• Korean Journal of Acupuncture
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• v.40 no.4
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• pp.149-155
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• 2023

Objectives : Hapgok (LI4) is one of the most widely used acupoints in clinical practice. This study aims to investigate the trend of clinical studies including LI4 acupoint stimulation in Korea. Methods : Papers of clinical researches including LI4 acupoint stimulation in Korean journals were searched in Korean databases of Korean Traditional Knowledge Portal, Korean Studies Information Service System, Korea Citation Index, DBpia, Research Information Sharing Service, and ScienceON. The papers were then analyzed focusing on the number of publications by year, the types of the clinical research, interventions, research topics, institutes, and journals. Results : A total of 154 publications were included in this study. The first paper was published in 1981, and the number of papers has gradually increased since the 1990s. Although LI4 acupoint stimulation was included, most of the papers had additional acupoints and interventions. Diseases of the nervous system were the most common, followed by diseases of the digestive system and diseases of the circulatory system. Kyung Hee University is the institution that published the most papers, and the journal that published the most papers is The Journal of Korean Oriental Internal Medicine. Conclusions : Since the 1990s, the number of clinical studies on LI4 acupoint has increased. However, the results of the studies are insufficient to prove the efficacy of LI4 acupoint because most of the studies were case reports using additional acupoints and interventions. Therefore, more rigorous studies are needed to prove the efficacy of LI4 acupoint.

• Journal of Physiology & Pathology in Korean Medicine
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• v.25 no.2
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• pp.217-226
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• 2011

The aim of this study is to identify central neural pathway of neurons following the projection to the large intestine and Hapgok(LI4) which is Won acupoint of the large intestine meridian of hand-yangmyeong. In this experiment, Bartha's strain of pseudorabies virus was used to trace central localization of neurons related with large intestine and acupoint(LI4) which has been known to be able to regulate intestinal function. The animals were divided into 3 groups: group 1, injected into the large intestine; group 2, injected into the acupoint(LI4); group 3, injected into the acupoint(LI4) after severing the radial, ulnar, median nerve. After four days survival of rats, PRV labeled neurons were identified in the spinal cord and brain by immunohistochemical method. First-order PRV labeled neurons following the projection to large intestine, acupoint(LI4) and acupoint(LI4) after cutting nerve were found in the cervical, thoracic, lumbar and sacral spinal cord. Commonly labeled neurons were labeled in the lumbosacral spinal cord and thoracic spinal cord. They were found in lamina V- X, intermediomedial nucleus and dorsal column area. The area of sensory neurons projecting was L5-S2 spinal ganglia and T12-L1 spinal ganglia, respectively. In the brainstem, the neurons were labeled most evidently and consistently in the nucleus tractus solitarius, area postrema, dorsal motor nucleus of vagus nerve, reticular nucleus, raphe nuclei(obscurus, magnus and pallidus), C3 adrenalin cells, parapyramidal area(lateral paragigantocellular nucleus), locus coeruleus, subcoeruleus nucleus, A5 cell group, periaqueductal gray matter. In the diencephalon, PRV labeled neurons were marked mostly in the arcuate nucleus and median eminence. These results suggest that overlapped CNS locations are related with autonomic nuclei which regulate the functions of large intestine-related organs and it was revealed by tracing PRV labeled neurons projecting large intestine and related acupoint(LI4).

• Korean Journal of Acupuncture
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• v.26 no.2
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• pp.61-74
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• 2009

Objectives: The warm needling technique is a method which combines the effects of acupuncture with those of moxibustion. The purpose of this study was to find the stimulus effects of a high frequency warm needling device when stimulating acupoint $LI_4$ on the carrageenan-induced arthritis. Methods: This study was to observe the effects to edema reaction, WBF(weight bearing force), NO concentration, nNOS expression after the electro high frequency stimulus of high frequency warm needling device on LI4 with insulated acupuncture needle. Results: The effect of the high frequency warm needling device is to rise up the temperature in proportion to the current intensity. After stimulating on the acupoint $LI_4$ of the carrageenan-induced arthritis in rats with the high frequency warm needling device, it significantly reduced edema in the rat's foot. In addition, WBF, NO concentration of spinal cord (nmol/mg), and nNOS relative expression were reduced. Conclusions: The above results support the idea that stimulus by the high frequency warm needling device on $LI_4$ produces a potent analgesic effect in the arthritis pain model of the rat. Moreover, stimulus by the high frequency warm needling device modulates endogenous NO through the suppression of nNOS protein expression.

