研究背景：激痛点与肌筋膜疼痛综合征等多种疾病的发生和转归有密切联系。激痛点针灸疗法在Ii面床治疗中应用广泛，但其相关作用机理还不十分清楚。因此，激痛点针灸疗法作用机理的研究有十分重要的理论意义和临床价值。 研究目的：初步总结激痛点针灸疗法的作用机制，为丰富激痛点针灸疗法及提高临床疗效提供思路。 研究方法：本文以“激痛点、“扳机点、“触发点 “激痛点针灸和“机制、为主题词’检索中国期刊全文资料库（ CNKI ）；以“Trigger point、“DryNeedling和“Mechanism为关键字检索英文文献数据库PubMed 。结合激痛点相失生理病理研究结论，对近年来激痛点针灸疗法机制的相关研究进行整理。 结论：破坏激痛点局部的独特生理病理结构’即功能障碍终板的完整性，抑制伤害戚受器的传人可能是激痛点针灸疗法的主要局部镇痛机制。其失’针刺本身参与的局部镇痛及通过脊髓相失节段调整远部牵涉痛、内脏痛；激发全身镇痛、抗炎、生物力学调整等，都是激痛点针灸疗法的镇痛的可能机制。

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 1999. / Among the many modalities used by chiropractors is acupuncture. However, it has not yet been put to the test by research whether the addition of acupuncture for the treatment of lower back pain is of benefit or not to the patient. It is hypothesised that the addition of the acupuncture modality with the chiropractic adjustment will be of more benefit than the chiropractic adjustment alone. As the purpose ofthis study was to compare a chiropractic adjustment to a chiropractic adjustment followed by acupuncture the experimental method was used. The adjustments used were those indicated after following the diagnostic protocol of Natal Technikon using the Diversified Technique of Chiropractic. The acupuncture points used were the Urinary Bladder, 23, 25, 31, 36 and 40 and Gall Bladder 30 in all patients in the group receiving acupuncture. Thirty patients were selected randomly and split into two groups of 15. Patients were treated a maximum of 8 times or less if they become pain free in less treatments. The results of the Oswestry Low Back Pain Disability, Numerical Pain Rating Scale-101 and McGill Pain Questionnaires were recorded before the 1st, 5th, and after the last treatment and again at the 1 month follow up consultation, along with the BROM II and Algometer readings. The statistical tests used were the Intragroup Wilcox Signed Rank Test, the Intergroup Mann Whitney U Test and Power statistics according to the UCLA web site. Both treatments were / M

