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11[29] ShenYanJu, Peng Lan Liao Zhiling, etc. STZ replication process of experimental type 2 diabetic rats model and experience summary [J]. J g journal of guangxi medical university, 2011, 28 (6) : 821-821.
Biophysical Characteristics of Meridians and Acupoints Commonly Used in the Reproductive System
LI Juan, 1 WANG Qing,1 LIANG Hui-ling,1 DONG Hao-xu,1 LI Yan,1 ERNEST Hung Yu Ng,2 WU
Xiao-ke 1
1Department of Obstetrics and Gynecology, National Key Discipline and Clinical Base, Heilongjiang University of Chinese Medicine, Harbin 150040, China Department of Obstetrics & Gynecology, The University of Hong Kong, Hong Kong Special Administrative Region, China
Abstract
Numerous experiments have demonstrated meridians and acupoints having many biophysical properties which include electric characteristics, thermal characteristics, acoustic characteristics, optical characteristics, magnetic characteristics, isotopic characteristics, and myoelectric characteristics. However, there is little evidence of the biophysical characteristics of meridians and acupoints commonly used in treating gynecological diseases. Therefore, we summarized these biophysical characteristics of meridians and acupoints commonly used in the reproductive system in this paper. The study implied that meridians and acupoints commonly used in treating gynecological diseases also have biophysical characteristics that are different from non-acupuncture points, and these properties are significant for gynecological effects. Owing to the limitations of previous studies, the application of biophysical characteristics of meridians and acupoints in various clinical specialties should be attention. And more experimental mechanistic studies and randomized controlled trials are warranted to further explore and evaluate the therapeutic mechanisms from the perspectives of the biophysical characteristics of meridians and acupoints.
Key Words : biophysical characteristic; meridian; acupoints; reproductive system
Acupuncture is an integral part of traditional Chinese medicine which dates back 3000-5000 years, and has become more established in Western medicine as a complement or alternative to conventional therapies. As a major part of acupuncture, meridian theory has guided clinical practice of acupuncture for thousands of years. Recently, researches on meridian essence have become core
issues. Numerous experiments have demonstrated meridians and acupoints having many
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biophysical properties which are different from those of non-acupuncture points ' .The characteristics include electric characteristics, thermal characteristics, acoustic characteristics, optical characteristics, magnetic characteristics, isotopic characteristics, and myoelectric characteristics3.
The use of acupuncture within the area of reproductive endocrinology and infertility has gained increased popularity worldwide. Existing literatures shows that acupuncture is a suitable alternative or complement for inducting ovulation, adjusting endocrine and metabolic disorders, and used in vitro fertilization and embryo transfer without adverse side effects4,5.
However, there is little evidence of the biophysical basis of acupuncture in the reproductive system, such as biophysical characteristics of meridians and acupoints commonly used in treating gynecological diseases, and their applications in gynecology and obstetrics. Therefore, we searched
the electronic databases MEDLINE, EMBASE, CINAHL, EMBR, CNKI, Wanfang, and Vip from the beginning to December 2012to further explore the biophysical characteristics of meridians and acupoints commonly used in the reproductive system.
1. Meridians and Acupoints Commonly Used in Treating Gynecological Diseases
Chen6 summarized acupoints mentioned in 42 ancient acupuncture and gynecological
monographs, as well as 294 modern literatures of treating gynecological diseases between 1979 and 2007. The gynecological diseases mentioned in ancient literatures including disorders of menses, pregnancy, prenatal, and postnatal diseases. The modern literatures mainly concerning dysmenorrhea, infertility, abnormal uterine bleeding, abortion, hasten parturition, midwifery, menstrual disorders, ovarian cysts, pelvic inflammatory diseases, uterine fibroids, endometriosis and uterine prolapse. The author summarized 115 acupoints commonly used in treating gynecological diseases. Furthermore, he calculated the ratio of acupoints effective for treating gynecological diseases in corresponding meridian, and analyzed their utilization frequency. In conclusion,the meridians commonly used in treating gynecological diseases are liver meridian, kidney meridian, conception vessel and heart meridian. And the acupoints are spleen (SP) 6, conception vessel (CV) 4, CV 3, CV 6, and stomach (ST) 36.
