Deviation of Needling Depth of Heart Meridian Acupuncture Points in Underweight and Overweight People
https://doi.org/10.52667/2712-9179-2025-5-2-2-18
Abstract
The depth of needle insertion is determined by the acupuncturist during the procedure based on the patient's sensory responses and motor responses that may occur at the tip of the inserted needle (De-qi reaction). Despite the existing specific recommendations and standards for the selection of acupuncture depth for almost all acupuncture points, the difficulty of performing acupuncture in patients with significant deviations in body weight from the norm remains. In this regard, we decided to determine the De-qi needling depth (DND) by the needling method and the safe needling depth (SND) by the ultrasound method of acupuncture points: HT1, HT2, HT3, HT4, HT5, HT6, HT7 in healthy people taking into account the body mass index (BMI). Materials and methods: 90 volunteers were examined by needling method to determine DND and by ultrasound to determinate the depth of underlying neurovascular structures and SND after converting individual Сun to millimeters. Results: DND of HT1, HT2, and HT3 were more superficial in UWG compared to HWG at 1.83 mm and deeper in OWG compared to HWG at 4.9 mm. In contrast, the DND deviation of HT4, HT5, HT6, HT7 was significant but mild in both groups, with a slight decrease in UWG compared to HWG of only 0.54 mm and a slight increase in OWG compared to HWG not exceeding 1.5 mm. Conclusion: The depth of the acupuncture points of the heart meridian HT1, HT, HT3 strongly depends on the degree of obesity in overweight people and is less responsive to body weight in underweight people. At the same time, changes in the points HT4, HT5, HT6 and HT7 have slight deviations in underweight and overweight people compared to people with healthy weight. Moreover, the depth of the heart meridian points is directly related to the depth of the underlying neuroarterial structures and weakly correlates with the Cun value in millimeters.
About the Author
Mustafa Al-Zamil
Peoples’ Friendship University of Russia; Medical Dental Institute
Russian Federation
Russian Federation
117198 Moscow;
127253 Moscow.
References
1. Lee, I.S.; Ryu, Y.; Chae, Y. Oversimplifying the name of the 12 meridian channels. Integr Med Res. 2023, 12:101002. doi: 10.1016/j.imr.2023.101002. 2
2. Focks, C. Atlas of Acupuncture. Chapter 7 - Important Points According to Region. Churchill Livingstone. 2008, 619-663. ISBN 9780443100284. doi:10.1016/B978-044310028-4.50010-2.
3. Beach, P. 12 - Decoding the Chinese meridial map, Muscles and Meridians, Churchill Livingstone. 2010, 153-185. ISBN 9780702031090, doi:10.1016/B978-0-7020-3109-0.00017-1.
4. Al-Zamil, M.Kh. Efficacy of Heart Meridian Acupuncture in Treating Brachial Plexitis Patients with Weak or Absent Qi Sensorimotor Response. Vestnik. 2025, 1:44–47.
5. Seo, S.Y.; Bang, S.K.; Kang, S.Y.; Cho, S.J.; Choi, K.H.; Ryu, Y.H. Acupuncture Alleviates Anxiety and 22-kHz Ultrasonic Vocalizations in Rats Subjected to Repeated Alcohol Administration by Modulating the Brain-Derived Neurotrophic Fac-tor/Corticotropin-Releasing Hormone Signaling Pathway. Int J Mol Sci. 2021, 22(8):4037. doi: 10.3390/ijms22084037.
6. Cai, R.L.; Cui, S.; Wu, Z.J.; He, L.; Yu, Q.; Wang, J.; Peng, C.Y.; Hu, L.; Zhou, Y.P. Effect of Electroacupuncture at "Shenmen" (HT 7)- "Tongli" (HT 5) of Heart Meridian on Neuronal Activities in Paraventricular Nucleus of Hypothalamus in Myocar-dial Ischemia Rats]. Zhen Ci Yan Jiu. 2018, 43(7):406-413. doi: 10.13702/j.1000-0607.180144.
7. Zhou, M.Q.; Zhou, Y.P.; Wang, K.M.; Hu, L.; Wang, Y.L.; Chen, Y.N. Study on effects of acupuncture at the heart meridian on gene expression pattern of heart in rats with acute myocardial ischemia. Zhongguo Zhen Jiu. 2006, 26(8):587-594. doi: 10.1007/s11726-008-0292-9.
