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Abstract : Background: Bell’s palsy, an acute unilateral facial paralysis, is frequently treated with acupuncture in many countries. Bell’s palsy is easy to recur, and it is important to receive appropriate treatment quickly to give the dramatic effect of facial paralysis on a patient’s appearance, quality of life, and psychological well-being and to decrease the likelihood of incomplete recovery. Methods: We report two cases of facial nerve palsy treated by Electro-acupuncture on the affected side of the face using the points based on the RSN acupuncture method and by cupping therapy. Results: The clinical outcomes were assessed using the House-Brackmann Grading Scales (HBGS) before and after the treatment. In Case 1, a 44- year-old female with left facial palsy was treated for four weeks. HBGS VI before the treatment has improved to HBGS I after five treatments with Electro-acupuncture and cupping therapy. In Case 2, a 43-year-old female with right facial palsy was treated for three weeks. HBGS V before the treatment has improved to HBGS I after five treatments with Electro-acupuncture and cupping therapy. Conclusion: This study found that the RSN acupuncture method effectively improves Bell’s palsy during the progress phase. Electro-acupuncture and cupping therapy can be a safe and effective method to treat Bell’s palsy.

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Abstract : Introduction: Internal and External Orifices of Intervertebral Foramen (Naegu and Oegu) are important acupoints of acupotomy for lumbar spine diseases. They are used in adhesiolysis of hardened myofascial meridian. Adhesiolysis of soft tissue using acupotomy has been continuously researched abroad, but it has not been well introduced in Korea. Therefore, we provide basic information and acupotomy guidelines about these acupoints. Methods: We presented the surface anatomical definition and acupoint ultrasound image of Oegu and Naegu. Also, we introduced previous research about procedure guidelines and precautions. Finally, we suggested approach guide of Oegu and Naegu. Results: Approach of Oegu starts with inserting acupotomy needle to the root of transverse process (2-3 cm lateral to center of spinous process). Then, change the acupotomy tip to the medial superior direction and enter along the lateral edge of the facet joint. At last, incise soft tissue 2-5 mm. Approach of Naegu starts with inserting acupotomy needle to the medial side of facet joint (0.8-1 mm lateral to interspinous space). Then, incline the acupotomy tip by 10 degrees outward based on the medial edge of the facet joint. At last, enter only 2-5 mm between ligament flavum and the back of the intervertebral foramen and make 2-3 incisions. Conclusion: Accurate locating and needling method are very important for the treatment effect and safe procedure. We suggest using the guidelines presented by us for selecting accurate acupotomy needling point, depth, and direction.

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Abstract : Background: The aim of this article is to propose the safe and effective protocol for ultrasound- guided acupotomy procedure at ligamentum flavum. Deep needling at the ligament flavum can cause side effects such as leakage of cerebrospinal fluid or hematoma, or exacerbation of the patient’s symptoms, which are difficult to respond to in primary medical institutions. In this regard, the need to present a safer and more accurate method of needling at ligamentum flavum is enhanced. Methods: While treating 12 patients aged 60-80 years, the method of needling the shortest length with identifing the tip of acupuncture on the image was studied. An ultrasound machine was used with GE LOGIQ P9 XDclear and C1-6D Single Crystal Convex Probe. The initial study used a SMC 0.40×60 mm needle. After the operation became proficient with the needle, MAANSHAN BOND MEDICAL INSTRUMENTS CO. LTD. GB 60×60 acupotomy was used. Results: A safe procedure method and a manual for education methods were proposed. Conclusion: Because of the long axis entry, the procedure can be performed without missing the full length and tip of the acupuncture on image. It can be performed with small invasion compared to previous in-plane studies performed by laying down the angle.

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Abstract : Background: 3rd lumbar transverse process syndrome is a common cause of low back pain and is a biomechanically important location. However, in the case of a person who intermittently has a transition in the location of the kidney, there is a risk of damaging the kidney during the procedure. Methods: Among patients who visited a single medical institution and who underwent 3 lumbar transverse process syndrome, we report several cases of a patient with a transition in kidney position. Results: Kindey was closely observed under the 3rd lumbar transverse process in 4 patients. In particular, in the case of 2 cases confirmed by ultrasound, the distance between the 3rd lumbar transverse process and the kidney is about 2-3cm, so there may be a risk of kidney damage during blind insertion. Conclusion: This study proposes the need for an intermediate process that can consider the patient’s anatomical characteristics for safe needle acupuncture of the 3rd lumbar transverse process.

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Abstract : Background: The third lumbar transverse process syndrome refers to local tenderness and other symptoms accompanied by pain in the lower back, hips, and legs due to chronic damage to muscles, fascia, and other soft tissues attached to third lumbar transverse process. The third lumbar transverse process syndrome was proposed in acupotomology, and the third lumbar transverse process syndrome accounts for a large part of low back pain. We investigated the importance of third lumbar transverse process syndrome from view of biomechanical, anatomical physiology, and neurochemical. Methods: We searched and organized of literature on third lumbar process syndrome through pubmed, google scholar & CNKI. Results: The effects of acuptomy treatment were examined from three perspectives. From a biomechanics point of view, Acupotomy treatment relieves abnormal tension in soft tissues and stimulates recovery. From anatomical physiology point of view, acupotomy treatment into fascia can improve blood flow and normalize wrinkles and elasticity to restore the normal function of the fascia. From a neurochemistry point of view, acupotomy treatment reduces the high concentration of NO produced by iNOS and promotes the repair of soft tissue, also reduces chronic pain by lowering TNF-α and IL-1β serum levels. Conclusion: The finding of this paper will help to provide understanding of biomechanical, anatomical, and neurochemical perspectives of the third lumbar transverse process Syndrome and It’s significance.

