世界卫生组织采纳的针灸穴位标准一.pdf

WHO Standard aCUPUnCtUrE POInt LOCatIOnS In tHE WEStErn PaCIfIC rEgIOnUpdated and Reprinted 2009WHO Library Cataloguing in Publication data WHO Standard Acupuncture Point Locations in the Western Pacific Region 1.Medicine,traditional.2.acupuncture Point Locations ISBN 978 92 9061 248 7 (NLM Classification:WB50)World Health Organization(2008)Publications of the World Health Organization enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention.for rights of reproduction or translation of WHO publications,in part or in toto,application should be made to the Office of Publications,World Health Organization,Geneva,Switzerland,or to the Regional Office for the Western Pacific,Manila,Philippines.The World Health Organization welcomes such applications.the designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the World Health Organization concerning the legal status of any country,territory,city or area or of its authorities,or concerning the delimitation of its frontiers or boundaries.The mention of specific companies or of certain manufacturers products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned.Errors and ommissions excepted,the names of proprietary products are distinguished by initial capital letters.the authors alone are responsible for the views expressed in this publication.fOrEWOrd vaCKnOWLEdgEMEntS viigEnEraL gUIdELInES fOr aCUPUnCtUrE POInt LOCatIOnS 1WHO Standard aCUPUnCtUrE POInt LOCatIOnS 23 Lung Meridian 25 Large Intestine Meridian 33 Stomach Meridian 45 Spleen Meridian 69 Heart Meridian 81 Small Intestine Meridian 87 Bladder Meridian 99 Kidney Meridian 135 Pericardium Meridian 151 Triple Energizer Meridian 157 gallbladder Meridian 171 Liver Meridian 195 governor Vessel 203 Conception Vessel 219 rEfErEnCES 233ANNEX 235 taBLE Of COntEntSAlong with herbal medicine,acupuncture has been used for more than 2500 years as one of the main pillars of traditional medicine in the Western Pacific Region.Accordingly,the WHO Regional Committee for the Western Pacific adopted resolutions supporting the proper use of acupuncture and herbal medicine in 1985 and 1987.With the aim of standardization in the field of acupuncture,the WHO Regional Office for the Western Pacific organized a Working Group for the Standardization of Acupuncture nomenclature in 1981 and,after 10 years of effort,a consensus was reached on the proposed standard international acupuncture nomenclature.In 1991,A Proposed Standard International Acupuncture Nomenclature was published by WHO Headquarters and a revised edition of Standard Acupuncture Nomenclature was published by the WHO Regional Office for the Western Pacific.It was reported,however,that there was controversy among Member States regarding approximately one-fourth of regular acupuncture point locations,raising doubts and uncertainty regarding the efficacy and safety of acupuncture treatment.It is not known when this disparity in location of acupuncture points first arose but,in recent decades,there has been a growing international demand for standardization of acupuncture point locations for education,research and clinical practice.However,since each Member State has its own initiatives and traditions,international standardization of acupuncture point locations has proved extremely difficult.As an initial step in standardizing acupuncture point locations,the WHO Western Pacific Regional Office convened the first Informal Consultation on the Development of WHO Standard of acupuncture Point Locations in October 2003.Experts from China,Japan and the republic of Korea attended that consultation,and 10 further serial meetings were organized subsequently by the Regional Office.In the beginning,it appeared it would be almost impossible to harmonize the activities of the various participants.However,with the passing of time and the development of mutual understanding and trust,the experts managed to reach a consensus on most of the controversial acupuncture point locations,one by one.It took three years to achieve a set of internationally unified acupuncture point locations,an effort that has provided a firm and solid basis in the field of acupuncture.fOrEWOrdRecently,modern scientific apparatus,such as functional magnetic resonance imaging(f-MRI)and positron emission tomography(PET)has been utilized for acupuncture research.However,that research has not focused on developing standard acupuncture point locations.Therefore,the experts taking part in the consultations agreed on the development of principles and methods by combining document analysis,experts clinical experiences and factual measurements.their efforts and the resulting outcomes will further enhance scientific research on acupuncture point locations.I would like to highlight that the experts involved in this project will be remembered,not just for standardizing acupuncture point locations,but also for building