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J Acupunct Res > Volume 31(3); 2014 > Article
Yuk, Kim, Jeon, Kim, and Kim: A Review of Trends for Acupotomy

Abstract

Objectives :

The purpose of this review is to overview and evaluate the current state of the usage of acupotomy.

Methods :

Eight electronic databases (Science direct, Pubmed, five Korean databases, CKNI) were searched for relevant articles and data from January 1999 to May 2014.

Results :

Thirty-nine articles were included. Acupotomy were used in musculoskeletal diseases (n=34) and other diseases (n=5). Among musculoskeletal diseases, lumbar spine (n=12) neck (n=5) and shoulder (n=3) diseases were mostly often used. Most studies (n=21) had small sample size (under 10 people) and combined with other therapies (acupuncture, herbal medicine, physical therapy, etc.).

Conclusion :

Acupotomy appears to be effective and useful for musculoskeletal diseases and some other diseases. But there were a few clinical studies for acupotomy and had many limitations to judge its effectiveness. Further modified studies are required.

Fig. 1.
Process of the selecting data
acupunct-31-3-35f1.tif
Fig. 2.
The annual number of published clinical acupotomy papers
acupunct-31-3-35f2.tif
Fig. 3.
The number of sample size of each clinical acupotomy studies
acupunct-31-3-35f3.tif
Table 1.
Classification Diseases Used Acupotomy
Classification Specific disease Number (%)
Musculoskeletal diseases Back Spinal stenosis, herniation of intervertebral disc, discogenic lumbocrural pain, back muscles fasciitis, third lumbar vertebrae transverse process syndrome 13 (33.3 %)
Neck Herniation of intervertebral disc, cervical sprain, ossification of posterior longitudinal ligament, nerve-root Cervical Spondylopathy 5 (12.8 %)
Ankle & foot Tarsal tunnel syndrome, achilles tendinitis, ankle sprain, calcaneus spur 4 (10.2 %)
Shoulder Partial tear of supraspinatus tendon, adhesive capsulitis 3 (7.6 %)
Wrist Carpal tunnel syndrome, ganglion with wrist 2 (5.1 %)
Leg Avascular necrosis of femur head, Multiple osteonecrosis of femur and tibia 2 (5.1 %)
Knee Degenerative arthritis 2 (5.1 %)
Head Whiplash, cervicogenic headache 2 (5.1 %)
Elbow Lateral epicondylitis 1 (2.5 %)
Others diseases Common peroneal nerve palsy 1 (2.5%)
Heart failure 1 (2.5 %)
Polyarteritis nodosa 1 (2.5 %)
Lymphedema, Peripheral neuropathy 1 (2.5 %)
Simple obesity 1 (2.5 %)
Total 39 (100 %)
Table 2.
Classificaton Acupotomy Treatment Points
Classification Treatment points Number (%)
Musculoskeletal diseases Back Spinal stenosis Supraspinous ligament, interspinous ligament, facet joint, transversospinalis, Hyeopcheok hyeol 13 (33.3 %)
Herniation of intervertebral disc Supraspinous ligament, interspinous ligament, facet joint, transversospinalis, sacrospinous ligament, sciatic notch, Hyeopcheok hyeol, Ashi points, Sinsu (BL23), Gihaesu (BL24), Daejangsu (BL25), Yoyanggwan (GV3)
Back muscles fasciitis Ashi points, trigger points
Third lumbar vertebrae transverse process syndrome Ashi points, trigger points, 3rd lumbar vertebrae transverse process (tender point)
Neck Herniation of intervertebral disc Ligamentum nuchae, trapezius, semispinalis capitis, splenius capitis, sternocleidomastoid, longissimus capitis 5 (12.8 %)
Cervical sprain Ligamentum nuchae, trapezius, semispinalis capitis, splenius capitis, sternocleidomastoid, longissimus capitis
Ossification of posterior longitudinal ligament Ligamentum nuchae, trapezius, semispinalis capitis, splenius capitis, sternocleidomastoid, longissimus capitis
Nerve-root cervical spondylopathy Trigger points in the neck & shoulder
Ankle & foot Tarsal tunnel syndrome Malleolus flexion retinaculum 4 (10.2 %)
