Using Ultrasonography Measurements to Determine the Depth of the GB 21 Acupoint to Prevent Pneumothorax

Analysis of Research Trends in Ultrasound-Guided Acupuncture and Dry-Needling: A Scoping Review

Background: This study aimed to summarize the current status of research on ultrasound-guided acupuncture and dry-needling treatment and the specific treatment methods applied to patients. Methods: A scoping review was conducted, surveying three English databases (PubMed, Embase, and the Cochrane Library) for studies published up to May 2024. All studies related to ultrasound-guided acupuncture and dry-needling treatment were considered. Literature was selected using selection and exclusion criteria, and extracted and organized using EndNote. Results: A total of 107 eligible studies were included. Among the 107 studies, non-comparative studies accounted for the largest proportion (n = 47, 43.9%), followed by randomized controlled trials (RCTs; n = 41, 38.3%). Diseases of the musculoskeletal system or connective tissue (15 diseases of the musculoskeletal system or connective tissue) accounted for most (n = 48, 55.8%) of the 86 diseases studied, followed by symptoms, signs, or clinical conditions not otherwise classified (n = 17, 19.8%). Conclusions: Ultrasound-guided acupuncture and dry-needling have been actively studied and applied for the treatment of various diseases. However, higher-quality studies are needed for further applications in research and clinical practice.

A case report on hemopneumothorax caused by acupuncture at Huatuo-Jiaji points

Acupuncture is generally safe; however, severe side effects, such as syncope and pneumothorax (PTX), have sometimes been reported. No cases of hemopneumothorax following acupuncture have been reported in Korea. This study reports a case of progression and prognosis of hemopneumothorax after acupuncture in a patient who visited a hospital for digestive disorders and underwent acupuncture treatment at the Huatuo-Jiaji points to control the autonomic nerves. The patient complained of shortness of breath and chest pain after acupuncture. However, neither the patient nor the doctor suspected PTX. Chest radiography, conducted after a day, confirmed hemopneumothorax of the right lung, and the patient was immediately hospitalized. During hospitalization, oxygen therapy and medication were administered, and the patient was discharged 6 days later. However, PTX recurred, and the patient was rehospitalized. The patient was discharged after 4 days, and it was confirmed that he was completely cured, as evident from both radiation findings and patient symptoms on day 20. This study demonstrates that physicians should pay more attention to and be aware of PTX and its symptoms when performing acupuncture on the thoracic chest.

Practice recommendations for physiotherapists in Canada managing adverse events associated with acupuncture

In Canada, acupuncture is a regulated medical practice that involves inserting thin needles at specific points on the body to alleviate pain and other health conditions. Acupuncture is a controlled act in physiotherapy practice. Therefore, physiotherapists who incorporate acupuncture into their practice should have the necessary education and roster this controlled act with the regulatory college in their province. Although acupuncture can be helpful, potential complications can arise, ranging from minor bruising to life-threatening conditions such as pneumothorax and cardiac tamponade. This article provides information on the potential adverse effects of acupuncture and provides recommendations for physiotherapists regarding prevention and management of any incidents that may arise during treatment.

Iatrogenic Pneumothorax during Acupuncture: Case Report

Acupuncture treatment in local areas is commonly used to treat pain or soreness; however, acupuncture around the neck or shoulder may be a risk factor for pneumothorax. Herein, we report two cases of iatrogenic pneumothorax after acupuncture. These points indicate that physicians should be aware of these risk factors through history-taking before acupuncture. Chronic pulmonary diseases, such as chronic bronchitis, emphysema, tuberculosis, lung cancer, pneumonia, and thoracic surgery, may be associated with a higher risk of iatrogenic pneumothorax after acupuncture. Even if the incidence of pneumothorax should be low under caution and fully evaluated, it is still recommended to arrange further imaging examinations to rule out the possibility of iatrogenic pneumothorax.