team spirit among international scholars in the field of traditional medicine.Shigeru Omi,MD,Ph.D.regional directorThe World Health Organization,Regional Office for the Western Pacific expresses its appreciation to all those who contributed to the production of this document.The Regional Office recognizes the experts who supported and attended eleven serial meetings on developing standard of acupuncture point locations such as Professor Wang Xuetai,Professor Huang Longxiang,Professor Shuichi KataI,Professor Shoji SHINOHARA,Professor Kang Sung-keel and Professor Kim Yong-suk.We also wish to extend our gratitude to the Ministry for Health,Welfare and family affairs,Republic of Korea for their financial support,to the State Administration of Traditional Chinese Medicine,China,the Japan Liaison of Oriental Medicine,the World federation of acupuncture and Moxibustion Societies,the Institute of acupuncture and Moxibustion of the China academy of Chinese Medical Sciences,the Korean Society for Meridian and acupoint,and IdO-nO-nIPPOn-SHa with the 2nd Japan acupuncture Point Committee for their technical supports.aCKnOWLEdgEMEntSPREFACEAcupuncture has been practised for more than 2500 years in the Western Pacific Region and has become a global therapeutic method in recent decades.However,it was reported that acupuncturists differed by up to 25%in the acupuncture points they used,raising doubts and uncertainty regarding the efficacy and safety of acupuncture treatment,as well as causing difficulties in the fields of acupuncture research and education.Member States therefore increasely began to demand standardization in acupuncture point locations.Responding to this request,the WHO Western Pacific Regional Office initiated a project to reach consensus on acupuncture point locations and thus convened 11 serial meetings,resulting in these guidelines.The standard for acupuncture point names used in the guidelines is based on WHO 90/8579-atar-8000,A Proposed Standard for International Acupuncture Nomenclature.However,while standardized measurement systems for length and width generally require adoption of an international unit system,it is impossible to use any absolute standard value to determine the location of acupuncture points on the human body due to the vast differences in peoples sizes and heights.Only by using the Equal Proportional Measurement method,also known as the Proportional Bone(Skeletal)Measurement method,can the proper location of acupuncture points be established for all population groups and individuals.this method was adopted by WHO as the standard measuring unit for acupuncture points at an international conference held in Seoul,republic of Korea,in 1987.this measuring unit has therefore been adopted in these guidelines for location of acupuncture points.gEnEraL gUIdELInES fOr aCUPUnCtUrE POInt LOCatIOnSgeneral guidelines for acupuncture Point Locations2I.Scopethis Standard stipulates the methodology for locating acupuncture points on the surface of the human body,as well as the locations of 361 acupuncture points.the Standard is applicable for teaching,research,clinical service,publication and academic exchanges involving acupuncture.II.Terms and definitionsThe following terms and definitions are used in this Standard.1.Standard measuring units:Proportional bone(skeletal)cun(B-cun)This method divides the height of the human body into 75 equal units.Using joints on the surface of the body as the primary landmarks,the length and width of every body part is measured by such proportions.The specific method is:divide the height of the human body into 75 equal units,then estimate the length and width of a certain part of the body according to such units.One unit is equal to one cun.for further information on the commonly used proportional bone(skeletal)cun of a whole body,refer to the related section on page 11.Finger cun(F-cun)This method is based on the finger cun of the person to be measured for acupuncture point locations.for information on the commonly used method of measurement,refer to the section on Locating Method by“finger-cun measurement”on page 13.Fingerbreadth(F-breadth)This method utilizes the width of the distal phalanx of the middle finger.This should be distinguished from the middle finger cun.This method is rarely used e.g.for locating St6 and St40.2.Standard position and terms of direction:the standard position and the terms for the orientation of the human body used in traditional acupuncture point location are not the same as those used in modern anatomy.for example,according to the traditional method,the palmar side of the upper limbs,or the flexional side,is called the medial aspect.This medial aspect is the distribution area of the acupuncture points of the three Yin hand meridians.The dorsal side of the upper limbs,or the extensional side,is called the lateral aspect.This lateral aspect is the distribution