| 足三里 zú sān lǐ | Trois distances du pied (Nguyen Van Nghi 1971) Trois mesures du pied (Lade 1994) Trois distances (Trois internes) (Laurent 2000) Trois miles du pied (Deadman 2003) Trois Li sur le membre inférieur (Pan 1993, Despeux 2012) | Leg Three Li (Ellis 1989) |
|---|
Zu (Ricci 5191) : pied, jambe.
San (Ricci 4196) : trois.
Li (Ricci 3060) :
Dans le Nei jing, le nom originel de ce point est San li, le Sheng ji zhong lu l'appelle Zu san li (Guillaume 1995).
| San Li | 三里 | Three Li (Ellis 1989) | Sheng ji (mais nom principal selon Nei jing, Guillaume 1995) |
|---|---|---|---|
| Xiàlíng | 下陵 (1) | Lower Mound (Ellis 1989) | Lingshu chapitre « Ben shu » (Guillaume 1995) |
| Xia ling san li | 下陵三里 | Lower Mound Three Li (Ellis 1989) | Lingshu chapitre « Ben shu » (Guillaume 1995) |
| Guǐxié | 鬼邪 (2) | Ghost Evil (Ellis 1989) | Qian lin yao fang (Guillaume 1995) |
| Xiàsānlĭ | 下三里 | Lower San Li (Ellis 1989) | Ji cheng (Guillaume 1995) |
| Xiaxusanli | Lower Hollow Three Li (Ellis 1989) | ||
| Xiaqihai | Lower Sea of Qi (Ellis 1989) |
Items de localisation
| 34VB | 35E | 9Rte |
| ↑ ← 36E → ↓ | ||
|---|---|---|
| 37E | ||
| latéral | côté droit | médial |
Zusanli (ST 36), Shangjuxu (ST 37) and Xiajuxu (ST 39) are considered as the lower He-sea points, which are located along the leg lines of stomach meridian of foot Yangming from top to bottom. According to the corresponding zang-fu of lower He-sea points, the distribution order from top to bottom is stomach, large intestine and small intestine. This is significantly different from digestive physiology function sequence of stomach, small intestine and large intestine in modern medicine. However, it conforms to their anatomical position from top to bottom. In order to make a further confirmation that the indication specificity of Zusanli (ST 36), Shangjuxu (ST 37) and Xiajuxu (ST 39) is closely associated with anatomical location, a great number of ancient and modern literature is reviewed. It is found that the functions of the three acupoints are obviously related to stomach, large intestine and small intestine, respectively, indicating that the sequence of Zusanli (ST 36), Shangjuxu (ST 37) and Xiajuxu (ST 39) is related to anatomical position of corresponding zang-fu. This study conclusion could play an important role for exploring the significance of anatomical location in indication specificity of acupoints.
| Acupuncture | Moxibustion | Source |
|---|---|---|
| Selon Su wen, puncturer à 1 distance, laisser l'aiguille le temps d'une expiration, selon Tong ren puncturer à 0,5 distance, selon Ming tang, puncturer à 0,8 distance, laisser l'aiguille le temps de 10 expirations, disperser pendant 7 inspirations | Selon Su wen appliquer 3 cônes de moxa, selon Tong ren, appliquer 3 cônes de moxa, selon Ming tang appliquer de 7 à 100 cônes de moxa par jour, selon Qian jin, appliquer 500 cônes de moxa, de 100 à 200 cônes au minimum | Zhen jiu ju ying (Guillaume 1995) |
| Needle along the lateral edge of the tibia, 1,0-2.0 in. | Moxa stick 5-20 min., 5-15 moxa cones | Li Su Huai 1976 |
| 1) Piquer perpendiculairement à 1-2 distances; 2) Piqûre oblique vers le bas, à 2-3 distances | Cautériser 5-15 fois, chauffer 10-30 minutes | Roustan 1979 |
| Puncture perpendiculaire, légèrement inclinée vers le tibia, entre 1 et 1,5 distance de profondeur | Cautérisation avec 5 à 15 cônes de moxa, moxibustion pendant 10 à 30 minutes | Guillaume 1995 |
| Piqûre perpendiculaire de 1 à 2 cun | Moxas : 5 à 7 ; chauffer 20 à 30 mn | Laurent 2000 |
| Qigong : focalisation de l'attention sur un point | voir 5.3 |
|---|
Sensation de puncture