Achilles tendinitis Achilles tendon
Ankle sprain Anterior talofibular ligament, posterior talofibular ligament
Calcaneus spur Ashi points, the most painful point
Shoulder Partial tear of supraspinatus tendon Trapezius, teres major, teres minor, latissimus dorsi, rhomboid, levator scapulae, deltoid, erector spinae 3 (7.6 %)
Adhesive capsulitis Trapezius, teres major, teres minor, latissimus dorsi, rhomboid, levator scapulae, deltoid, erector spinae, supraspinatus.
Wrist Carpal tunnel syndrome Daereung (PC7), Taeyeon (LU9), Sinmun (HT7) 2 (5.1 %)
Ganglion of wrist Around the ganglion
Leg Avascular necrosis of femur head Around the femoral trochanter (from the skin to the periosteum) 2 (5.1 %)
Multiple osteonecrosis of femur and tibia Inguinal ligament, around the trochanter, adductor tendon, obturator foramen
Head Whiplash Sternocleidomastoid, levator scapulae, Splenius capitis, Wangol (GB12), Pungbu (GV16), Pungji (GB20), Gyeonjeong (GB21)
Cervicogenic headache Occipitalia, both of left and right side: altogether were 8 points, including tenderness point of postmastoid; the mid-point between mastoid and C2 spinous process; the internal 1/3 attachment between occipital protuberance and mastoid process; the posterior midline of C2 spinous process open to 1.5∼2 cm 2 (5.1 %)
Knee Degenerative arthritis Suprapatellar bursa, tibial collateral ligament, infrapatellar fat pad, lateral collateral ligament, pes anserinus mucous cyst, Ashi points 2 (5.1 %)
Elbow Lateral epicondylitis Tendon of extensor carpi radialis brevis, Gokji (LI11) 1 (2.5 %)
Others diseases Common peroneal nerve palsy Ashi points under the neck of fibula 1 (2.5 %)
Dyspnea by heart failure Gworeumsu (BL14), Simsu (BL15) 1 (2.5 %)
Polyarteritis nodosa Ashi points 1 (2.5 %)
Lymphedema, Peripheral neuropathy Daereung (PC7), Taeyeon (LU9), Sinmun (HT7) 1 (2.5 %)
Simple obesity Jungwan (CV12), Cheonchu (ST25), Sanggeoheo (ST37), Sameumgyo (SP6), etc 1 (2.5 %)
Total 39 (100 %)
Table 3.
Size of Acupotomy According to Disease
Acupotomy size Disease
Length 50 mm, diameter 0.1 mm Herniation of intervertebral disc (cervical), cervical sprain, ossification of posterior longitudinal ligament, tarsal tunnel syndrome, achilles tendinitis, ankle sprain, carpal tunnel syndrome, ganglion of wrist, avascular necrosis of femur head, multiple osteonecrosis of femur and tibia, lateral epicondylitis, whiplash
Length 35 mm, diameter 0.1 mm Lymphedema, adhesive capsulitis, partial tear of supraspinatus tendon
Length 80 mm, diameter 0.5 mm Spinal stenosis, herniation of intervertebral disc (lumbar)
Length 80 mm, diameter 1.0 mm Spinal stenosis, herniation of intervertebral disc (lumbar)
Length 50 mm, diameter 0.5 mm Polyarteritis nodosa
Length 40 mm, diameter 0.6 mm Simple obesity
Length 35 mm, diameter 0.9 mm Nerve-root cervical spondylopathy
Length 30 mm, diameter 0.5 mm Osteoarthritis of the knee
Table 4.
Combination Treatment with Acupotomy
Treatment Number (%)
Acupotomy only 9 (23.0 %)
Acupuncture 25 (64.1 %)
Herbal medicine 20 (51.2 %)
Physical therapy 15 (38.4 %)
Pharmacopuncture therapy 9 (23.0 %)
Cupping therapy 8 (20.5 %)
Others 2 (5.1 %)
Table 5.
The Assessment Tool about the Effect of Acupotomy
Classification Assessment tool
Musculoskeletal diseases VAS (n=24)
Oswestry disability index (ODI) (n=7)
ROM (n=5)
Others diseases Common peroneal nerve palsy  Tinel sign, motor test, ROM, Takakura scale
Dyspnea by heart failure NYHA dyspnea index, baseline dyspnea index, five-point likert scale
Polyarteritis nodosa  VAS
Lymphedema, peripheral neuropathy  VAS, tinel sign, phalen test
Simple obesity Body weight, body mass index (BMI), obesity degree, blood lipid and fasting blood sugar (FBS)

