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Status and Strategies Analysis on International Standardization of Auricular Acupuncture Points

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Status and Strategies Analysis on International Standardization of Auricular Acupuncture Points Online Submissions:http://www.journaltcm.com J Tradit Chin Med 2013 June 15; 33(3): 408-412 [email protected] ISSN 0255-2922 © 2013 JTCM. All rights reserved. REVIEWTOPIC Status and strategies analysis on international standardization of auricular acupuncture points Lei Wang, Baixiao Zhao, Liqun Zhou aa Lei Wang, Baixiao Zhao, School of Acupuncture-Moxibus- Germany. Clinical AAP research was done in Italy, tion and Tuina, Beijing University of Chinese Medicine, Bei- Austria, Switzerland, Spain, the UK, Holland, Japan, jing 100029, China Russia, and Africa. However, AAP research was not Liqun Zhou, Department of Humanities of Traditional Chi- communicated internationally. The World Federa- nese Medicine, School of Basic Medical Sciences, Beijing Uni- tion of Acupuncture-Moxibustion Societies recom- versity of Chinese Medicine, Beijing 100029, China Supported by a Grant of Key Technology Standard Promo- mended international standard of auricular acu- tion Project (No. 2006BAK04A20) from the Ministry of Sci- puncture points (ISAAPs). Standardized nomencla- ence and Technology of China, and a Grant (No. 2009B26) ture and locations of AAPs would provide a solid from the World Federation of Acupuncture and Moxibustion basis to draft an international standard organiza- Societies tion. Correspondence to: Prof. Baixiao Zhao, School of Acu- puncture-Moxibustion and Tuina, Beijing University of Chi- CONCLUSION: Experts need to find common nese Medicine, Beijing 100029, China. baixiao100@gmail. points from different countries or regions, provide com evidence of different ideas, and list the proposal as Telephone: +86-10-64286737; +86-13911040781 a recommendation for an international standard. Accepted: January 27, 2013 © 2013 JTCM. All rights reserved. Abstract Key words: Acupuncture, ear; Reference standards; Information storage and retrieval OBJECTIVE: To supply literature for developing an international standard of auricular acupuncture points. INTRODUCTION METHODS: Electronic database searches were con- The diagnosis and treatment of auricular acupuncture ducted in the Chinese National Knowledge Infra- points (AAPs), one of the most popular therapies in structure and VIP, and the Western databases, the micro-acupuncture system, has prominent clinical therapeutic effects and extensive applications. Howev- Pubmed, the National Science and Technology Li- er, there are different auricular schools in China, the brary, and the German Journal of Acupuncture, United States, France, Germany, and Italy. China, the from 1990 to April, 2012. We also searched the doc- origin of AAPs, started the standardization of AAPs in uments of international symposiums for auricular the late 1980s. acupuncture points (AAPs). Keywords were "auricu- China published the following standards: Nomencla- lar points", "auricular acupuncture points", "ear ture and Location of AAPs (GB/T13734-1992),1 No- points", or "auriculotherapy". menclature and Location of AAPs (GB/ T13734-2008),2 Auricular Acupuncture—the 3rd part RESULTS: Basic and clinical research on AAPs was of the criterion of acupuncture-moxibustion manipula- performed in China, the United States, France, and tion techniques,3 and Auricular Massage for Health JTCM | www. journaltcm. com 408 June 15, 2013 |Volume 33 | Issue 3 | Wang L et al. / Review Care—the 6th part of the criterion of TCM health and vertical coordinates in 2010. However, this was dif- care manipulation techniques.4 ficult to use clinically because it was not convenient for At the end of 2011, the World Federation of Acupunc- manipulation. ture-Moxibustion Societies (WFAS) published its pro- Alimi made the surface of the auricle into a semicircle fessional international standard, Nomenclature and Lo- with 20 equal parts by taking the conjunction of the cation of AAPs.5 Meanwhile, France proposed the Uni- ear helix, tragus, and lobe with the face as the basic versal Nomenclature of Auriculotherapy. Experts from lines in 2010. He then took the crossing point of the the United States, France, Germany, and Italy offered lines passing through the transaction and coronal sec- their proposals for promoting an international stan- tion of corpus callosum as the center. His thinking was dard of auricular acupuncture points (ISAAPs). similar to that of Wojak but this was also difficult to apply clinically. METHODS Analysis of AAPs approved by previous international symposiums Literature sources and search strategy There were 39 AAPs discussed and approved by the We searched the Chinese databases, the Chinese Na- WHO in 19908 including: ear center, urethra, external tional Knowledge Infrastructure and VIP, and the