COMPARATIVE ANALYSIS OF THE TOPOGRAPHICAL LOCATIONS OF ACUPUNCTURE POINTS AND CHAPMAN’S REFLEX POINTS OK BAE KIM A dissertation submitted in partial fulfillment of the requirements for the degree of Master of Osteopathy, Unitec New Zealand, 2007 ABSTRACT Introduction: Both Acupuncture points (APs) and Chapman’s reflex points (CRPs) are used to treat the internal organ systems of patients throughout the world. The AP system developed from Eastern medical philosophy and the CRP system from Western osteopathic philosophy. Although the two point systems started separately, their final purposes are the same, to treat disturbances of internal organ system. To date, no data has been published which compare relationships between the two point systems. The aim of this study was to find any relationships between the two point systems. Methods: A Single Model Experiment (SME) based on a literature-based analysis was used to find their relationships. The data collection incorporated both literature data and experimental data. Based on the data from the literature, the CRP system (102 CRP points) and associated APs (102 points) were mapped onto both anterior and posterior surfaces of the body of the participant and their distances from anatomical landmarks to APs and from APs to nearby CRPs were measured. The measured data were statistically analyzed Results: Literature-based analysis showed that of the APs identified as anatomically near by one of the CRPs, 71.1% of the anterior points and 93.1% of the posterior points were related pathologically to CRP points. SME revealed that: The topographical congruency of the pathologically related points was in the range of 20.6% (anterior points) - 44.2% (posterior points). Mean distance between AP and CRP of the posterior points (16.5 ± 1.9 mm) was smaller than the anterior points (27.8 ± 6.0 mm) for pathologically related points. Nearest neighbour analysis revealed that the distribution pattern of the two point systems on the surface of human body was between random and regular for both anterior and posterior points. Intraclass correlation coefficient suggested that the distance of APs from the anatomical landmark was not a predictor of the distance from the APs to the CRPs. Conclusion: This study has provided clinical evidence of a close relationship between the AP and CRP system on a single subject. This study is the first to map these two point systems on a human body. The data recorded forms the basis for subsequent study of these two point systems. Key terms: Acupuncture point, Chapman’s reflex point, topographical relationship ii DECLARATION Name of candidate: Ok Bae Kim This dissertation is submitted in partial fulfillment of the requirements for the Unitec programme of Master of Osteoathy. The regulations for the programme are set out in the “Master of Osteopathy: Programme Schedule” and are elaborated in the course handbook. Candidate’s declaration I confirm that: * This dissertation represents my own work; * The contribution of any supervisors and others to the research and to the dissertation was consistent with the Unitec Code of Supervision. Candidate: Date: Supervisors’ declaration I confirm that, to the best of my knowledge: * The research was carried out and the dissertation prepared under my direct supervision; * Except where otherwise approved by the Graduate School Academic Committee of Unitec, the research was conducted in accordance with the programme regulations and rules; * The contribution made to the research by me, by other members of the supervisory team, by other members of staff of Unitec and by others was consistent with the Unitec code of supervision. Supervisor: Clive Standen Date iii Supervisor: Derek Nash Date: iv ACKNOWLEDGEMENTS I would like to thank my original supervisor John McPartland for the guidance he gave me in selecting the topic of my study. Grateful thanks to my principal supervisor Clive Standen and associate supervisor Derek Nash. Thanks also to the staff at the Unitec Graduate School for their help. Finally, I like to thank Joon Kim for helping me in identifying Acupuncture points during the experiment of this study. v TABLE OF CONTENTS Page ABSTRACT.............................................................................................................ii DECLARATION.....................................................................................................iii ACKNOWLEDGEMENTS.....................................................................................iv TABLE OF CONTENTS.........................................................................................v LIST OF TABLES..................................................................................................vii LIST OF FIGURES...............................................................................................viii LIST OF ABBREVIATIONS..................................................................................ix 1.0 INTRODUCTION..............................................................................................1 1.1 Background...........................................................................................1 1.2 Literature Review.................................................................................2 1.2.1 Acupuncture Points.............................................................2 1.2.2 Chapman’s Reflex Points....................................................5 1.2.3 Relationships between Point Systems.................................7 2.0 METHODS.......................................................................................................11 2.1 Study Design......................................................................................11 2.2 Data....................................................................................................11 2.2.1 Data Analysis....................................................................11 2.3 Literature–based Analysis..................................................................13 2.3.1 Anterior versus Posterior Design......................................13 2.4 Single Model Experiment (SME) Protocol........................................14 2.4.1 Pre-experimental Test.......................................................14 2.4.2 Participant.........................................................................15 2.5 Experimental Procedure....................................................................15 2.5.1 Mapping and Data Collection...........................................15 2.5.2 Trouble Points...................................................................18 3.0 RESULTS.........................................................................................................19 3.1 Literature-based Analysis..................................................................19 vi 3.2 Single Model Experiment..................................................................20 4.0 DISCUSSION...................................................................................................23 4.1 Overview...........................................................................................23 4.2 Literature–based Analysis..................................................................23 4.2.1 Proposed Physiological Reason for the Relationship Between Pathologically Related Points...........................24 4.2.2 Literature-based Difficulties.............................................24 4.2.3 Literature Reproduction Errors.........................................25 4.3 Single Model Experiment..................................................................26 4.3.1 Blinding............................................................................26 4.3.2 Palpation of Anatomical Landmarks................................27 4.3.3 Accuracy of Correlation Data...........................................27 4.4 Data Analysis of Single Model Experiment......................................28 4.4.1 Percentage Correlation......................................................28 4.4.2 Mean Distance..................................................................30 4.4.3 Nearest Neighbour Analysis.............................................31 4.4.4 Intraclass Correlation Coefficient.....................................32 4.5 Validity of Paper Correlation Studies................................................32 4.6 Limitations of the study.....................................................................33 4.7 Clinical Implications..........................................................................34 4.8 Conclusion.........................................................................................35 5.0 REFERENCES.................................................................................................36 6.0 APPENDICIES.................................................................................................41 Appendix 1: Illustration of AP Points......................................................41 Appendix 2: Illustration of CRP Points....................................................42 Appendix 3: Results of Literature-based Analysis...................................43 Appendix 4: Results of Single Model Experiment...................................56 Appendix 5: Mapping of Point Systems...................................................60 Appendix 6: Participant Information Sheet..............................................61 Appendix 7: Participant Consent Form....................................................62 vii viii LIST OF TABLES Table 3.1 Numbers of Pathologically not Related nearby APs for Each CRP Condition-----------------------------------------------------19 Table 3.2 Identified Quantities of APs for Each Meridian---------------------------20 Table 3.3 Results of Data Analysis------------------------------------------------------21 Table 6.1 Results of Literature-based Analysis------------------------------------- --42 Table 6.2 Experimental Results of Anterior Points-----------------------------------55 Table 6.3 Experimental Results of Posterior Points----------------------------------57 ix LIST OF FIGURES Figure 2.1 Distribution Patterns of Nearest Neighbour Analysis ----------------13 Figure 6.1 Mapping of Anterior System----------------------------------------------59 Figure 6.2 Mapping of Posterior System---------------------------------------------59 x