Using a Flipped Classroom to Compare 2 Ultrasonography Operating Methods to Improve Practice in Ultrasound Detection Acupuncture

Objective

Ultrasound (US) detection acupuncture (UDA) is an innovative acupuncture technique that uses ultrasonography (USG) to detect the depth of the lung before performing acupuncture on the points around the chest to avoid puncturing the lungs. For acupuncturists to use UDA appropriately, it is crucial to have a good operating method to identify the pleura with USG. This study compared 2 US operating methods through active learning in a "flipped classroom" setting for acupuncture students.

Materials and Methods

Students and interns were recruited to complete the UDA flipped classroom course and evaluate the operations of 2 US methods on either of 2 simulation models: (1) a single B-mode or (2) a combined M-mode + B-mode. Participants were interviewed and satisfaction surveys were administered to obtain feedback.

Results

A total of 37 participants completed the course and evaluations. The combined mode had better measurement accuracy, acupuncture safety, and operating time (P < 0.05), and no pneumothoraxes occurred. Among both participant groups, the combined mode allowed the student group to learn quickly and the intern group to become more proficient. Both interviews and satisfaction surveys yielded positive feedback.

Conclusions

Using a combined mode for UDA can improve its performance greatly. The combined mode is definitely helpful for learning and promotion of UDA.

Studies on Location of Acupoints with X-ray Fluorescence Analysis Based on Synchrotron Radiation

Acupuncture and moxibustion are commonly accepted treatments in traditional Chinese medicine (TCM). One of the important issues of interest is determining the accurate location of acupoints in acupuncture. Modern hightechnology methods were utilized to verify the accuracy of acupoint positions in TCM, reducing the uncertainty of manually locating the positions. The acupoint location was established according to the richness of trace elements (TEs). The relative content of TEs was perceived by X-ray fluorescence (XRF) analysis. The distribution of TEs was determined after the dates were calibrated and the processes were optimized. The relative content of TEs was significantly different in acupoint and non-acupoint areas. There was an uneven distribution of calcium, iron, copper, and zinc in the sample. The relative content of these elements was increased in the acupuncture areas, and the standard deviation was also relatively large, especially for calcium, showing obvious enrichment. According to the enriched area of the TEs, the distance was about 6 mm between the conception channel and the kidney meridian, and the distance to the stomach meridian was about 23 mm for the rabbit sample. The position of the acupoints and spacing of meridians, which were determined according to the enrichment of TEs, were consistent with the TCM theory. The results show that synchrotron radiation-based XRF is a suitable method for determining the location of acupoints.

Traumatic Pneumothorax in a 58-Year-Old Man: A Case Report of a Rare Post-Acupuncture Adverse Event

Patient: Male, 58-year-old

Final Diagnosis: Pneumothorax

Symptoms: Chest pain

Medication: —

Clinical Procedure: Chest tube

Specialty: General and Internal Medicine• Pulmonology

Development and Evaluation of Inexpensive Ultrasound Using A-Mode and M-Mode Signals to Identify Lung Depth and Avoid Risk of Pneumothorax in Acupuncture

Purpose

To increase patient safety, ultrasound detection acupuncture (UDA) has been developed, which can detect a safe depth for acupuncturists to avoid causing pneumothorax. This study aims to develop and evaluate a single-transducer ultrasound for acupuncture (UFA) to promote UDA.

Methods

Special A-mode and M-mode signals were analyzed to identify the depth of the lung. Six subjects were recruited to test the reliability and validity of UFA on GB21, LV14 and BL43 acupuncture points.

Results

The result showed UFA’s coefficient of variation was less than 0.2 and no difference in age, gender, and BMI of the subjects statistically, demonstrating excellent reliability. However, the content validity index of 0.51 did not meet expectations. UFA has good reliability, but it cannot reach the level of medical ultrasound. UFA uses A-mode and the seashore sign of M-mode to make a good identification of the lung, and it would be useful in the promotion of UDA.