8. He, Z.; Yang, Y.; Wen, Q.; Yin, T.; Li, Z.; Ma, P.; Zheng,, H.; Yang, Y.; Jiang, Y.; Fang, J.; Lan, L.; Zeng F. Acupuncture for chronic stable angina pectoris based on the theory of Meridian-Viscera Association: study protocol for a multicenter ran-domized controlled trial. Trials. 2020, 21 (1):915. doi: 10.1186/s13063-020-04836-8.
9. Yang, X.Y.; Yang, N.B.; Huang, F.F.; Ren, S.; Li, Z.J. Effectiveness of acupuncture on anxiety disorder: a systematic review and meta-analysis of randomised controlled trials. Ann Gen Psychiatry. 2021, 20:1-9. doi: 10.1186/s12991-021-00327-5.
10. Fleckenstein, J.; Krüger, P.; Ittner, K.P. Effects of single-point acupuncture (HT7) in the prevention of test anxiety: Results of a RCT. PLoS One. 2018, 3(8):e0202659. doi: 10.1371/journal.pone.0202659.
11. Wu, P.; Cheng, C.; Song, X.; Yang, L.; Deng, D.; Du, Z.; Chen, X.; Zou, T.; Qiao, L.; Li, N.; Zhou, P.; Du, L.; Zhu, Y. Acupoint combination effect of Shenmen (HT 7) and Sanyinjiao (SP 6) in treating insomnia: study protocol for a randomized con-trolled trial. Trials. 2020, 21(1):261. doi: 10.1186/s13063-020-4170-1.
12. Li, B.; Deng, S.; Zhuo, B.; Sang, B.; Chen, J.; Zhang, M.; Tian, G.; Zhang, L.; Du, Y.; Zheng, P.; Yue, G.; Meng, Z. Effect of Acupuncture vs Sham Acupuncture on Patients With Poststroke Motor Aphasia: A Randomized Clinical Trial. JAMA Netw Open. 2024, 7(1):e2352580. doi: 10.1001/jamanetworkopen.2023.52580.
13. Yang, X.; Shi, L.; Ran, D.; Li, M.; Qin, C.; An, Z. The treatment of post-stroke dysarthria with a combination of different ac-upuncture types and language rehabilitation training: a systematic review and network meta-analysis. Ann Transl Med. 2022, 10(23): 1281. doi: 10.21037/atm-22-5583.
14. Ning, Y.; Zheng, S.; Feng, S.; Yao, H.; Feng, Z.; Liu, X.; Dong, L.; Jia, H. The altered intrinsic functional connectivity after acupuncture at shenmen (HT7) in acute sleep deprivation. Front Neurol. 2022, 26(13):947379. doi: 10.3389/fneur.2022.947379.
15. Yang, K.; Zhang, L.; Li, B.; Liu, T.; Chao, Y.; Li, W.; Cao, R.; Chen, S. Analysis of acupoint selection and prescription rules of acupuncture for treatment of stable angina pectoris based on a Traditional Chinese Medicine inheritance calculation plat-form: A systematic review. Medicine (Baltimore). 2022, 101(49):e31466. doi: 10.1097/MD.0000000000031466.
16. Fu, X.; Li, H.; Yang, W.; Li, X.; Lu, L.; Guo, H.; Wu, Z.; Guo, K.; Xu, H.; Huang, Z. Electroacupuncture at HT5 + GB20 pro-duces stronger activation effect on swallowing cortex and muscle than single points. Heliyon. 2023, 9(11):e21922. doi: 10.1016/j.heliyon.2023.e21922.
17. Yang, N.; Ge, X.; Ye, J.; Liu, Q.; Wu, Y.; Yan, H.; Han, X. Efficacy of acupuncture for urinary incontinence in middle-aged and elderly women: A systematic review and meta-analysis of randomized controlled trials. Eur J Obstet Gynecol Reprod Biol. 2021, 257:138-143. doi: 10.1016/j.ejogrb.2020.11.001.
18. Bai, Q. Clinical observation on post-stroke shoulder pain treated with balance acupuncture. Zhongguo Zhen Jiu. 2010, 30(11):921-923.
