Available online 15 May 2023

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By reviewing the historical background and the current state of dry needling (DN), including the "Anti-DN Independence" movement by the acupuncture profession in the west, this paper emphasizes that DN is acupuncture, or more precisely, a "de-meridian" style of acupuncture. Clinical applications of DN and its modern studies have seen a tremendous growth spurt during the past two decades, which suggests that the meridian theory of traditional Chinese medicine (TCM) may not be the exclusive theory to guide acupuncture. Even certain high-quality DN trials may serve as good examples for acupuncture research, such as refining the stimulation targets in acupoints, recognizing the reflex properties of acupoints known as acu-reflex points (ARPs), or establishing standardized indicators of stimulus amount while objectively assessing the needling efficacy. Like any other therapies, DN has its shares of drawbacks or limitations, which reminds that while innovating classical acupuncture, it is still necessary to inherit the valuable experience of classic acupuncture and the rational core of meridian theory. This is crucial for enhancing the efficacy of clinical acupuncture intervention including DN to broaden the treatment scope and indications of acupuncture.

摘要

通过回顾干针的发展和现状, 包括西方针灸界的“反干针独立”运动, 本文强调干针就是针灸, 是一种“去经络化”的针灸.关于干针的临床实践和现代研究在过去二十年中出现了前所未有的增长, 提示中医经络理论不是指导针灸的唯一理论.某些高质量的干针试验甚至可以成为针灸研究的范例, 例如细化穴位内的刺激靶点, 认识穴位 (反映点) 的反射特性, 或建立标准化的刺激量指标, 同时客观评估针刺疗效.与任何其他疗法一样, 干针也有其缺点或局限性.在对经典针灸实施创新之际, 也须继承经典针灸的宝贵经验与经络理论的合理内核.这对提高包括干针在内的针灸干预措施的疗效及拓宽针灸治疗范围和适应证至关重要.

Section snippetsA historical background and current state of DN in the west

Whenever revisiting the history of DN, it is obvious that one first need to go way back in time to the discovery of ‘trigger point’ in the early 19th century, then the recognition of myofascial pain [9], [10], [11] a bit later. The term myofascial trigger point (MTrP) was coined by Dr. Janet Travell (1901–1997) and Seymour Rinzler in the 1950s [11], reflecting their finding that hardened knots do exist and often refer pain to both muscles and overlying fascia [12]. The two-volume book

DN: A "de-meridian" style of modern acupuncture

As the above mentioned, DN proponents in the west, nowadays frequently claim that DN is not acupuncture (de-acupuncture) as it does not use the meridian theory as a guide principle (de-meridian), and its non-acupuncturist practitioners do not need to receive the necessary training required by acupuncturists. In 2016, the authors published a pioneer paper [5] to refute this misconception, and clarified that "De-Meridian" is not "De-Acupuncture". DN is acupuncture, and at best, a form of modern

Drawbacks or limitations of DN by using only MTrPs as stimulating targets

To gain insight into the necessity of inheritance and innovation of classical acupuncture from the rise of DN, we can first analyze the drawbacks or limitations of DN. Because DN refuses to inherit the meridian theory, it will miss the experience of thousands of years of classical acupuncture, limit its indications, and neglect a holistic notion in the clinic. The following are five drawbacks or limitations in its clinical application.

(1) The stimulation of DN only targets at the muscle level

Inspirations from DN on the inheritance and innovation of classical acupuncture

The rapid rise and popularity of DN in the west has provided two important inspirations for the development of acupuncture today. First, for the rapid integration of acupuncture into mainstream medicine, the principles of acupuncture therapy must be able to be comprehended in a modern context, and the whole process of acupuncture therapy, including the selection of the stimulation target, the control of the stimulation amount, and the correct assessment of the efficacy, must be able to

Ethical statement

Not applicable.

Data availability

Not applicable.

CRediT authorship contribution statement

Guan-Yuan JIN: Conceptualization, Writing – original draft. Louis Lei JIN: Writing – review & editing. Belinda Jie HE: Writing – review & editing. Bonnie Xia JIN: Writing – review & editing.

Declaration of Competing Interest

The author has no competing interests to declare.

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© 2023 Published by Elsevier B.V. on behalf of World Journal of Acupuncture Moxibustion House.