VI. References

1. Lim NR, Kim SC, Jang EH, et al. Case study of oriental medicine treatment with acupotomy therapy of the carpal tunnel syndrome. The Journal of Korean Acupuncture & Moxibustion Society. 2008;25(4):163–70.

2. The Institute of Korean Acupotomy Medicine. Acupotomy. Seoul: Jeongdam. 2003:81–2, 87111113127.

3. Zhu HZ. Acupotomy. Beijing: Chinese Medicine Publishing Company. 1992:9–42.

4. Yuk DI, Song IN, Ko MK, et al. Five cases of frozen shoulder patients treated by acupotomy combined with oriental medical treatments. The Journal of Korean Acupuncture & Moxibustion Medicine Society. 2012;29(5):167–76.

5. Kim SC. Clinical characteristics of poor responders to acupotomy and safety pretreatment management. The Journal of Korean Acupuncture & Moxibustion Society. 2008;25(4):117–25.

6. Ko MK, Kim JH, Hong KE. The study on post acupotomy headache. The Journal of Korean Acupuncture & Moxibustion Society. 2010;27(2):89–95.
pmid
7. Cho KH, Ki W, Yuk DI, Sung IS, Kim MJ, Hong KE. The study on the infection control of acupotomy. The Acupuncture. 2013;30(4):181–7.
crossref pdf
8. Kim SH, Park MY, Lee SM, Lee SK, Lim JY, Kim SC. The case report of common peroneal nerve palsy treated with musculoskeletal ultrasound-guided acupotomy therapy. The Journal of Korean Acupuncture & Moxibustion Medicine Society. 2012;29(5):177–85.
pmid
9. Kim MJ, Hong KE. A case report of congestive heart failure treated with acupotomy therapy. The Journal of Korean Acupuncture & Moxibustion Society. 2009;26(2):207–12.
pmid
10. Lee ES, Kam CW, Youn HM, et al. Case report of polyarteritis nodosa treated with oriental treatments including acupotomy. The Journal of Korean Acupuncture & Moxibustion Medicine Society. 2012;29(3):129–37.
pmid
11. Jang EH, Kim SY, Kim HS, Kim SC. Acupotomy and venesection in upper limb lymphedema and peripheral neuropathy following breast cancer surgery. The J of Korean Institute of Pharmacopuncture. 2009;12(4):119–27.
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12. Chen M, Shi XY, Xu B, et al. Clinical observation on acupotomy for treatment of simple obesity. Chinese Acupuncture & Moxibustion. 2011;31(6):539–42.
pmid
13. Kim YM, Hong KE. The clinical study on the effect of acupotomy in shoulder disease. The Journal of Korean Acupuncture & Moxibustion Society. 2008;25(4):141–8.
pmid
14. Oh MS, Gwak JM. The clinical study on the effect of Chuna therapy for patients with lumbar disc herniation. The J of the Institute of Oriental Medicine, Daejeon University. 1998;14(1):21–30.

15. Mun MS, Kim I, Han IH. A clinical study of cervical spondylosis. The J of Korean Orthopaedic Association. 1973;8(1):29–35.

16. The Korean Orthopaedic Association. Orthopaedic. Seoul: Choisinuihaksa. 1982:314.

17. Sung IS, Yuk DI, Song DH, Kim MJ, Hong KE. Case study of with Dochim (刀鍼) & Gwanchim (管鍼) therapy combined with Korean medicine treatment of herniated lumbar intervertebral disc patients. The Journal of Korean Acupuncture & Moxibustion Society. 2011;28(5):153–9.
crossref pdf
18. Jang EH, Kim SC, Lim NR, et al. Case study of oriental medicine treatment with acupotomy therapy of the herniated lumbar intervertebral disc patient. The Journal of Korean Acupuncture & Moxibustion Society. 2008;25(4):171–81.
pmid
19. Yun JY, Kim DH, Kim HW, et al. The clinical effects of acupuncture and acupotomy therapy for HIVD. The Journal of Korean Acupuncture & Moxibustion Society. 2010;27(4):85–97.
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20. Kwak BM, Hong KE. Four case of HIVD-lumbar spine patient treated with acupotomy. The Journal of Korean Acupuncture & Moxibustion Society. 2008;25(4):149–56.
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21. Lee GM, Kim DH, Kim HW, et al. The study on the effect of acupotomy in lumbar HIVD. The Journal of Korean Acupuncture & Moxibustion Society. 2008;25(4):183–90.
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22. Park SW, Kim SS, Kim JY, Kim SH, Lee GM. The comparative study of effects between acupotomy and its cotreatment with spine decompression therapy on HIVD patients. The Journal of Korean Acupuncture & Moxibustion Medine Society. 2012;29(3):29–39.
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23. Jung KY, Sur YC, Jang WS, et al. Study and three cases report for lumbar spinal stenosis treatment using a combination of acupotomy and existing treatments. Korean J Oriental Physiology & Pathology. 2012;26(1):120–7.
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24. Yuk DI, Sung IS, Song DH, Kim MJ, Hong KE. Clinical study of lumbar spine stenosis treated by using acupotomy combined with oriental medical treatments. Journal of Pharmacopuncture. 2013;16(3):46–51.
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25. Kim HS, Heo WY, Hyun MK, Kim JS, Gang IA. Four case of partial tear of supraspinatus tendon treated by acupotomy combined oriental medical treatments. The Acupuncture. 2014;31(1):167–76.
crossref pdf
26. Kim EK, Kim HW, Lee GH, Lee GM. The clinical study on effects of acupotomy therapy in patients with cervical herniated intervertebral disc. The Journal of Korean Acupuncture & Moxibustion Society. 2009;26(1):67–79.
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27. Park SW, Kim SS, Yang SB, Lee GM. The clinical effects of acupotomy for ossification of the posterior longitudinal ligament. The Journal of Korean Acupuncture & Moxibustion Society. 2011;28(4):127–35.
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28. Guo C, Liu N, Li X, et al. Effect of acupotomy on nitric oxide synthase and beta-endorphin in third lumbar vertebrae transverse process syndrome model rats. J Tradit Chin Med. 2014;34(2):194–8.
crossref pmid
29. Liang XH, Zhang XG, Xu GT, Wei WY. Combination of canales sacralis drop with acupotomy dissolution in treatment of discogenic lumbocrural pain. J of Zhejiang University. 2011;40(1):90–3.

30. Wen YL, He C, Huang M, Liang XS. Observation on therapeutic effect of the third lumbar transverse process syndrome treated with acupotomy and blood pricking therapy. Chinese Acupuncture & Moxibustion. 2012;32(4):345–8.
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