prononciation
articles connexes: - 20VB - 22VB - Méridien - |
肩井 jiān jǐng | Puits de l'épaule (Chamfrault 1954, Soulié de Morant 1957, Nguyen Van Nghi 1971, Pan 1993, Lade 1994) | Shoulder Well (Ellis 1989) |
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nom | traduction française | traduction anglaise | source classique | |
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Bo jing | 膊井 | Puits de l'épaule (Laurent 2000) | Shoulder Well (Ellis 1989) | Sheng hui fang (Guillaume 1995) |
Jian jie | 肩解 | Su Wen (Guillaume 1995) |
Items de localisation
Point de croisement | Sources |
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Méridien TR | Chamfrault 1954, Da Cheng (Nguyen Van Nghi 1982), Wai Tai Mi Yao (Guillaume 1995), Li Ding 1992, Pan 1993, Laurent 2000 |
Méridien Yang wei | Da Cheng (Nguyen Van Nghi 1982), Wai Tai Mi Yao (Guillaume 1995), Li Ding 1992, Pan 1993, Laurent 2000 |
Méridien E | Chamfrault 1954, Da Cheng (Nguyen Van Nghi 1982), Li Ding 1992, Zhen Jiu Ju Ying (Guillaume 1995) |
Acupuncture | Moxibustion | Source |
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Puncturer à 5/10° de distance de profondeur | Moxas, cinq fois | Chamfrault 1954 |
Piqûre perpendiculaire à 0,5-1 distance | Cautériser 3-7 fois, chauffer 10-30 minutes. | Roustan 1979 |
Puncture profonde de 0,5 pouce. | Moxas 5 fois. tonifier, puis disperser | Da cheng selon Tong ren (Nguyen Van Nghi 1982) |
Puncture 0.5-0.8 cun perpendicularly | Li Ding 1992 | |
Insertion perpendiculaire au plan de la peau ; profondeur: 0,5-0,8 pouce | Zhang Rui-Fu 1992 | |
Perpendicular insertion 0.5-0.8 inch | Moxibustion dosage: 3-7 cones; stick 15 minutes | Chen 1995 |
Puncture perpendiculaire entre 0,5 et 0,8 distances de profondeur | 3-5 cônes de moxa, 5-10 minutes | Guillaume 1995 |
Puncture perpendiculaire de 0,5 à 0,8 cun | Moxas : 3 à 7; chauffer de 10 à 30 mn | Laurent 2000 |
Sensation de puncture
Soreness and distention, radiating around the shoulder and back (Li Ding 1992)
Needle sensation: distension and soreness radiating to the dorsal shoulder. (Chen 1995)
Sécurité
Etudes cliniques sur la sécurité
INTRODUCTIONS: Pneumothorax is the most frequent severe acupuncture-related adverse event occurring at the GB 21 acupoint. This study used ultrasonography (US) to measure the depth of the GB 21 acupoint in adults and assessed its applicability for ensuring safe acupuncture practices. MATERIALS AND METHODS: A US probe was used to measure the vertical depth from the skin to the pleural line of the apex of the lungs at the right and left GB 21 acupoints. The sex, age, body weight, height, and body mass index of each person were recorded. Student t test and generalized estimating equations were used for statistical analysis. RESULTS: Sixty women and 41 men with a median age of 29 years were included in this study. The depth of GB 21 increased with body weight, height, and body mass index (p < 0.001). The mean depth of GB 21 in men (17.4 mm) was greater than that in women (14.6 mm; p < 0.001). The depth difference between the right and left shoulders was significant in men (p < 0.001) but not in women. CONCLUSIONS: US can be used to measure GB 21 acupoint depth. Further control studies on its use to ensure safe clinical practices, including preventing acupuncture-related pneumothorax, are warranted.
Objective : To probe into the anatomic structure and safe needling depth of Jianjing (GB 21). Methods : Fifty-seven fresher adult corpses were randomly selected. Among them, 24 were male and 33 female. Anatomic sagittal sectional and lamelled methods were used to study the anatomic structure and suitable needle-insertion depth. Results : Anatomic structures of the perpendicular sections in order are skin, superficial fascia, deep fascia, trapezius muscle, lateral part of the levator muscle of scapula, serratus anterior muscle, external intercostal muscle, internal intercostal muscle and parietal pleura. If the acupuncture needle tip penetrates the parietal pleura, it will puncture the lung to induce pneumatothorax. When Jianjing (GB 21) punctured, the acupuncture needle should be controlled to advance straight downward, avoiding advancing obliquely toward the medial side of the chest. Conclusion : The mean dangerous depth for perpendicular needling insertion downward is 55.96 mm, and for safety, it is proposed that the depth for perpendicular needle-insertion is within 39. 17 mm in patient with medium build.
As an important acupoint on the shoulder, Jianjing (GB 21) is indicated for stiff neck, pain in the shoulder and back, mastitis and stiffness of the arm. However, improper needling on this acupoint may cause pneumothorax due to its location close to the apex and upper Jobe of the lung. This is a condition which is often seen in clinic reports. Following is the detailed topography we obtained from 20 cadavers (40 shoulders) and would like to share with our colleagues.