• Korean Journal of Acupuncture
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• v.31 no.4
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• pp.240-246
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• 2014

Objectives : The purpose of this study is to report the clinical effects of Korean medical treatment with Hominis Placenta Pharmacopunture(HPP) on cold hypersensitivity of hands. Methods : A 46-year-old female patient whose chief complaint was cold hypersensitivity of hands was treated with Placenta Pharmacopunture at LI4 and LI10, ten times for a month. Acupuncture and herbal medicine were added depending on the symptoms. Digital Infrared Thermal Imaging(D.I.T.I) was taken and Visual Analog Scale(VAS) was examined before and after each treatment. Results : After the treatments, the symptoms were improved. Conclusions : DITI and VAS showed that the patient's cold hypersensitivity of hands was improved after Korean medical treatment with Hominis Placenta Pharmacopuncture.

• Journal of Magnetics
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• v.19 no.1
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• pp.32-36
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• 2014

The purpose of this study was to investigate the effect of pulsed magnetic field (PMF) and low frequency low level laser (LFLLL) stimuli on acupoint LI4 (Hegu) using photoplethysmography (PPG). Our PMF system was designed to generate maximum intensity of 0.20 T at a transition time of 0.16 ms, with pulse intervals of 1 Hz. The diode laser with wavelength of 650 nm and power of 5 mW was also employed. It was observed the change of the pulsating blood volume through measuring PPG signals from both hands. These results imply that stimulating acupoint LI4 with PMF and LFLLL improves the circulation of peripheral vascular system. In particular, PMF stimulation brings a big improvement of the blood flow even with short term stimulation of 3-4 minutes compared to LFLLL stimulus.

• Journal of Acupuncture Research
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• v.21 no.3
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• pp.169-178
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• 2004

Objective : This study was designed to investigate the effects of acupuncture, moxibustion and electro-acupuncture at LI4 and LR3, BL18 and BL25 on serum gastin level in rats. Methods : LI4 and LR3 which belong to Large Intestine Meridian and liver Meridian are acupuncture points frequently used for healing gastrointestinal disease in oriental medicine. BL18 and BL25 which belong to Bladder Meridian are acupuncture points used for healing hepatic disease and intestinal disease in oriental medicine. Serum gastrin level by radioimmnunoassay was measured at 3 days after acupuncture, moxibustion and electro-acupuncture of those acupoints. Results & Conclusion : Moxibustion applied to the BL18 acupoint, BL25 acupoint decreased gastrin level of serum, but moxibustion applied to the BL18+BL25 acupoints did not produced significant effect. Acupuncture applied to the LI4 acupoint, LR4 acupoint did not produced significant effect, but acupuncture applied to the LI4+LR4 acupoints increased gastrin level of serum, Electro-acupuncture applied to the LI4 acupoint, LR4 acupoint increased gastrin level of serum, and electro-acupuncture applied to the LI4+LR4 acupoints also increased gastrin level of serum.

• Korean Journal of Acupuncture
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• v.26 no.4
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• pp.23-38
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• 2009

Objectives : The purpose of this study was to identify the effect of the tonification & sedation manipulation for LI4 and KI7 on lacking of sweating in cold environment. Methods: The participants were divided into 3 groups as intact group without acupuncture, acupuncture group inserting and twisting with LI4 tonificaton and KI7 sedation method(LI4-tonify KI7-purge) and acupuncture group inserting and twisting with LI4 sedation and KI7 tonificaton method(LI4-purge KI7-tonify). We obtained baseline data at cold condition with the temperature $14{\pm}1^{\circ}C$. After making the participant staying in cold condition for 10 minute, we measured sweating rate in skin surface, body temperature, oxygen saturation, pulse rate, systolic blood pressure, diastolic blood pressure, deoxy-Hb and oxy-Hb in subcutaneous. Results : After acupuncture in cold environment, the sweating rate in skin surface significantly decreased in KI7-purge LI4-tonify group comparing the intact groups. The body temperature significantly increased in LI4-tonify KI7-purge and LI4-purge KI7-tonify groups comparing the intact group. The oxygen saturation significantly increased in LI4-tonify KI7-purge group comparing the intact group. Conclusions : These findings indicated that LI4 tonificaton and KI7 sedation method(LI4-tonify KI7-purge) could be effective for production of sweating in cold condition.