OBJECTIVE: To explore the relationship between the theory of constitution in terms of Chinese medicine and clinical efficacy of acupuncture treatment via analyzling the characteristics of Deqi during acupuncture stimulation of Zusanli (ST 36) in healthy volunteers with different constitutions. METHODS: In the present study, a total of 527 healthy undergraduate student volunteers (267 girls and 260 boys) were recruited. They received questionnaire first about their constitutions in accordance with Professor WANG Qi's Classification and Determination of Constitution in terms of Chinese medicine. Then, the subjects were asked to take a supine position on a check-bed, a qualified acupuncturist held a sterilized fifiform needle to rapidly insert it into ST 36 and manipulated the acupuncture needle with uniform reinforcing-reducing technique at a frequency of about 60-90 times/min and an amplitude of 0.3-0.5 cm. The status of Deqi was assessed by using visual analogue scale (VAS). RESULTS: Needling sensations mainly involve soreness, numbness, heaviness, distension, dull pain and propagated sensations along meridian (PSC). During acupuncture stimulation, most subjects experienced distension sensation, accounting for 90.3%, followed by soreness, accounting for 45.9%. Except for PSC reaction, the rest 5 needling sensations had no statistical difference in their occurrence rates in those subjects with different constitutions (P>0.05). The PSC appeared a higher incidence in yin-yang harmony(balanced) constitution subjects than in qi- deficiency, yang-deficiency, blood-stagnation and qi-stagnation constitution subjects (P<0.05). The intensity of soreness was obviously stronger in the balanced constitution subjects than in qi-deficiency, yang-deficiency, yin-deficiency, phlegm-damp, damp-heat and qi-stagnation constitution subjects (P<0.05), while the intensity of distension sensation was apparently stronger in the balanced constitution subjects than in simpleyang-deficiency subjects (P<0.05). CONCLUSIONS: Except for PSC, the Deqi sensations of soreness, numbness, heaviness, distension and dull pain induced by acupuncture stimulation of ST 36 are comparable in the occurrence rates in healthy volunteer subjectswith different (9 types of) constitutions in terms of Chinese medicine, whereas the intensity of soreness may be the important factor for acupuncture induced pain relief. A certain correlation between the constitution and acupuncture effectiveness exists, suggesting that acupuncture treatment should vary from patient to patientin clinical practice.
Profondeur de ¤deqi
OBJECTIVE: To observe the dynamic changes of ultrosonographic images of Zusanli (ST 36) area during Deqi after inserting acupuncture needles, so as to provide objective evidence for clinical Deqi. METHODS: Sixty healthy volunteers (30 men and 30 women) were recruited in the present study. The subjects were asked to take a supine position on a test-bed, sterilized disposable filiform needles were perpendicularly inserted into bilateral ST 36 till Deqi (without lifting, thrusting and twirling), when, high-resolution ultrasound scanning was conducted over the regional skeletal muscles by using a radio-frequency (5-12 MHz) coil probe (Philips IU Elite Ultrasound Diagnostic Instrument) after smearing a layer of gel at the skin of ST 36. RESULTS: Among these 120 points of the 60 volunteer subjects, a marked Deqi was obtained from 108 points (consisting of 90%) including 52 points in men and 56 in women, and 53 at the left ST 36 and 56 at the right ST 36. Ultrosonographic scanning displayed that when a strongest Deqi feeling was obtained from bilateral ST 36 in these 60 volunteers, the acupuncture needle-tip was about (25.32±5.82) mm in the vertical depth, and was (5.45±0.55) mm lateral to the tibia, involving the anterior tibial muscle near the deep fascia in 46 acupoints, and the intersection fascia of anterior tibial muscle and extensor digitorum longus in 62 acupoints. CONCLUSIONS: The anterior tibial muscle near the deep fascia and the intersection fascia of anterior tibial muscle and extensor digitorum longus around ST 36 are involved in strongest Deqi. There are no significant differences in the gender and location (left and right).