Classe d'usage | ★ | point courant |
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Indication | Association | Source |
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Dermites et furoncles | 21VB + 40V + 11GI + 12VG | Xin zhen jiu xue (Guillaume 1995) |
Furoncles du dos | 21VB + 40V + 4VC et moxibustion des points qi zhou ma (PC en arrière su sterno-cleïdo-mastoïdien | Ji Cheng ( Guillaume 1995) |
Mastite | 21VB + 11IG + 1IG | Roustan 1979 |
Galactophorite | 21VB + 3VC + 6Rte | Shanghai zhen jiu xue (Guillaume 1995) |
Agalactie, mastite aiguë | 21VB + 18E + 36E | Zhang Rui-Fu 1992 |
Rétention placentaire du post partum | 21VB + 3Rn + 6Rte | Zhang Rui-Fu 1992 |
Rétention placentaire | 21VB (en cas de Jue ni dans le postpartum, puncturer à 5 fen de profondeur ; si une sensation d'angoisse apparaît, ajouter 36E) + 3VC + 6Rte | Zhen jiu feng yuan (Guillaume 1995) |
Adénopathie tuberculeuse de l'aisselle | 21VB + 38VB + 3MC | Roustan 1979, Shanghai zhen jiu xue ( Guillaume 1995) |
Adénopathie cervicale | 21VB + 11GI + 5E en dispersion | Zhang Rui-Fu 1992, Zhen jiu ju ying ( Guillaume 1995) |
Fever | 21VB + 14VG + 11GI + 4GI | Li Ding 1992 |
Accès de frissons et de fièvre avec reflux de Qi vers le haut et orthopnée | 21VB + 1TR | Qian jin (Guillaume 1995) |
AVC avec absence phonatoire | 21VB + 20VB + 20VG + 6MC + 26VG en dispersion | Zhang Rui-Fu 1992 |
Attaque directe par le vent avec obstruction du Qi, reflux des glaires vers le haut avec obstruction et aphasie | 21VB + 20VB + 20VG + 26VG + 6MC | Zhen jiu xue Jian bian (Guillaume 1995) |
Douleur scapulaire | 21VB + 20VB + 15GI | Roustan 1979, Shanghai zhen jiu xue (Guillaume 1995) |
Algies de la ceinture scapulaire, dorsalgies | 21VB + 11IG + 15GI | Zhang Rui-Fu 1992 |
Pain of the shoulder and the upper arm | 21VB + 15GI + 14TR + 11GI | Li Ding 1992 |
Algie du bras et de la main | 21VB + 11GI + 8GI | Zhang Rui-Fu 1992 |
Douleurs du bras | 21VB + 11GI | Zhen jiu zhi nan (Guillaume 1995) |
OBJECTIVE: To observe the effect of acupuncture of Jianjing (GB 21) and non-acupoint on gallbladder volume and clinical symptoms of chronic cholecystitis patients. METHODS: Sixty cases of chronic cholecystitis patients were equally randomized into Jianjing (GB 21) group and non-acupoint group. A filiform needle was inserted into Jianjing (GB 21) or non-acupoint (2 cun lateral to the mid-point between the spinous processes of the 6th and 7th cervical vertebrae) on the right side, manipulated for a while till “Deqi”, and retained for 30 min. A color Doppler ultrasound scanner was used to detect the volume of the gallbladder before and 15 min after acupuncture stimulation and 30 min after withdrawal of the acupuncture needle. Changes of the patients symptoms of shoulder-back pain, stomachache, distension and nausea were evaluated according to the patients' complaints. RESULTS: After acupuncture intervention, the remission rates of shoulder-back pain and stomachache in non-acupoint and GB 21 groups were 56.67% and 90.00% respectively, while the effective rates of the patients' gastric distention and nausea in non-acupoint and GB 21 groups were 16.67% and 23.33%, respectively. The therapeutic effect of Jianjing (GB 21) was apparently superior to that of non-acupoint in pain relief (P < 0.05). Fifteen min following acupuncture stimulation and 30 min after withdrawal of the acupuncture needle, the gallbladder volume in cholecystitis patients with deflated gallbladder was increased apparently in GB 21 group (P < 0.01), and that in patients with expanded gallbladder was decreased significantly (P < 0.01). No significant differences were found among pre-, during and post-treatment in the non-acupoint group in the effects of acupuncture on regulation of the deflated and expanded gallbladder volume (P > 0.05). CONCLUSION: Acupuncture stimulation of Jianjing (GB 21) can effectively relieve shoulder-back pain and stomachache, and regulate the volume of the deflated and expanded gallbladder in cholecystitis patients. The effect of acupuncture of non-acupoint is relatively poorer in relieving the cholecystitis patients' symptoms and regulating the gallbladder volume.
La mastitis aguda es una afección frecuente entre las mujeres que practican la lactancia natural. La medicina china denomina a esta enfermedad “absceso mamario”. Desde 1975, el Departamento de Acupuntura de nuestro hospital ha venido tratando la mastitis aguda mediante punción única del punto Jianjing (VB 21). Hasta Ia fecha se han tratado 393 casos de esta afección, obteniendo resultados muy satisfactorios.
Eighty-four cases of cervical-shoulder syndrome were divided into the electroacupuncture (EA) group (n=44) and the control group (n = 40) according to the order of their paying visit. In the EA group Jianjing (GB 21), taken as the main point, was electrically stimulated for 5 times as one course, and in the control group 25 mg diclofenac administered orally (tid.) plus application of supersonic waves with a moderate frequency given for 20 rninutes daily for 5 days as one course. After one course of treatments the cured rate was 34.09% in the EA group and 12.50% in the control group with a significant difference between the two groups ( P< 0 . 05). After two courses of treatments the cured rate was 72.72% and 27.50%, respectively, in the two groups (P<0.01), indicating rapid and good therapeutic efficacy of EA at Jianjing point (GB 21) for treating cervical-shoulder syndrome.
21VB controlatéral. Puncture sur 1 Cun. Recherche du Deqi. Effectuer 30 rotations de l'aiguille. Séance de 30mn durant lesquelles le patient déambule ou monte et descend des escaliers. Dans les cas aigus, la guérison peut être obtenue en une séance. Dans les cas chroniques, effectuer une séance par jour (10 jours). Sciatique évoluant depuis 6 mois : cédation immédiate à l'obtention du Deqi. 10 séances sont effectuées.