2. Biophysical Characteristics of Meridians Commonly Used in Treating Gynecological Diseases
2.1 Conception Vessel
According to the TCM theory, the conception vessel where yin meridians aggregated plays an important role in reproductive processes including menstruation, pregnancy and giving birth. Pan et al. found the infrared radiant track along the conception vessel could be observed over human body surface with advanced infrared thermal imaging technology after moxibustion. Their courses basically coincided with the fourteen meridians described by the Chinese ancientphysicians. It was a surprise that the infrared radiant track along meridian course (IRRTM) of kidney meridian displayed on the screen when local heating the non-acupuncture point beside CV 8. Furthermore,
o
Pan et al. investigated the diffusion rate of skin temperature along conception vessel during local heating CV 8. The maximum diffusion rate was 17 cm/min, the minimum diffusion rate was 0.78 cm/min, and the average speed was 4.31 cm/min. When different genders were compared, the diffusion rate of females was slower than that of males. They also found heating the acupoints or non-acupuncture points along the conception vessel on most subjects could significantly improve the appearance rate of IRRTM, increase the infrared radiant track distance, and make the tracks more consecutive and regular. However, its elicitation was determined by season, subjects' shape, and heating time.
2.2 The Three Yin Meridians of Foot
The three yin meridians of foot, kidney, liver, and spleen meridians, are distributed on the inner sideof lower extremity and closely related to the female reproductive function. According to TCM theory, kidney meridian connects with uterus via the thoroughfare, conception, and governor vessels, providing "essence" to menses, fetus and pregnancy; liver meridian intersects the conception and governor vessels at SP 6, CV 2, and governor vessel (GV) 20, which has important regulative functions on uterus activity; spleen meridian intersecting the thoroughfare and conception vessels at SP 6 and CV 3, also provides "essence" to menses, fetus and pregnancy. Guo10 tested for the sound waves of six meridians' "five shu points" on the lower limb, and concluded that: A) the sound waves of six meridians on the lower limb were transmitted along the channels; B) the sound waves' frequencies of six meridians on the lower limb were in the range of 21-33Hz; C) the sound waves' frequencies of yang meridians of foot were higher than that of yin meridians; D) the sound waves' frequencies of six meridians on the lower limb were very close to the natural frequencies of the muscle and fascia tissue.
2.3 Heart Meridian
In the TCM theory, heart governs blood circulation, and connects with uterus by uterine vessels. Reichmanis et al.1112 detected the frequency dependence of the skin impedance between two acupuncture points (heart3 (HT 3) and HT 4) and the acupoints impedance of a length of the heart meridian not containing any acupoints by Laplace plane analysis of the time domain response to an input voltage pulse. They found both the resistance and capacitance between the acupoints differed significantly from the corresponding controls. Furthermore, the resistance of the heart meridian was significantly lower than that of controls. Yang et al.13 observed the waveforms of electrical current on HT 9 and HT 7, as well as two non-acupuncture points. The waveforms of the heart meridian were sharp impulses, which were different from the non-meridian.
3. Biophysical Characteristics of Acupoints Commonly Used in Treating Gynecological Diseases
3.1 CV 4, CV 3, and CV 6
CV3, 4, and 6 are the acupoints on the conception vessel, which all located at abdomen, 3 cun caudal to the umbilicus, 1 cun cranial to the pubic bone in the midline, and 1.5 cun caudal to the umbilicus respectively. Zheng14 detected the electrical changes on CV 4 and GV 4 of 30 health young women in their menstrual cycle, and found CV 4 and GV 4 displayed regular electric changes in normal menstrual cycle. Moreover, the different potential changes in the conception and governor vessels reflected different functional characteristics in regulating the menstrual cycle. In addition, in patients with amenorrhea, the potential value of CV 4 was smooth without peak, which was different from that of healthy subjects with regular cycles15.Feng et al.16compared the differences of surface infrared radiation spectrum of CV 4 among the patients with different syndromes of hyperplasia of mammary glands. The result showed that the differences in intensity of infrared radiation of CV 4 might be associated with the patients with different syndromes of hyperplasia of mammary glands.
3.2 Spleen (SP) 6
SP 6 belongs to the spleen meridian of foot "taiyin", which is widely used in the treatment of gynecological diseases. Its location is 3 cun proximal to the medial malleolus. Wei et al.17 confirmed that SP 6 had two characteristics about non-linear and similar hysteresis by detecting
increased or decreased return current-voltage curve of bilateral ST 36, SP 6, LR 3 and the
18
corresponding non-acupuncture points as controls on healthy volunteers. Zhang et al. detected the locations of SP 6 and ST 36 in rats based on the biophysical properties of acupoints, and observed the effect of electro-acupuncture at SP 6 on intestinal mucosal blood flow with ST 36 as control. The result showed that there was no difference between the two acupoints in adjusting intestinal mucosal blood flow.
