Hanyang Med Rev HMR Hanyang Medical Reviews 1738-429X Hanyang University School of Medicine 10.7599/hmr.2010.30.2.91 Review Article Evidence Based Acupuncture Park Kyu Hyun M.D Yoo Tae Woo O.M.D * Department of Neurology, School of Medicine, Pusan National University, Pusan, Korea. Koryo Hand Therapy Institute, Korea. Corresponding author (qhynbak@pusan.ac.kr) 05 2010 31 05 2010 30 2 91 102 20 03 2010 15 04 2010 Copyright © 2010 Hanyang University School of Medicine 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Acupuncture is an important portion of Complimentary and Alternative Medicine and has been applied widely, but understanding of acupuncture is not complete, a steady progress has been made in recent years with modernized techniques. The controversies of acupuncture should be defined through scientific evidence. There are a lot of problems for application of acupuncture in practice and research, such as, in the diagnosis, therapy and evaluation of acupuncture. We need standardized tools and scientific methods for diagnosis and treatment. It is an essential key to refine the effect of acupuncture and to prove the mechanisms. We should have basic concepts of acupuncture and apply it objectively for promotion of health and prevention of illness and treatment of disease as mentioned in Medical Acupuncture. Korean Hand Acupuncture Therapy (KHT) has many advantages for this purpose. It was found and developed in 1971 and since has been widely used in the world. KHT is easy to learn and to practice without side effect. The important concept of health in KHT is defined as the harmonized state of cerebral circulation which consists of anterior and posterior circulation. Disease and dysfunction result from imbalance of the anterior and posterior circulation. We present the basic concept of KHT and some studies to prove the mechanism of acupuncture using thermograph, transcranial Doppler and fMRI. We need a standard research protocol of acupuncture. KHT can be a good candidate for this purpose. KHT fulfills the requirements such as role, theory, diagnosis, treatment and evaluation and study.

 Complement Alternative Medicine (CAM) Korean Hand Acupuncture (KHT) Pulse Diagnosis Acupuncture

This work was supported for two years by Pusan National University Research Grant.