Leung Ka Man. / Thesis submitted in: August 2002. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2003. / Includes bibliographical references (leaves 81-84). / Abstracts in English and Chinese. / Abstract --- p.ii / Acknowledgements --- p.iv / Contents --- p.v / List of Figures --- p.viii / List of Tables --- p.x / Chapter 1. --- Introduction --- p.1 / Chapter 1.1 --- Surgical Needle Simulation --- p.4 / Chapter 1.1.1 --- Data Source --- p.5 / Chapter 1.1.2 --- Computer-aided training simulation --- p.6 / Chapter 1.1.3 --- Existing Systems --- p.8 / Chapter 1.2 --- Research Goal --- p.10 / Chapter 1.3 --- Organization of this Thesis --- p.12 / Chapter 2. --- Haptization of Needle Interactions --- p.13 / Chapter 2.1 --- Data Collection --- p.13 / Chapter 2.1.1 --- Force Measurement --- p.14 / Chapter 2.1.2 --- Data Correlation --- p.17 / Chapter 2.1.3 --- Expert Opinion --- p.18 / Chapter 2.2 --- Haptic Display Devices --- p.18 / Chapter 2.2.1 --- General-purpose Devices --- p.19 / Chapter 2.2.2 --- Tailor-made Devices --- p.20 / Chapter 2.3 --- Haptic Models for Tissues --- p.21 / Chapter 2.3.1 --- Stiffness Models --- p.21 / Chapter 2.3.2 --- Friction Models --- p.22 / Chapter 2.3.3 --- Modelling of needle operations --- p.23 / Chapter 2.4 --- Chapter Summary --- p.24 / Chapter 3. --- Haptic Rendering of Bi-directional Needle Manipulation --- p.25 / Chapter 3.1 --- Data Source and Pre-processing --- p.26 / Chapter 3.1.1 --- Virtual Body Surface Construction --- p.28 / Chapter 3.1.2 --- Tissue Mapping for Haptic Rendering --- p.29 / Chapter 3.2 --- The PHANToM´ёØ Haptic Device --- p.31 / Chapter 3.3 --- Force Profile Analysis --- p.33 / Chapter 3.4 --- Haptic Model Construction --- p.37 / Chapter 3.4.1 --- Skin --- p.41 / Chapter 3.4.2 --- Adipose Tissue --- p.48 / Chapter 3.4.3 --- Muscle --- p.49 / Chapter 3.4.4 --- Bone --- p.50 / Chapter 3.5 --- Force Composition --- p.51 / Chapter 3.5.1 --- Structure Weight Compensation --- p.52 / Chapter 3.5.2 --- Path Constraint Force --- p.52 / Chapter 3.5.3 --- Needle Axial Force --- p.53 / Chapter 3.6 --- Interactive Calibration --- p.60 / Chapter 3.7 --- Skin Deformation --- p.61 / Chapter 3.8 --- Chapter Summary --- p.63 / Chapter 4. --- Parallel Visual-Haptic Rendering --- p.64 / Chapter 4.1 --- Parallel Network Architecture --- p.64 / Chapter 4.2 --- Visual Rendering Pipeline --- p.65 / Chapter 4.3 --- Haptic Rendering Pipeline --- p.67 / Chapter 4.4 --- Chapter Summary --- p.67 / Chapter 5. --- User Interface --- p.68 / Chapter 5.1 --- Needle Practice --- p.68 / Chapter 5.1.1 --- Moving Mode --- p.69 / Chapter 5.1.2 --- Acupuncture Atlas --- p.70 / Chapter 5.1.3 --- Training Results --- p.70 / Chapter 5.1.4 --- User Controls --- p.71 / Chapter 5.2 --- Device Calibration --- p.72 / Chapter 5.3 --- Model Settings --- p.72 / Chapter 5.4 --- Chapter Summary --- p.72 / Chapter 6. --- Conclusion --- p.73 / Chapter 6.1 --- Research Summary --- p.73 / Chapter 6.2 --- Suggested Improvement --- p.74 / Chapter 6.3 --- Future Research Works --- p.75 / Appendix A: Mapping Table for Tissues --- p.76 / Appendix B: Incremental Viscoelastic Model --- p.78 / Appendix C: Model Parameter Values --- p.80 / Bibliography --- p.81

The ability to precisely locate appropriate acupoints is, according to both traditional and contemporary theories, essential to deliver acupuncture treatments. More than half of the acupoints defined in acupuncture literature are sufficiently distant to anatomical landmarks, to require the use of specialised techniques in order to locate them. However no research has been conducted to investigate the precision of any manual method (electrical detection is discussed at detail with reference to numerous conflicting research papers). This thesis details the design, conduct and results of experimentation carried out to measure the precision of four methods (named the directional, proportional, elastic and ruler methods) used to locate acupoints. The methods include two based upon the traditional Chinese anatomical unit of measurement, the cun, and two based upon the traditionally reported lengths of areas of the human body. The reasons for selecting these methods, and for excluding others, are explained. Seventy two subjects were involved in testing the precision of the four methods by applying them when locating a fictitious acupoint. The subjects marked the attempts to locate the fictitious acupoint with invisible ink. The marks were transferred to plastic films and measurements made from reference points. A significant difference was found between the methods (F3,120 = 11.74, p less than 0.0001). No significant difference was found between the two traditional methods of point location (directional mean = 11.35, and proportional mean = 11.17) (p less than 0.998), nor between the two variant methods of point location (elastic mean = 7.63, and ruler mean = 6.34) (p less than 0.68). Significant differences were found between the two traditional methods and the two variant methods. The directional method was less precise than both the elastic method (F3,120 = 11.74, p less than 0.007) and the ruler method (p less than 0.00009). The proportional method was also less precise than both the elastic method (F3,120 = 11.74, p less than 0.011) and the ruler method (p less than 0.0002). Each subject also completed a short questionnaire regarding ease and comfort of use of the four methods. The two more precise methods were generally not well received by subjects in this study. Their two primary concerns were not with precision, but rather of application of the method, and its perceived appearance to patients. An analysis was also carried out to describe any variation in acupoint location descriptions reported by prominent authors. 151 clinical research papers reporting acupuncture studies were selected according to a number of criteria. The five most frequently prescribed acupoints in these papers comprised the sample used in the examination of seven acupuncture texts. Variability was found between the texts, and is discussed in consideration of the presently poor understanding of the anatomical make-up of an acupoint. Also examined was the usefulness of measures of sensitivity to palpation used when locating acupoints. No statistically significant difference was found between any of the acupoints tested and the related control points. The thesis discusses the implications for acupuncture practice, research and education in light of the lack of precision measured, the subjects' preference for the more imprecise methods, the inability to locate or even verify the location of an acupoint using pressure, variability in reported acupoint locations between reference texts, and the related short-comings in published acupuncture research.