West- genitals, anus, ear apex, finger, wrist, elbow, shoulder, ern databases, Pubmed, the National Science and Tech- heel, ankle, knee, buttock and hip, sciatic nerve, sympa- nology Library, and the German Journal of Acupunc- thetic nerve, cervical vertebra, thoracic vertebra, neck, ture, from 1990 to April, 2012. The documents of in- thorax, shenmen, external nose, apex of tragus, phar- ternational symposiums of AAPs were also searched. ynx and larynx, lung, trachea, endocrine, triple energiz- Keywords were: "auricular points", "auricular acupunc- er, mouth, esophagus, cardia, duodenum, small intes- ture points", "ear points", and "auriculotherapy". tine, cecum and appendix, large intestine, liver, pancre- as and gall bladder, ureter, bladder, and eye. Of them, Data extraction and analysis 24 (61.5%) were based on nomenclature of Nogier, in- AAP maps from different countries and the documents cluding ear center, urethra, external genitals, finger, of all international symposiums were collected, summa- wrist, shoulder, heel, buttock and hip, sciatic nerve, rized, and classified into basic research, clinical re- sympathetic nerve, cervical vertebra, thoracic vertebra, search, and standard research. Documents were com- neck, chest, lung, endocrine, esophagus, cardia, small pared for unified ISAAPs. intestine, large intestine, liver, pancreas and gall blad- der, bladder, and eye. The remaining 15 (38.5%) were RESULTS based on Chinese AAPs. The idea of naming an AAP by assigning an English abbreviation with a number Analysis of the AAPs status was put forward by Oleson. 4 For nomenclature of AAPs, a Chinese draft of ISAAPs Among the 93 ISAAPs developed by WFAS, 34 was developed with a statistical and literature study. (36.6%) were based on the nomenclature and locations The principle of nomenclature in the integration of of Nogier, including rectum, urethra, external genitals, Chinese and Western Medicine was emphasized. It is finger, wrist, shoulder, clavicle, heel, hip, sciatic nerve, presented in English. sympathetic nerve, buttock, lumbosacral vertebrae, For the location of AAPs, based on the anatomy of the chest, thoracic vertebrae, neck, cervical vertebrae, adre- surface of the ear, the report adopted the standardiza- nal gland, forehead, occiput, subcortex, esophagus, car- tion of zones and points combined to cover the ear. By dia, stomach, small intestine, large intestine, bladder, integrating anatomy, morphology, mathematics, and pancreas and gall bladder, liver, spleen, heart, lung, en- auricular acupuncture studies, the report clarified the docrine, and eye. Twenty-one (22.6% ) were based on boundary of anatomical structures on the surface of the anatomical terminology of the surface of the auri- the auricle. This ISAAP resulted in the creation of a cle, including ear center, anterior ear apex, ear apex, new system of AAP locations based on the latest stud- posterior ear apex, node, superior triangular fossa, mid- ies from American and European countries. dle triangular fossa, upper tragus, lower tragus, apex of The drafts of ISAAPs proposed by the United States, tragus, anterior intertragicus, posterior intertragicus, Germany, and France were over-idealized and poor in apex of antitragus, central rim, angle of superior con- clinical application. Oleson put forward a method of cha, center of superior concha, anterior ear lobe, upper auricle zone nomenclature6 in 1983 and in 1996.7 He ear root, root of ear vagus, lower ear root, and groove proposed to name the zones by English letters and of posteromedial surface. The remaining 38 (40.8% ) numbers. However, there were only zones, and no AAP were based on Chinese AAPs, including: anus, helix 1, names. He used the zones to mark Chinese and Euro- helix 2, helix 3, helix 4, Feng-windstream, elbow, toe, pean AAPs. ankle, knee, abdomen, internal genitals, shenmen, pel- Wojak divided the zones into subzones using abscissa vis, external ear, external nose, pharynx and larynx, in- JTCM | www. journaltcm. com 409 June 15, 2013 |Volume 33 | Issue 3 | Wang L et al. / Review ternal nose, forehead, temple, brain stem, duodenum, (e) Authoritative: it is made and organized by WFAS appendix, kidney, ureter, trachea, Triple Energizer, and reviewed by many acupuncture-moxibustion ex- tooth, tongue, jaw, internal ear, cheek, tonsil, heart of perts throughout the world. posteromedial surface of the ear, lung of posteromedial (f) Popular: it is adopted by various textbooks on Chi- surface of the ear, spleen of posteromedial surface of nese medicine and acupuncture and is published in the ear, liver of posteromedial surface of the ear, and most countries and regions, including the UK, South kidney of posteromedial surface of the ear. These Chi- Korea, and the United States. nese AAPs were closely combined with clinical practice. Oleson used zones based on the anatomy of the surface Of the 93 ISAAPs
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