 NIH Consensus Development Program Acupuncture Accessibility verified November 11, 2008 http://consensus.nih.gov/1997/1997Acupuncture107htm Park KH Brain activation with Korean Hand acupuncture 2000 Shindonga 434 441 Litscher G Computer-based quantification of traditional Chinese-, ear- and Korean hand acupuncture: needle-induced changes of regional cerebral blood flow velocity Neurol Res 2002 24 377 380 Boehler M Mitterschiffthaler G Schlager A Korean hand acupressure reduces postoperative nausea and vomiting after gynecological laparoscopic surgery Anesth Analg 2002 94 872 875 Schlager A Boehler M Puhringer F Korean hand acupressure reduces postoperative vomiting in children after strabismus surgery Br J Anaesth 2000 85 267 270 http://www.koryohandtherapy.com Yoo TW Comparative studies between Seo Geum Medicine and Oriental Medicine http://www.koryohandtherapy.com/ Linde K Streng A Jurgens S Hoppe A Brinkhaus B Witt C Wagenpfeil S Pfaffenrath V Hammes MG Weidenhammer W Willich SN Melchart D Acupuncture for patients with migraine: a randomized controlled trial JAMA 2005 293 2118 2125 Linde K Allais G Brinkhaus B Manheimer E Vickers A White AR Acupuncture for tension-type headache Cochrane Database Syst Rev 2009 1 CD007587 Linde K Allais G Brinkhaus B Manheimer E Vickers A White AR Acupuncture for migraine prophylaxis Cochrane Database Syst Rev 2009 1 CD001218 Alecrim-Andrade J Maciel-Júnior JA Cladellas XC Correa-Filho HR Machado HC Acupuncture in migraine prophylaxis: a randomized sham-controlled trial Cephalalgia 2006 26 520 529 Diener HC Kronfeld K Boewing G Lungenhausen M Maier C Molsberger A Tegenthoff M Trampisch HJ GERAC Migraine Study Group Efficacy of acupuncture for the prophylaxis of migraine: a multicentre randomised controlled clinical trial Lancet Neurol 2006 5 310 316 Cho ZH Chung SC Jones JP Park JB Park HJ Lee HJ Wong EK Min BI New findings of the correlation between acupoints and corresponding brain cortices using functional MRI Proc Natl Acad Sci U S A 1998 95 2670 2673 Retraction in: Cho ZH, Chung SC, Lee HJ, Wong EK, Min BI. Proc Natl Acad Sci U S A. 2006;103:10527 Litscher G Wang L Wiesner-Zechmeister M Specific effects of laserpuncture on the cerebral circulation Lasers Med Sci 2000 15 57 62 Litscher G Schikora D Cerebral Vascular Effects of Non-invasive Laser needles Measured by Transorbital and Transtemporal Doppler Sonography Lasers Med Sci 2002 17 289 295 Oishi K Ikeda T Watanabe K Senba M Suga K Nagatake T A fatal case of streptococcal toxic shock-like syndrome probably caused by acupuncture Kansenshogaku Zasshi 1998 72 776 780 Yamashita H Tsukayama H Tanno Y Nishijo K Adverse events related to acupuncture JAMA 1998 280 1563 1564 http://www.bokuennews.com/ Wu MT Hsieh JC Xiong J Yang CF Pan HB Chen YC Tsai G Rosen BR Kwong KK Central nervous pathway for acupuncture stimulation: localization of processing with functional MR imaging of the brain--preliminary experience Radiology 1999 212 133 141 Buckner RL The hemodynamic inverse problem: Making inferences about neural activity from measured MRI signals Proc Natl Acad Sci U S A 2003 100 2177 2179 Hui KK Liu J Makris N Gollub RL Chen AJ Moore CI Kennedy DN Rosen BR Kwong KK Acupuncture modulates the limbic system and subcortical gray structures of the human brain: evidence from fMRI studies in normal subjects Hum Brain Mapp 2000 9 13 25 Dhond RP Kettner N Napadow V Neuroimaging acupuncture effects in the human brain J Altern Complement Med 2007 13 603 616 Hsieh JC Tu CH Chen FP Chen MC Yeh TC Cheng HC Wu YT Liu RS Ho LT Activation of the hypothalamus characterizes the acupuncture stimulation at the analgesic point in human: a positron emission tomography study Neurosci Lett 2001 307 105 108 Uchida S Kagitani F Suzuki A Aikawa Y Effect of acupuncture-like stimulation on cortical cerebral blood flow in anesthetized rats Jpn J Physiol 2000 50 495 507 Litscher G Ten Years Evidence-based High-Tech Acupuncture– A Short Review of Centrally Measured Effects* (Part II) Evid Based Complement Alternat Med 2009 6 305 314 Koryo Hand Therapy Web site Accessibility verified Novmeber 11.2008 http://www.soojichim.com/new/eng/fu-05.htm Yoo TW Korean Hand Therapy 2009 12th ed Seoul, Korea Eum Yang Maek Jin Publishing Co. Yoo TW Yin Yang Pulse Diagnosis & Tonification and Sedation 1994 Seoul Eum Yang Maek Jin Publishing Co. Yoo TW Seogeum Therapy 2009 2nd ed Seoul, Korea Eum Yang Maek Jin Publishing Co. Park KH Yoo TW Useful method to confirm tender points of primary headache: Corresponding points of Koryo Hand Acupuncture Therapy Internet J Altern Med 2005 3 1 Park KH Joo H Kim DS Jung DS Yoo TW Where are pain localizations in migraineurs? localization of pain in head, shoulder and abdomen in migraineurs J Korean Pain Res Soc 2003 13 81 85 Kara SA Erdemoglu AK Karadeniz MY Altinok D Color Doppler sonography of orbital and vertebral arteries in migraineurs without aura J Clin Ultrasound 2003 31 308 314 Litscher G Rachbauer D Ropele S Wang L Schikora D Fazekas F Ebner F Acupuncture using laser needle modulates brain function: first evidence from functional transcranial Doppler sonography and functional magnetic resonance imaging Lasers Med Sci 2004 19 6 11 Park KH Yoo TW The Change Of Cerebral Blood Flow Before And After Treatment Of Koryo Hand Therapy Internet J Altern Med 2001 1 1 Park KH Yoo TW Relieving Migraine Headache by Regulating Cerebral Blood Flow with Koryo Hand Therapy Internet J Altern Med 2001 1 1 Park KH Park KP Shin JH Jung TW Migraine Headache and Cerebral Circulation J Korean Pain Res Soc 2006 16 93 98 Park KH Kim HJ Baek SY Cho BM Yoo TW Effect of Acupuncture on Blood Flow Velocity and Volume in Common Carotid and Vertebral Arteries in Migraine Patients Med Acupunct 2009 21 47 54 (http://www.liebertonline.com/toc/acu/21/1) Macchi C Lova RM Miniati B Gulisano M Pratesi C Conti AA Gensini GF The circle of Willis in healthy older persons J Cardiovasc Surg (Torino) 2002 43 887 890 Macchi C Molino Lova R Miniati B Gulisano M Pratesi C Conti AA Gensini GF Relationship between the calibre of carotid arteries and the configuration of the circle of Willis in healthy older persons J Cardiovasc Surg (Torino) 2003 44 231 236 von Büdingen HC Staudacher T von Büdingen HJ Ultrasound diagnostics of the vertebrobasilar system Front Neurol Neurosci 2006 21 57 69 Hendrikse J Hartkamp MJ Hillen B Mali WP van der Grond J Collateral ability of the circle of Willis in patients with unilateral internal carotid artery occlusion: border zone infarcts and clinical symptoms Stroke 2001 32 2768 2773 Cho ZH Hwang SC Wong EK Son YD Kang CK Park TS Bai SJ Kim YB Lee YB Sung KK Lee BH Shepp LA Min KT Neural substrates, experimental evidences and functional hypothesis of acupuncture mechanisms Acta Neurol Scand 2006 113 370 377 Yoo TW Gold Meridian Therapy 2009 Seoul, Korea Eum Yang Maek Jin

