INTRODUCTION TO KOREAN HAND ACUPUNCTURE AND MOXIBUSTION

Jong Baik

What is Korean Hand Acupuncture and Moxibustion?

Korean Hand Acupuncture and Moxibustion, also known as Korean Hand Therapy or KHT, is a versatile and potent acupuncture microsystem that was discovered by the Korean acupuncturist Dr Tae Woo Yoo. Its well-defined theories and principles in diagnosis and various holistic tailored treatments enable KHT to perform the same potential functions as whole-body acupuncture (Park et al., 2012: 27-37). This modern acupuncture microsystem is simple to learn and safe to perform as it has minimal side effects. It offers both invasive and non-invasive treatment options with minimum pain or discomfort (pressure with a probe or use of acupressure discs) for maximum treatment effect.

KHT theorises that the hands reflect the anatomy and physiology of the whole body, furthermore all the functions of the internal organs and tissues can be controlled by gentle stimulation of their corresponding points and areas on the hands for prevention, management, and treatment of various diseases. KHT is theoretically unique and philosophically more profound than other micro systems; the precise mapping of corresponding body and organ parts, 404 reflex points and 14 micro-meridians on the hands allows the application of almost all aspects of body acupuncture theories (Jodorkovsky, 1999:25).

Possible mechanisms underlying KHT

The close link between the hands and the brain through the large territories associated with the hand in the motor cortex and sensory cortex of the brain suggest the important role of the hands in controlling all functions of the body. The stimulation of the hand points and areas, according to KHT theories, can modulate the autonomic nervous system by reducing or suppressing over-exited sympathetic nerves, thus restoring a balance between the sympathetic and parasympathetic nervous systems. This is due to the presence of a large number of sympathetic nerve fibres condensely distributed on the hands with around the same amount as is found on whole of the human body (Yoo, 2009:58)

The advantages of KHT over other micro-systems

Micro acupuncture systems1 are special systems of acupuncture that are based on stimulating specific points on specific areas of the human body to treat prevent, manage and treat diseases. Each of the points and areas reflects information of the body as a whole. There are other hand micro systems originating from different times, countries and areas. Although they share some concepts, different hand micro systems show the reflected organs in remarkably different places (Dale, 1990:141-162; Wang, 2009:1).

In a clinical setting, KHT may combine with other treatment or therapies in four ways: effectively, simultaneously, alternatively and alternately (Dale, 1990:141-162; Jung, H J and Park, S Y, 2013:215-24). It is also useful for people to learn simple treatment appropriate to them and use this to assist themselves between treatments at the clinic.

KHT treatments are very safe procedures and the most of them are non-invasive. Thus the discomfort of treatment is minimised. It is an ideal treatment option for children, elderly, disabled and people who are nervous about the needles (Kobrin, 2000:29-30).

Diagnosis and treatment

The focus of diagnosis in KHT is to find the fundamental root organ which is most out-of-balance and is at the root of the presenting symptoms. It could be one of 12 internal organs. It is essential to diagnose the fundamental root of the problem in addition to the branches (Eckman, 1990:1-6).

KHT pulse diagnosis (Yin Yang pulse diagnosis) and the classification of postnatal constitutions are used as the foundation of all diagnosis to find the fundamental root or organ.

Firstly, by identifying which postnatal constitution the patient has, through a special examination which primarily focuses on abdominal palpation, once constitutions are determined, then by identifying which organ within that constitution is the ‘root organ’ and whether the organ is in a state of excess, deficiency, hot and cold through KHT pulse diagnosis. KHT treatment corrects imbalances in the functioning of the internal organs where the organs are impacting on one another after an imbalance has occurred in the root organ (Kobrin, 1990:5-16).

KHT pulse diagnosis

KHT pulse diagnosis was mentioned in the Huangdi Neijing2 repeatedly in various ways over many chapters. It has not been utilised in clinical settings for a long time because of its vague and poor explanation. Dr Yoo recognised the usefulness of the KHT pulse diagnosis to discern abnormalities of the internal organs by comparing the ratio of the widths and sizes of the radial and carotid pulses (Yoo, 1993:255-322). KHT pulse diagnosis is also utilised to discover how severe the symptoms or diseases are, to measure changes indicating improvement after treatment and to evaluate how the patient’s symptoms or diseases have changed or evolved.

The pulses of the common carotid arteries are palpated at St9. The pulses of the vertebral arteries cannot be easily palpated directly from the arteries because they are circulating deeper inside the body. Therefore, the condition of the radial pulse at Lu9 is used as a proxy for the vertebral artery since both the vertebral and radial arteries have the same origin at the subclavian artery.

According to KHT theory, the left and right-sided carotid and radial pulses should have a regular and equal blood flow, indicating a balanced flow to the brain and good circulation of blood and normal function of the internal organs. Therefore the purpose of treatment when the pulses are unbalanced is to regain normal balance throughout the body. This is similar to traditional acupuncture, which attempts to achieve this balance and improve health by promoting harmonious flow of Qi in the acupuncture meridians.

Park and Yoo have demonstrated that an imbalance in the cerebral blood flow in the carotid arteries and vertebral arteries can be altered in a controlled manner with KHT. A 56 year old male patient with Parkinson’s disease had a silver acupressure disc applied on KHT point E8 (the corresponding point of the common carotid artery) to decrease the velocity of the carotid artery and a gold acupressure disc applied on KHT point I2 (the corresponding point of the vertebral artery) to increase the velocity of the vertebral artery. The blood flow velocity was measured at the radial artery (Lu9), on the distal part of common carotid artery (St9) and the vertebral artery (acupuncture point Bladder 10) using 2, 8MHz probes of EME Pioneer

Transcranial Doppler before and after applying the acupressure discs. The velocity of the carotid artery decreased from 20/sec to 18/sec and the velocity of the vertebral artery and radial artery respectively increased from 36/sec to 48/sec and from 10/sec to 23/sec (Park and Yoo, 2001)

KHT Research

Research published in English supporting the effectiveness of KHT is limited. The majority of these evaluate the antiemetic efficacy of the non-invasive stimulation on KHT points. There have also been some review articles about KHT published in peer reviewed journals.