area of the acupuncture points of the three Yang hand meridians.the side of the lower limbs closer to the midline is called the medial aspect,which is the distribution area of the acupuncture points of the three Yin foot meridians.the side of the lower limbs away from the midline is called the lateral WHO Standard aCUPUnCtUrE POInt LOCatIOnS3aspect.the posterior portion of the lower limbs is called the posterior aspect,and this apsect,along with the lateral aspect,is the distribution area of the acupuncture points of the three Yang foot meridians.The anterior and posterior median lines of the head,face and trunk are the respective distribution areas of the Conception Vessel and the governor Vessel.these median lines are the baselines for locating acupuncture points on either side of each pair of the two meridians.the modern anatomical position is adopted by this Standard to describe acupuncture point locations:the body stands upright,eyes look forward,feet together with toes pointing forward and upper limbs hanging by the sides with palms facing forward.For the location of certain specific points,other positions are recommended,such as the knee-chest position(BL35),lying on the side with the thigh flexed(GB30),etc.terms of direction(Figures 1 and 2)the terms of direction follow standard anatomical terminology.Medial and lateral:closer to the median sagittal plane is medial;further away from the median sagittal plane is lateral.On the forearm,the same concepts are replaced with ulnar and radial,and on the legs,with tibial and fibular.Superior and inferior:closer to the upper(head)extremity of the body is superior;closer to the lower(feet)extremity of the body is inferior.Superior and inferior may also be used to relate the location of acupuncture points to other points or anatomical landmarks.In this case they refer to directly above or below on a straight line.Anterior and posterior:closer to the ventral surface of the human body is anterior;closer to the dorsal surface is posterior.Proximal and distal:closer to the trunk is proximal;further away from the trunk is distal.3.Landmarks on the body surface for locating acupuncture points:Head Midpoint of the anterior hairline (Fig 3,5)the midpoint of the anterior hairline Midpoint of the posterior hairline (Fig 4,5)the midpoint of the posterior hairline Corner of the forehead(Fig 3,5)the lateral corner of the anterior hairline on the forehead The glabella(Fig 3)the midpoint between the eyebrowsgeneral guidelines for acupuncture Point Locations4 The auricular apex(Fig 3,4,5)the highest point of the auricle when the ear is folded forwards.Upper limbs The centre of the axillary fossa(Fig 6)the centre of the axillary fossa The anterior axillary fold(crease)(Fig 7)the anterior end of the axillary fold The posterior axillary fold(Fig 7)the posterior end of the axillary fold The cubital crease(Fig 7,8)The crease of elbow when it is flexed 90 degrees.The palmar wrist crease(Fig 7,8)the crease on the line connecting the distal ends of the styloid processes of the ulna and radius when the wrist is flexed.When more than one crease is present,the most distal is used.The dorsal wrist crease (Fig 7)the crease on the line connecting the distal ends of the styloid processes of the ulna and radius when the wrist is extended.When more than one crease is present,the most distal is used.the border between the red and white flesh(Fig 9,14)the junction of the palmar and dorsal skin/the junction of the plantar and dorsal skin where there is a change in the texture and colour.the corner at the root of the nail (Fig 10)the angle formed by the medial/lateral border of the nail and the base of the nail bed.Lower limbs The gluteal fold(Fig 11)The fold between the buttock and the thigh on the posterior side of lower limbs The popliteal crease(Fig 11)the crease of the popliteal fossa the prominence of the lateral malleolus(Fig 12,13)the most prominent point of the lateral malleolus the prominence of the medial malleolus(Fig 12,13)the most prominent point of the medial malleolus WHO Standard aCUPUnCtUrE POInt LOCatIOnS54.regions of body the regions of human body used in the description of acupuncture point locations are based mainly on the latest version of International Anatomical Terminology,issued by the Federative Committee on Anatomical Terminology(FCAT)in 1998.Some regions in the International Anatomical Terminology are too difficult a fit for location of acupuncture points.Here regions of the body are divided into the head,neck,back,chest,abdomen,limbs and perineum.the smaller subdivisions of the body are as follows:RegionsBorderlineHeadHeadLine connecting the superior margin of orbit,the upper border of the zygomatic arch,the upper border of the external ear,the tip of the mastoid process,the upper border of the neck,and the external occipital protuberancefaceLine connecting the superior margin of orbit