3.3 Stomach (ST) 36
ST 36 belongs to the stomach meridian of foot "yangming", which is on the anterior aspect of the lower leg, 3 cun distal to ST 35, and one finger width lateral from the anterior ridge of the tibia.
Di19 summarized that ST 36, when used together with other acupoints, could treat 7 kinds of
20
gynecological disorders by reviewing ancient literatures. Xu et al. investigated the skin impedance of "five shu points" of the stomach meridian on healthy people, and found skin impedance of "five shu points" of the stomach meridian was lower than peripheral region. Moreover, skin impedance decreased with the ranking order as: ST 36, ST 41, ST 43, ST 44, and ST 45.
4. Summary and Future Directions
Recent studies confirm that meridians and acupoints commonly used in treating gynecological diseases also have many biophysical properties, which are different from those of non-acupuncture points. And the relationship between these biophysical characteristics and "qi and blood" functions of meridians and acupoints commonly used in the reproductive system are closer than others. They contribute to understanding the changes of body in different function states, diagnosing diseases, exploring new therapy, clarifying the pathogenesis, and differentiating symptomatic types and
constitutions in TCM. And they may facilitate the understanding of the therapeutic mechanisms of acupuncture in treating gynecological diseases.
Owing to the limitations of previous studies, the application of biophysical characteristics of meridians and acupoints in various clinical specialties should be attention. And more experimental mechanistic studies and randomized controlled trials are warranted to further explore and evaluate the therapeutic mechanisms from the perspectives of the biophysical characteristics of meridians and acupoints. References
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The Value of Qualitative Research in Polycystic Ovary Syndrome
Huiling Liang1,Hongxia Ma2, Hongli Ma1, Jingshu Gao1, Jianping Liu3, Ernest HY Ng4, Annika
Billhult 5,Elisabet Stener-Victorin6, Xiaoke Wu1
1Heilongjiang University of Chinese Medicine,Department of Obstetrics and Gynecology , Harbin, China
2The First Affiliated Hospital of Guangzhou Medical College, Department of traditional Chinese
medicine, Guangzhou, China
3
BeijingUniversity of Chinese Medicine, School ofPreclinical Medicine,Beijing, China 4 The University of Hong Kong,Department of Obstetrics & Gynecology, Hong Kong 5Research and development unit, Primary Health Care, Vastra Gotalandsregionen, Sven Eriksonsplatsen 4, Boras, Sweden
6Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Abstract
As a heterogeneous condition, polycystic ovary syndrome (PCOS) is not only a physical disorder of reproductive women but is also associated with psychosocial distress. It is important to treat the physical symptoms to improve their quality of life by understanding their concerns and expectations. In this aspect, quantitative approaches in research may not provide sufficient information or capture the specific problem. Qualitative methods can serve as a good complement. Due to the paucity of research concerning the value of qualitative research in PCOS, this article introduces qualitative research and discusses how it can be applied the study of PCOS.
1 Introduction
Polycystic ovary syndrome (PCOS) is a common endocrine disorder with variable presentations. Apart from the typical symptoms including anovulation/oligoovulation, hyperandrogenism with excessive hair growth, acne and/or male pattern boldness, and polycystic ovaries (PCO), it is also related to metabolic disturbances including obesity and insulin resistance with a high risk of developing type 2 diabetes, and cardiovascular disease[1,2].
Recently, more researches have focused on the health-related quality of life (HRQoL) in women with PCOS. A meta-analysis of 423 patients and 285 controls from 5 articles that used the Short Form 36 (SF-36) questionnaire showed that women with PCOS score lower in each dimension of the SF-36, mostly in the emotional role function[3]. Another study also showed that the HRQoL is poorer in women with PCOS even when compared with other serious health conditions using the Polycystic Ovary Syndrome Questionnaire (PCOSQ) [4]. The main symptoms of PCOS such as infertility, menstrual dysfunctions, hirsutism and obesity can, by themselves, cause increased psychosocial stress. Although most clinicians recognize that the "score" is lower and HRQoL is poorer in women with PCOS, there has been a paucity of research that focuses on the psychosocial aspects of living with this syndrome and coping with psychosocial distress[5,6].