Four studies have shown that the application of a capsicum plaster or capsaicin ointment on KHT point D2 (analogous to Li2) reduced the incidence of postoperative nausea and vomiting (PONV). Kim K S et al. (2002:1103-7) investigated the antiemetic effect of the KHT point D2 in the prevention of PONV after abdominal hysterectomy. A capsicum plaster at either the KHT point D2 or the acupoint P6 reduced PONV in patients undergoing abdominal hysterectomy with significantly less need for rescue antiemetics. Koo M S et al. (2013:539-43) showed that a capsicum plaster at either the KHT point D2 or the acupoint Pericardium 6 reduced the incidence and severity of PONV and the need for rescue antiemetics compared to the patients in the control and sham groups, with improved satisfaction during the 24hr period after thyroid surgery. Agarwal A et al. (2005:1185-8) also reported the incidence of PONV and rescue antiemetic need following laparoscopic cholecystectomy were reduced in patients who had capsaicin ointment applied on the KHT point D2. An interesting study conducted by Jung H J and Park S Y (2013:215-24) concluded that a pharmacologic and nonpharmacologic combination prevents PONV more effectively than pharmacologic antiemetic therapy alone. The combination of a capsicum plaster on the KHT point D2 with intravenous prophylactic ramosetron 0.3mg more effectively reduced the PONV compared with ramosetron alone in patients with PONV undergoing gynaecologic laparoscopic surgery with significantly less rescue anti-emetic need.

Three studies have shown that the application of acupressure on KHT point K9 (analogous to P6) reduced the incidence of PONV and motion sickness. Schlager A et al. (2000:267–270) showed an advantage of an acupressure disc on KHT point K9, versus no-treatment control in preventing postoperative vomiting in children scheduled for strabismus surgery. Boehler M et al. (2002: 872-5) reported that a group with the application of an acupressure disc on KHT point K9 experienced a significantly lower incidence of nausea and vomiting (40% and 22.5%) than the placebo group (70% and 50%). Bertalanffy P et al. (2004:220-3) reported acupressure on KHT point K9 was effective in lowering subjective motion sickness and nausea during emergency trauma transport of geriatric patients with a high risk of motion sickness.

KHT case studies and written reports are vast in Korea and are regularly presented and discussed at the bi-annual Korea-Japan KHT Symposiums since 1978. These studies are commonly seen as a vehicle that attempts to bridge the practicalities between theory and clinical practice in KHT. Unfortunately, however, many of these articles are written in Korean and Japanese, and not easily accessible to Western practitioners.

Several KHT studies published in Korean focus on for paediatric (Jodorkovsky, 1999:25-28), gynaecological and geriatric disorders. Results from a number of these studies suggest that KHT may be beneficial for relieving premenstrual syndromes (Shin K R, 2009: 171-186), menstrual symptoms (Shin K R et al., 2004:256-263; Kim H K et al. 2004:233-243; Chang Y S and Kim J N, 2003:432-444; Hong Y R, 2005:109-116; Lee I S and Choi H S, 2005:77-82) and menopausal symptoms (Shin H S et al. 2006:291-300; Shin H S and Song Y A, 2006:25-32; Shin H S and Song Y A, 2006:291–300). KHT may also help reduce headaches (Hong Y R, 2005:427-435) and ease intermittent or recurrent abdominal pain in children (Hong Y R, 2005:487-493; Hong Y R, 2001:519-529). It also may help reduce knee pain (Koh H J et al., 2011:4022-4029; Park J S et al., 2003:244-253), shoulder pain (Lee Y O and Kim C N, 2010:229-241) and post stroke pain (Choi Y A and Jung K O, 2005:49-59) and relieve constipation in elderly patients (Kim N J, 2007:37–49; An Y H and Kim Y K, 2012:109-118). An interesting study by Choi Y A et al. (2004:281-291) showed a rehabilitation programme including KHT may be an effective programme option to improve physical function, self-esteem and quality of life for post-stroke elderly patients.

Most of studies were conducted using non-invasive treatment techniques such as moxibustion, acupressure discs and electrical stimulation. Therefore, KHT appears to be a reasonable option to consider for the elderly, children, females and people who are anxious about invasive treatment. There is some evidence that KHT works for a small number of specific conditions, including migraine (Park and Yoo, 2001) and PONV. However, the evidence that KHT works for numerous conditions is still limited and more scientific research is needed to establish the wider scope of health conditions for which KHT can be effective.

Conclusion

KHT is a theoretically unique and philosophically profound micro acupuncture system. Its well-defined theories and principles in diagnosis and treatments make it possible to perform the same potential functions as whole-body acupuncture. It is useful not only to practitioners but also to the general public because it is easy to learn, safe to use, cost effective and practical to manage health and prevent diseases (Baik et al, 2014:164-189).

There have been some studies of its potential usefulness for certain illnesses; however more extensive research into the use of KHT in the treatment of various health conditions is needed.

The introduction of KHT as a choice of treatment modality readily available to the public in the Europe is in its early stage. It is hoped that this article introduces the possibilities and advantages of KHT to a wider audience and raises the profile of KHT as a possible treatment option for various health conditions amongst both patients and practitioners.

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