Relationships between Eum (yin) and Yang; liver and gallbladder; heart and small intestine (pericaridium and triple warmer); spleen and stomach; lung and larger intestine; kidney and urinary bladder, and correlation of five elements of live, heart, spleen, lung and kidney or gallbladder, small intestine, stomach, large intestine and urinary bladder.

This sheet shows Korean Hand Acupuncture Point and Micromeridian. There are 14 micromeridians and 403 acupuncture points on the hand (Adapted from reference 29).

A) Corresponding experiment was performed with KHT pellet on A-28 and KHT acupuncture needle on A-24 and checked the change of temperature on the nose and neck in 2, 5, 7 and 10 minutes (above). B) Corresponding experiment was done with dry ice on A-8 and the change of temperature in the umbilicus was noted (below).

The newly developed hold frame was used to check the blood flow velocities in several arteries continuously and simultaneously (Lee PH frame maker: Handok Medical Company).

Four vessels were recorded at left vertebral (Ch 1), right vertebral (Ch 2), left carotid (Ch 3) and left radial artery (Ch4) using EME Transcranial Doppler to Park 0 0 diagnosed as migraine headache. The acupuncture treatment was done at E8 and I2 of Korean Hand Acupuncture Points.

Axial MR image of the neck at the level of cervical 4th spine with fast low angle shot sequence. Flow-compensated image is shown in (A) and flow-encoding image is in (B). Regions of interest are manually drawn in each common carotid artery (long arrows) and the vertebral artery (short arrows) in both sides. Flow velocity and flow volume were calculated automatically by the MR machine soft ware.

Problems for Acupuncture Application

Role of Acupuncture(Beyond pain and disease to health)

Diagnostic Methods in KHT

Therapeutic Tools in KHT

Therapeutic strategy in KHT

Evaluation in Koryo Hand Therapy

Advantages of Koryo Hand Therapy