• Korean Journal of Acupuncture
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• v.20 no.1
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• pp.21-30
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• 2003

Objectives : The pain was induced on upper and lower incisor of the rat based on the theory of 'connections of upper incisor pain with stomach meridian and lower incisor pain with large intestine meridian'. Such acupoints as LI4 and ST36 were used for alleviation of upper and lower incisor pain. Methods : The digastric myogram (dEMG) was utilized for the pain measurement. Results : The ST36 acupuncture after induction of upper incisor pain was gradually decreased or increased the dEMG. The LI4 acupuncture after induction of upper incisor pain was gradually decreased the dEMG. The ST36+LI4 acupuncture after induction of upper incisor pain was gradually decreased the dEMG. We knew this thing which the ST36+LI4 acupuncture decreased the dEMG most greatly and kept long compared to ST36 acupuncture, LI4 acupuncture. Conclusions : Acupuncture treatment at the loci of not only ST36 acupuncture but LI4 acupuncture were relieved the upper incisor pain. It was well suitable to the theory 'connections of upper incisor pain with stomach meridian' that ST36 acupuncture decreased the upper incisor pain. But there was not to decrease the dEMG for the ST36 acupuncture. We are considered as tracing study continuously about ST36 acupuncture. It was not suitable to the theory 'connections of upper incisor pain with stomach meridian' that LI4 acupuncture decreased the upper incisor pain. These results was considered as the function by the characteristic of the LI4 acupoint.

• Korean Journal of Acupuncture
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• v.24 no.2
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• pp.217-230
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• 2007

Objectives : Ulcerative colitis or Crohn's disease has been recognized as Ha-ri (下痢) or Jang-Byok in Korean oriental medicine. A purpose of the present study is to investigate the anti-inflammatory effect of moxi-tar herbal acupuncture at LI4 (HapGok) on 2,4,6-trinitrobenzene sulphonic acid (TNBS) induced colitis in rats and further elucidate the possibility of herbal acupuncture on ulcerative colitis which is chronic inflammatory disease of the gastrointestinal tract. Methods : Sprague-Dawley rats, weighing $170{\sim}190$ g, were subjected to intrarectal injection of either saline (300 ${\mu}l$, 500 ${\mu}l$) for a control or 2,4,6-trinitrobenzene sulphonic acid (TNBS) (300 ${\mu}l$, 500 ${\mu}l$) for a colitis, Moxi-tar (20 mg/ml) were subcutaneously injected to the LI4 just after the secondary injection time of TNBS in rats. To study the effects of Moxi-tar acupuncture in LI4, body weight, RBC count, WBC count, total protein, Paw edema rate, rate of protein leakage into CMC-pouch fluid, IgG levels and IgM levels were observed. Results: Moxi-tar acupuncture in LI4 on TNBS-induced colitis inhibited the body weight lose rate but not effect RBC, WBC count. In addition, it inhibited the reduction of total protein concentration, paw edema, rate of protein leakage into CMC-pouch fluid, IgG levels and IgM levels. Conclusions : It is suggested that moxi-tar herbal acupuncture at LI4 helps to recover TNBS-induced colitis and plays an important role for an treatment of the irritable bowel syndrome (IBS).

• Korean Journal of Acupuncture
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• v.27 no.2
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• pp.203-216
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• 2010

Objectives : The purpose of this study is to identify the effect of tonifying or sedative manipulation on LI4 and KI7 for sweet deficiency under cold environment. Methods : The participants were divided into 4 groups; intact group without acupuncture(Intact), acupuncture group inserting straightly with LI4 & KI7 method((LI4-straight KI7-straight), acupuncture group inserting twisting with LI4 tonificaton & KI7 tonificaton method(LI4-tonify KI7-tonify) and acupuncture group inserting twisting with LI4 sedation & KI7 sedation method(LI4-purge KI7-purge). We obtained the baseline data under cold condition with the temperature $14{\pm}1^{\circ}C$. After making the participant staying under cold condition for 10 minute, we measured sweating rate on skin surface and biological responses such as body temperature, oxygen saturation, pulse rate, systolic blood pressure, diastolic blood pressure, deoxy-Hb and oxy-Hb in subcutaneous. Results : The sweating rate on skin surface was not different in all treatment groups compared to the intact group. The body temperature was significantly increased in LI4-straight KI7-straight group compared to the intact group. The oxygen saturation significantly increased in LI4-purge KI7-purge group compared to the intact group. The systolic blood pressure was significantly increased in LI4-purge KI7-purge group compared to the intact group. The deoxy-Hb was significantly decreased in LI4-purge KI7-purge group compared to the intact group. Conclusions : The above results, the effect of LI4, KI7 acupuncture due to the tonifying or sedative manipulation on sweating control could be observed. However, other biological responses with the acupuncture of tonifying or sedative manipulation were giving different expressions. We suggest that continued research of tonifying or sedative manipulation is of importance order to find these expressions.