body weight, height, thumb measurement, four finger measurement, the length from cubital crease to wrist crease (CW), the length from transverse popliteal crease to the tip of malleolus lateral (PM), the length from sternocostal angle to the center of umbilicus (SCU). WHO standard was used for the measurement standard. The writer decided to use the right side of the body part for the calculation.The weight and height of each subject were measured using conventional scales.The data for finger measurement were taken from thumb measurement and four-fingers measurement. To measure the width of thumb measurement, use dial caliper to measure thumb measurement. Thumb measurement is taken from the width of the thumb’s interphalangeal joint.To measure the length of four-fingers measurement, place the hand on the table with dorsal upside. Use the dial caliper to measure the width of index, middle, ring and little close together at the level of the dorsal skin crease of the proximal interphalangeal joint of the middle finger.For the bone proportional measurement, the data were taken from the length of cubital crease to wrist crease and from the length of transverse popliteal crease to the tip of malleolus lateral. The measurements above use WHO standard.The length from sternocostal angle to the center of umbilicus was measured. To determine sternocostal angle, palpate the lower borders of the ribcage unite at the lower sternal border, forming the sternocostal angle. To avoid mistake of the sternocostal angle for the tip of the xiphoid process, palpate along the costal cartilage in a superior direction to where it meets the sternocostal angle.There are two calculations done in this research to compare the results of two cun measurement method.First, all the data were transformed into1-cun length. The length of four-fingers (4F) were divided into3, the length of cubital crease to wrist crease (CW) were divided into12, the length of popliteal crease to the tip of malleolus lateral (PM) were divided into16, the length of arcus costae to umbilicus (ACU) were divided into8. Using1-cun ACU as a control, then all the data were compared. Statistical analyses of the values were completed using one-way analysis of variance (ANOVA) and examined by post hoc comparisons using the LSD test. Statistical significance is inferred at the p<0.05levels.Second, all bone proportional measurement (CW, PM and ACU) were transformed into finger-cun length using standards of1cun (from thumb measurement) and3finger cun (from4F measurement). To calculate the finger-cun length:the distance between two landmarks were divided by each finger cun standard length and the distances were expressed in finger cun unit relative to the standard.Results:The first calculation:For finger measurement,1cun-thumb and1cun-4F are statistically significant with1cun-ACU as the control in underweight and normal weight group, but not in overweight group.For bone proportional measurement,1cun-CW and1cun-PM are both statistically significant with1cun-ACU as the control in all BMI groups. The second calculation:-In all groups, ACU-Thumb is statistically different with8cun as the standard of ACU.-In all groups, ACU-4F is statistically different with8cun as the standard of ACU.-In all groups, CW-Thumb is statistically different with12cun as the standard of CW.-In underweight and normal weight group, CW-4F is statistically significant with12cun as the standard of CW, but not in overweight group.-In all groups, PM-Thumb is statistically different with16cun as the standard of PM.-In all groups, PM-4F is statistically different with16cun as the standard of PM.Conclusion:To locate abdominal acupuncture points, bone measurement is more reliable than finger measurement. But four fingers measurement is reliable to locate the acupuncture points at forearm.The width of cun measurement of each part of the body is different. But the width of1cun-thumb and1cun-4F is statistically significant with1cun-ACU but not in overweight group. The changes of abdomen shape make the measurement is not significant.The width of1cun-CW and1cun-PM are statistically significant with1cun-ACU, means that to locate abdominal acupuncture points, bone measurement is more reliable.In clinical practice, the combination of the three methods of acupuncture points location methods are very important to be applied. The using of anatomical landmark and followed by bone proportional measurement is preferable. If the practitioners still find the difficulties, the finger measurement can be used.After locate the approximate point location with those methods, the acupuncturist should feel for a depression in the body surface when palpating the location of an acupuncture point, and then, the most important that the acupuncturist must find the tenderness. |
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