19. Liu, L.; Xu ,X.B.; Qu, Z.Y.; Zhao, L.P.; Zhang, C.S.; Li, Z.J.; Lyu, T.L.; Wang, X.F.; Jing, X.H.; Li, B. Determining 5HT7R's Involvement in Modifying the Antihyperalgesic Effects of Electroacupuncture on Rats With Recurrent Migraine. Front Neu-rosci. 2021, 15:668616. doi: 10.3389/fnins.2021.668616.
20. Pei, P.; Liu, L.; Zhao, L.P.; Qu, Z.Y.; Tang, C.Y.; Wang, L.P.; Yang, W. Electroacupuncture exerts an anti-migraine effect via modulation of the 5-HT7 receptor in the conscious rat. Acupunct Med. 2019, 37(1):47-54. doi: 10.1136/acupmed-2017-011410.
21. Li, X.; Li, J.C.; Lu, Q.Q.; Zhan,g F.; Zhang, S.Q. Research status and prospects of acupuncture for autism spectrum disor-ders. Front Psychiatry. 2023, 14:942069. doi: 10.3389/fpsyt.2023.942069.
22. Yang, C.H.; Choi, S.H.; Kim, J.S.; Ryu, Y.H., Lim, Y.J.; Kim, M.S. The Effects of Acupuncture Stimulation for Brain Activation and Alcohol Abstinence Self-Efficacy: Functional MRI Study. Evid Based Complement Alternat Med. 2017, doi: 10.1155/2017/2850124.2017:2850124.
23. Goh, Y.L.; Ho, C.E.; Zhao, B. Acupuncture and depth: future direction for acupuncture research. Evid Based Complement Al-ternat Med. 2014, 871217. doi: 10.1155/2014/871217.
24. Lin, J,G,; Chou, P.C.; Chu, H.Y. An exploration of the needling depth in acupuncture: the safe needling depth and the nee-dling depth of clinical efficacy. Evid Based Complement Alternat Med. 2013, 740508. doi: 10.1155/2013/740508.
25. Godson, D.R.; Wardle, J.L. Accuracy and Precision in Acupuncture Point Location: A Critical Systematic Review. J Acu-punct Meridian Stud. 2019, 12(2):52-66. doi: 10.1016/j.jams.2018.10.009.
26. Molsberger, A.F.; Manickavasagan, J.; Abholz, H.H.; Maixner, W.B.; Endres, H.G. Acupuncture points are large fields: the fuzziness of acupuncture point localization by doctors in practice. Eur J Pain. 2012, 16(9):1264-1270. doi: 10.1002/j.1532-2149.2012.00145.x.
27. Yang, X.Y.; Shi, G.X.; Li, Q.Q.; Zhang, Z.H.; Xu, Q.; Liu, C.Z. Characterization of deqi sensation and acupuncture effect. Evid Based Complement Alternat Med. 2013, 319734. doi: 10.1155/2013/319734.
28. Andersson, S,; Lundebergm, T. Acupuncture--from empiricism to science: functional background to acupuncture effects in pain and disease. Med Hypotheses. 1995, 45(3):271-281. doi: 10.1016/0306-9877(95)90117-5.
29. Kwon, O.S.; Kim, J.; Choi, K.H.; Ryu. Y.; Park; J. Trends in deqi research: a text mining and network analysis. Integr Med Res. 2018, 7(3):231-237. doi: 10.1016/j.imr.2018.02.007.
30. Streitberger, K.; Eichenberger, U.; Schneider, A.; Witte, S.; Greher, M. Ultrasound measurements of the distance between acupuncture needle tip at P6 and the median nerve. J Altern Complement Med. 2007, 13(5):585-591. doi: 10.1089/acm.2007.6247.
31. Al-Zamil, M. Kh. Decreased sensorimotor reaction of De-qi to needle insertion during acupuncture of the Zusanli point (ST 36) on the side of the affected peroneal nerve. Vestnik. 2025, 1:20–25.
32. Al-Zamil, M.Kh. Possible complications after acupuncture and how to eliminate them. Journal of clinical neurology. 2020, 4:3-10.
33. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
34. https://www.who.int/data/gho/data/indicators/indicator-details/GHO/prevalence-of-underweight-among-adults-bmi-18-(age-standardized-estimate)-(-)
35. Yang, Z.; Zhang, L.; Tang, L.; Tu, W.; Qu, S.; Huang, Y. Basic Knowledge of Acupuncture and Moxibustion. In: Huang, Y., Zhu, L. (eds) Textbook of Traditional Chinese Medicine. Springer, Singapore. 2024, doi:10.1007/978-981-99-5299-1_3
36. Xu, M.; Yang, C.; Nian, T.; Tian, C.; Zhou, L., Wu, Y.; Li, Y.; Deng, X.; Li, X.; Yang, K. Adverse effects associated with acu-puncture therapies: An evidence mapping from 535 systematic reviews. Chin Med. 2023, 18(1):38. doi: 10.1186/s13020-023-00743-7.
37. Van Ha, l .M.; Dydyk, A.M.; Green. M.S. Acupuncture. StatPearls [Internet]. Treasure Island (FL). 2023, StatPearls Publishing.
38. Huang, C.C.; Kotha, P.; Tu, C.H.; Huang, M.C.; Chen, Y.H.; Lin, J.G. Acupuncture: A Review of the Safety and Adverse Events and the Strategy of Potential Risk Prevention. Am J Chin Med. 2024, 52(6):1555-1587. doi: 10.1142/S0192415X24500617.
39. Lin, C.L.; Chern, A.; Wang, M.J.; Lin, S.K. Incidence of nerve injury following acupuncture treatments in Taiwan. Comple-ment Ther Med. 2024, 80:103007. doi: 10.1016/j.ctim.2023.103007.
40. Yang, S.D.; Li, Y.D.; Jiang, G.H.; Hu, N.N.; Cong, S.Y. [Study on needling depth of Fengfu (GV 16) with CT]. Zhongguo Zhen Jiu. 2008, 28(1):47-48. Chinese.
41. https://clincalc.com/stats/samplesize.aspx
42. Belousov, O.V. Acupuncture points of Chinese Zhenjiu therapy. Almaty, 2004, 148-157.
43. Chou, P.C.; Chu, H.Y.; Lin, J.G. Safe needling depth of acupuncture points. J Altern Complement Med. 2011, 17(3):199-206. doi: 10.1089/acm.2010.0192.
44. Wei, Z.W.; Tang, Y.; Li, S.N. Anatomic study on safe insertion of acupuncture needle in Qiuhou (EX-HN7) acupoint. Zhen Ci Yan Jiu. 2020, 45(5):416-418. doi: 10.13702/j.1000-0607.190431.
45. Chou, P.C.; Huang, Y.C.; Hsueh, C.J.; Lin, J.G.; Chu, H.Y. Retrospective study using MRI to measure depths of acupuncture points in neck and shoulder region. BMJ Open. 2015, 7:e007819. doi: 10.1136/bmjopen-2015-007819
46. Hou, H.K.; Liu, C.Z.; Lin, L.L. Magnetic resonance imaging study of safe needling depth and angulation for acupuncture at BL40. Acupunct Med. 2021, 39(4):343-350. doi: 10.1177/0964528420958714.
47. Lin, J,G.; Chou, P.C.; Chu, H.Y. An exploration of the needling depth in acupuncture: the safe needling depth and the nee-dling depth of clinical efficacy. Evid Based Complement Alternat Med. 2013, 740508. doi: 10.1155/2013/740508.
48. Huang, C.C.; Kotha, P.; Tu, C.H.; Huang, M.C.; Chen, Y.H.; Lin, J.G. Acupuncture: A Review of the Safety and Adverse Events and the Strategy of Potential Risk Prevention. Am J Chin Med. 2024, 52(6):1555-1587. doi: 10.1142/S0192415X24500617.
49. Xu, S.; Wang, L.; Cooper, E.; Zhang, M.; Manheimer, E.; Berman, B.; Shen, X.; Lao, L. Adverse events of acupuncture: a systematic review of case reports. Evid Based Complement Alternat Med. 2013, 581203. doi: 10.1155/2013/581203.
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For citations:
Al-Zamil M. Deviation of Needling Depth of Heart Meridian Acupuncture Points in Underweight and Overweight People. Personalized Psychiatry and Neurology. 2025;5(2):2-18. https://doi.org/10.52667/2712-9179-2025-5-2-2-18
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