| Classe d'usage | ★★ | point essentiel |
|---|
| symptomes | zheng | auteur |
|---|---|---|
| palpitation and restlessness | deficiency of heart qi | Wang Yifang 1992 |
| Indication | Association | Source |
|---|---|---|
| Blessure par le froid-shang han qui traverse les méridiens, avec absence de transpiration | 36E + 14F | Tian xing bi que (Guillaume 1995) |
| Syncope vagale | 36E + 20VG + 26VG + 4GI + 3F | Zhen jiu xue jian bian (Guillaume 1995) |
| Prévention des accès convulsifs ou atténuation de la symptomatologie | 36E + 6MC + 7MC + 34VB + Tai yang-PC2 + 14IG | Xin zhen jiu xue (Guillaume 1995) |
| Hypertension artérielle | 36E + 11GI + 6MC + 6Rte | Zhen jiu xue jian bian (Guillaume 1995) |
| Chaleur résiduelle | 36E + 11GI + 4GI | Zhen jiu xue jian bian (Guillaume 1995) |
| Bourdonnements d'oreille, lombalgie | Puncturer d'abord Wu hui (9E ?) puis puncturer + 21TR + 36E | Tian xing bi que (Guillaume 1995) |
| Odontalgies, les céphalées, le Bi de la gorge | 36E + 2GI | Tian xing bi que (Guillaume 1995) |
| Difficulté pour marcher | 36E + 4F + 3F | Yu Long Ge (Roustan 1979), Yu long Fu (Guillaume 1995) |
| Enflure chronique du pied-jiao qi | 36E + 9VC + 7VC | Yu long Fu (Guillaume 1995) |
| Hoquet | 36E + 2VC + 6MC + 17V + 22VC | Zhong guo hen jiu xue gai yao (Guillaume 1995) |
| Vomissements | 36E + 6MC + 4Rte + 12VC | Zhong guo zhen jiu xue gai yao (Guillaume 1995) |
| Epigastralgie | 36E + 12VC + 6MC | Zhong guo zhen jiu xue gai yao (Guillaume 1995) |
| Borborygmes abdominaux | 36E + 19E | Zhi Shen Jing (Roustan 1979, Guillaume 1995) |
| Stagnation des aliments | 36E + 21VC | Tian xing bi que (Guillaume 1995) |
| Pancréatite | 36E + 39E + 34VB + 6MC | Roustan 1979, Shanghai zhen jiu xue (Guillaume 1995) |
| Invagination intestinale | 36E + 4GI + 6MC + 12VC + 25E + 25V + 32V | Roustan 1979 |
| Dyspepsie | 36E + 4GI + 25E + 6VC | Roustan 1979, Shanghai zhen jiu xue (Guillaume 1995) |
| Atteinte directe par les pervers-zhong xie et la diarrhée cholériforme | 36E + 7VC | Bai zheng fu (Guillaume 1995) |
| Entérite chronique | 36E + 25E + 37E + 4VC + 2F + 26E | Xin zhen jiu xue (Guillaume 1995) |
| Troubles digestifs de la grossesse | 36E + 6MC + 13VC | Zhong guo zhen jiu xue gai yao (Guillaume 1995) |
| Raideur de la nuque avec enflure et douleur, le corps lourd et la parésie lombaire-yao tan | 36E + 65V | Tai yi ge (Guillaume 1995) |
| Oedème du pied jiao qi et les affectionsdes lombes | 36E + 34VB + 9Rte + 62V + 6Rn | Ling guang fu (Guillaume 1995) |
| Gonflement des pieds-jiao zhong accompagné de douleur | 36E + 39VB + 34VB + 9Rte + 3F | Xi hong fu (Guillaume 1995) |
| Douleur des pieds, enflure des genoux | 36E + 39VB + 9Rte + 34VB + 6Rte + 3F | Da quan-Xi hong fu (Guillaume 1995) |
| Absence de dispersion du Qi de la Vessie | 36E + 31VB | Xi hong fu (Guillaume 1995) |
Objective : To observe the therapeutic effect of electroacupuncture (EA) of “Zusanli” (ST 36) and “Weishu” (BL 21 ) on the experimental gastric ulcer in Xu-period of a day for analyzing the best opportunity of acupuncture treatment of gastric ulcer. Methods : 49 Wistar rats were randomly divided into 1 control group, (2) ST-36-Xu group, (1) BL-21 1 -Xu group, (4) ST-36-Chen group, 5 BL-21 1 -Chen group, (P ST-36-IT group, and (7) BL-21 1 -IT group, with 7 rats in each group. Rat gastric ulcer model was established using intra-gastric administration of glacial acetic acid. Gastric mucosal thickness, mucosal muscular defect width, superficial mucosal mucus index (MI) , intramucosal MI , Total Mi, plasma 6-keto-PGF 1 a , serum NO and gastric tissue CGRP concentrations were used as the indexes. The EA treatment was conducted once daily at Xu-period (7 - 9 o'clock in the evening), Chen-period (8 - 10 o'clock in the morning) and irregular time (IT) with 6 days being a therapeutic course, two courses altogether. Results: After EA treatment, 1 the regenerated mucosal thickness values of the aforementioned 6 EA groups. particularly ST-36-Xu group and BL-21-Xu group, were all apparently higher than that of control group (P< 0. 