Thesis (Ph. D.)--University of Hong Kong, 2010. / Includes bibliographical references (leaves 194-218). Also available in print.

The ability to precisely locate appropriate acupoints is, according to both traditional and contemporary theories, essential to deliver acupuncture treatments. More than half of the acupoints defined in acupuncture literature are sufficiently distant to anatomical landmarks, to require the use of specialised techniques in order to locate them. However no research has been conducted to investigate the precision of any manual method (electrical detection is discussed at detail with reference to numerous conflicting research papers). This thesis details the design, conduct and results of experimentation carried out to measure the precision of four methods (named the directional, proportional, elastic and ruler methods) used to locate acupoints. The methods include two based upon the traditional Chinese anatomical unit of measurement, the cun, and two based upon the traditionally reported lengths of areas of the human body. The reasons for selecting these methods, and for excluding others, are explained. Seventy two subjects were involved in testing the precision of the four methods by applying them when locating a fictitious acupoint. The subjects marked the attempts to locate the fictitious acupoint with invisible ink. The marks were transferred to plastic films and measurements made from reference points. A significant difference was found between the methods (F3,120 = 11.74, p less than 0.0001). No significant difference was found between the two traditional methods of point location (directional mean = 11.35, and proportional mean = 11.17) (p less than 0.998), nor between the two variant methods of point location (elastic mean = 7.63, and ruler mean = 6.34) (p less than 0.68). Significant differences were found between the two traditional methods and the two variant methods. The directional method was less precise than both the elastic method (F3,120 = 11.74, p less than 0.007) and the ruler method (p less than 0.00009). The proportional method was also less precise than both the elastic method (F3,120 = 11.74, p less than 0.011) and the ruler method (p less than 0.0002). Each subject also completed a short questionnaire regarding ease and comfort of use of the four methods. The two more precise methods were generally not well received by subjects in this study. Their two primary concerns were not with precision, but rather of application of the method, and its perceived appearance to patients. An analysis was also carried out to describe any variation in acupoint location descriptions reported by prominent authors. 151 clinical research papers reporting acupuncture studies were selected according to a number of criteria. The five most frequently prescribed acupoints in these papers comprised the sample used in the examination of seven acupuncture texts. Variability was found between the texts, and is discussed in consideration of the presently poor understanding of the anatomical make-up of an acupoint. Also examined was the usefulness of measures of sensitivity to palpation used when locating acupoints. No statistically significant difference was found between any of the acupoints tested and the related control points. The thesis discusses the implications for acupuncture practice, research and education in light of the lack of precision measured, the subjects' preference for the more imprecise methods, the inability to locate or even verify the location of an acupoint using pressure, variability in reported acupoint locations between reference texts, and the related short-comings in published acupuncture research.

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 6 uppsatser.

Th.--Méd.--Caen, 1984. N°: 1236.

M. Tech.