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Abstract : Background: Ultrasound-guided acupuncture has gained significance in diverse medical applications, particularly in enhancing the accuracy and safety of procedures. This technique has shown promising results in clinical effectiveness and safety compared to traditional methods. Methods: We conducted a comprehensive review of studies involving ultrasound-guided acupuncture, analyzing its accuracy and clinical impact. We explored various conditions, such as musculoskeletal pain syndromes, trigger finger, knee osteoarthritis, and more, to compare the efficacy of ultrasound-guided acupuncture against conventional techniques. Results: Ultrasound-guided acupuncture demonstrated enhanced accuracy in targeting specific anatomical structures, thereby improving the precision and effectiveness of the treatment. Studies highlighted its superiority in reducing complications and recurrence rates, particularly in conditions like trigger finger and knee osteoarthritis. Conclusion: The development and application of ultrasound technology in guiding acupuncture procedures offer a safer and more effective approach to clinical practice. As ultrasound technology continues to advance, its integration with acupuncture can further refine and standardize protocols, potentially influencing future research and establishing standardized guidelines for practice.

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Abstract : Background: TE16, an acupuncture point near the second cervical vertebra’s spinous process (C2), signifies the 16th point on the Triple Energizer Meridian. ‘Celestial’ (天) denotes its upper body placement, while ‘pivot’ (牖) metaphorically describes a window for ventilation and light. Positioned at the back of the neck, aligned with the mandible’s angle, TE16 aligns with TE17 in the front and SI16 at the posterior shield-shaped cartilage’s height. Traditional Chinese Medicine literature associates these points with opening and connecting the “five senses” or facial orifices. Methods: Our study systematically reviewed anatomical and physiological aspects related to TE16, exploring both Korean and international databases. We included various study types, emphasizing anatomical structure or physiological mechanisms associated with TE16. Results: Of 250 studies, eight were selected, predominantly from China (eight), Taiwan (one), and Korea (one). The research focused on anatomical structure, with one study examining depth and another highlighting physiological mechanisms. Conclusion: The review disclosed TE16’s anatomical connection with the sternocleidomastoid muscle, its potential involvement in conditions like sudden deafness, and explored physiological mechanisms. Our findings endorse TE16’s use in clinical practice, emphasizing precise acupuncture depth and method while considering safety measures during needling. Integrating imaging technologies like ultrasound may enhance our understanding of TE16’s anatomical structures.

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Abstract : Introduction: The main symptoms of carpal tunnel syndrome are pain, numbness, and paresthesia in the thumb and second and third fingers along the area innervated by the median nerve. In this study, we observed and reported changes in median nerve thickness through ultrasound after acupotomy treatment. Methods: One patient who received acupotomy treatment for the treatment of carpal tunnel syndrome from June 29, 2022 to August 20, 2022. Results: The patient’s symptoms were similar until the end of treatment, but on ultrasound images, the thickness of the median nerve in the distal carpal tunnel decreased from 0.4 cm on June 29, when the patient first visited the hospital, to 0.33 cm on July 16. During the subsequent 4 treatments, all of them remained constant at 0.28 cm, resulting in a final decrease of 42%. Conclusion: Improvement of median nerve thickness was observed after applying acupotomy treatment for CTS.

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Abstract : Introduction: Cerebrospinal fluid (CSF) circulates in the subarachnoid space around the brain and spinal cord, and in the ventricles of the brain. It serves as a buffer to protect the brain from physical and immunological damage. Since important actions such as removing soluble waste from the brain occur as the CSF circulates, various diseases including cognitive disorders can occur if CSF circulation is impaired. Therefore, it is very important to find anatomical treatment points that improve CSF circulation. Methods: We summarized various clinical symptoms and related diseases caused by CSF circulation failure and reviewed anatomical structures that could affect CSF circulation. Based on the reviewed data, we proposed several treatment points that can contribute to the improvement of CSF circulation. Results: Symptoms and diseases caused by decreased CSF circulation include headaches, sleep disorders, and Alzheimer’s disease. In particular, Alzheimer’s disease was also related to cerebral blood flow, which was also closely related to CSF circulation. The anatomical structure associated with CSF circulation was dura mater, deep cervical lymph nodes, meningeal lymphatic vessels, and emissary vein. The structures connected to the dura mater were also important, such as the myodural bridge (MDB) directly connected to the dura mater and the soft tissues such as the suboccipital muscles and ligaments connected to the dura mater via MDB. Conclusion: We propose several treatment points based on anatomical structures that may affect CSF circulation. It is the soft tissues of the suboccipital site including MDB, submucosal tissue of the nasal cavity, stylomastoid foramen, and emissary vein.

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Abstract : Introduction: The aim of this study was to introduce two cases of the treatment effects related to Yin-deficiency related symptoms of Yijin Samul-tang Gagam, and to summarize the use within the Donguibogam to use it in the future. Methods: After administering Yijin Samul-tang Gagam to two patients who visited the hospital with Yin-deficiency related symptoms, the progress was analyzed. Symptom changes were measured by Symptom score (SS) and patient interview. Results: After the treatment, Case 1 showed a significant decrease in SS. When the night sweats symptoms were tracked based on SS 10 points during first visit, they decreased to 2 points after treatment, and most other symptoms improved. In Case 2, the frequency of occurrence of night-time lower convulsions improved from once/1 week to once/2 weeks, and other symptoms related to fatigue were also improved. Conclusion: This study reports that Yijin Samul-tang Gagam was effective for Yin-deficiency related symptoms.