05 - 0. 01), while the mucosal muscle layer defect width values of different EA groups, particularly ST-36-Xu group and BL-21-Xu group, were strikingly lower than that of control group (P < 0. 05 - 0. 01 ); Othe 3 MI of the 6 EA groups, particularly those of ST-36-Xu group were all significantly higher than those of control group (P< 0. 05 - 0. 0 1); (3) plasma 6-keto-PGF1a contents of the 6 EA groups, particularly those of ST-36-Xu and BL-21 I -Xu groups, were all significantly higher than that of control group (P< 0 - 05 - 0. 01); 4 serum NO and gastric tissue CGRP concentrations of the 6 EA groups, particularly those of ST-36-Xu and BL-21-Xu groups and CGRP concentration of ST-36-Chen group, were all significantly higher than those of control group (P<0. 05 - 0. 0 1); and 5 there were positive correlation between superficial Mi or total MI and NO level (r= 0. 858, 0. 987, P< 0. 05,and 0. 01), and between the superficial mucus index and CGRP concentration (r= 0. 9051, t = 4. 68, P < 0. 01 ), suggesting that the increase of the secretion function of the regenerated mucosal mucus is related to acupuncture induced increase of release of both NO and CGRP. Conclusion : The therapeutic effect of EA of ST-36 and BL-21 in Xu-period is better in the treatment of gastric ulcer. and that of EA of ST-36 is the best.
This study was aimed at assessing the physical characteristics underlying the action of moxibustion at acupoints Ren-12 (Zhongwan), St-25 (Tianshu), and St-36 (Zuzanli) in preventing acute injuries of the gastric mucous membrane induced by indomethacin in Wistar rats. Induction of gastric lesions, by means of intragastric administration of indomethacin (100 mg/kg), in adult male Wistar rats was followed by treatment with moxibustion using Artemisia vulgaris dried leaves at 60 or 45◦C, heating with Artemisia vulgaris charcoal at 50◦C, heating with a regular tobacco cigar at 50◦C, and heating with a regular water pad at 50◦C, The effects of the different heating protocols over the gastric lesions were then compared. In addition, another group of animals was pretreated with capsaicin (100 mg/kg, s.c.), in order to lesion C fibers and, 15 days later, subjected to indomethacin administration and moxibustion treatment. Moxibustion was significantly more efficient at 60◦C than at 45◦C in preventing gastric lesions triggered by indomethacin. Moxibustion applied in acupoints provided a significant reduction of the lesion area, which was two times less than that of animals stimulated in a nonacupoint (sham group). Comparing the therapeutic effects provided by different forms of heating over the gastric lesions, the burning of dry leaves of Artem´ısia vulgaris was significantly more efficient in preventing gastric lesions than moxibustion made with Artem´ısia charcoal or tobacco (cigar) or by heating the animal with a water pad. Desensitization of the afferent sensory C fibers by capsaicin significantly diminished the ability of moxibustion to block the lesions in the gastric mucous membrane. Moxibustion can efficiently prevent indomethacin-induced gastric lesions in rats and this effect is dependent on the temperature, the material used for moxibustion, the use of acupuncture points, and the integrity of C fibers.
Wang LQ, Chen Z, Zhang K, Liang N, Yang GY, Lai L, Liu JP. Zusanli (¤ST36) Acupoint Injection for Diabetic Peripheral Neuropathy: A Systematic Review of Randomized Controlled Trials. Journal of Alternative and Complementary Medicine. 2018;24(12):1138-1149. [209326]. doi
| Background | Acupuncture point (acupoint) injection is a common practice in China. Some trials showed that Chinese herbal extracts and/or conventional medication are injected at the Zusanli (¤ST36) acupoint for the treatment of diabetic peripheral neuropathy (DPN). The study aimed to assess the effectiveness and safety of acupoint injection for DPN at the ¤ST36 by systematically evaluating the evidence published to date. |
|---|---|
| Methods | Six databases were searched for randomized controlled trials (RCTs) of ¤ST36 injection for DPN with primary outcome of pain, global symptom improvement, and quality of life. Methodological quality was assessed by the Cochrane risk of bias (ROB) tool. Data were analyzed using RevMan 5.3. |
| Results | Fourteen RCTs involving 1,071 participants with DPN were included. All RCTs were assessed as unclear or high ROB. Few RCTs adequately reported methodology-related items and needling details according to Consolidated Standards of Reporting Trials (CONSORT) and Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA) statement. Medications injected at ¤ST36 included conventional medications (11 RCTs) and Chinese herbal extracts (3 RCTs). The authors of this study did not perform any meta-analysis due to the heterogeneity of medications used for injections. Two individual RCTs favored ¤ST36 injection in relieving pain compared with intramuscular injection of the same medication. For global symptom measured by Toronto clinical scoring system, one RCT showed that ST36 injection of Fufang Danggui was more effective than intramuscular injection of vitamin B12, two RCTs demonstrated that ST36 injection of mecobalamin or Danhong with cointervention was superior, while one RCT showed no significant differences between ST36 injection and intramuscular injection of mecobalamin. For improving nerve conduction velocity (NCV), three of four individual RCTs showed that ST36 injection was better than intramuscular or intravenous injection of the same medication, two RCTs favored ST36 injection with cointervention, and one RCT favored ST36 injection without cointervention. Four RCTs reported monitoring adverse events, all of which showed no significant difference between groups. |
| Conclusions | Limited evidence suggests that ST36 injection appears to be safe, and potentially effective in reducing pain score and improving NCV compared with intramuscular injection of the same medication. However, poor methodological and reporting quality reduced confidence in the findings. Rigorously designed and well-reported RCTs evaluating the effectiveness of ST36 injection for DPN are warranted. |
OBJECTIVE: To observe the effective mechanism of electroacupuncture for chronic fatigue syndrome (CFS).METHODS: The dynamic detection of chronobiology was used to test the event-related potentials in 20 healthy subjects and 20 CFS patients. P3a and P3b latencies at 4 equidistant time points (8:00, 14:00, 20:00, 2:00) within 24 hours were collected and analyzed. RESULTS: (1) Latency of P3a in CFS group was obviously prolonged at 14:00 compared to health group with statistical significance (P < 0.05), latency of P3b was decreased at 14:00 after electroacupuncture treatment with statistical significance compared to that of pre-treatment (P < 0.01). (2) There were obviously circadian rhythm in latency of P3a and P3b in health group (P < 0.05), which were not seen in CFS group (P > 0.05); the circadian rhythm latency of P3b restored after treatment (P < 0.05). (3) The latency acrophase of P3a and P3b pre-treatment obviously shifted backward compared to that of healthy subjects (P < 0.05), shifted forward after electroacupuncture treatment (P < 0.05).CONCLUSION: The event-related potential circadian rhythms are lost in CFS patients. Electroacupuncture at Shenshu (BL 23) and Zusanli (ST 36) can regulate the circadian rhythm of P3a and P3b latency and improve the cognition of the patients in daytime.