Traditional East Asian medical pulse diagnosis: a preliminary physiologic investigation.

BACKGROUND: Toyohari Meridian Therapy (TMT) is a Japanese system of acupuncture that utilizes radial pulse diagnosis to diagnose and guide acupuncture treatment, including ascertaining when the treatment has concluded. The "root" treatment involves manipulation of the body's Qi without penetration of the needle. There has been little research into the physiologic correlates of the changes detected through pulse diagnosis by Traditional East Asian Medicine practitioners practicing TMT. OBJECTIVES: The study objective was to investigate whether there were any concurrent changes in physiologic cardiovascular variables, specifically the Central (Buckberg) Sub Endocardial Viability Ratio (SEVR) or Heart Rate (HR) adjusted Augmentation Index (AI), with changes in the radial pulses produced by a TMT "root treatment." MATERIALS AND METHODS: A parallel, single-blind, randomized controlled design was utilized. Sixty-two (62) healthy volunteers were randomized to receive either a TMT root treatment or a sham-treatment. Two (2) TMT practitioners participated, with the same practitioner conducting the needling in each case. The SEVR and HR-adjusted AI were measured by a third researcher. STATISTICAL ANALYSIS: Within-groups analysis (paired Student t-test) and between-groups analysis (analysis of covariance) were used; a p-value of 0.05 was designated as statistically significant. RESULTS: SEVR improved significantly within the treatment group but not in the control group. CONCLUSIONS: Results indicate that changes detected in the pulse by the TMT practitioners were associated with a measurable improvement in the SEVR. The findings of this study offer the possibility for further investigation into radial pulse diagnosis practices in an effort to find a physiologic understanding or basis of TMT practice and the system of pulse diagnosis it uses.

Investigating the reliability of Japanese toyohari meridian therapy diagnosis.

BACKGROUND: Toyohari meridian therapy (TMT) is a Japanese system of acupuncture. Acupoint selection follows diagnosis of the primary and secondary patterns of disharmony (sho) and disturbances in the yang channels. Pulse diagnosis and abdominal palpation diagnosis are the two main diagnostic methods used. Little is known about the reliability of pulse, abdominal, and pattern diagnosis in TMT. This is important since diagnosis of the sho determines acupoint treatment. If diagnosis is unreliable, there can be less confidence that the patient will receive optimal treatment. OBJECTIVE: The objective of this study is to assess the level of agreement between two TMT practitioners on pulse diagnosis, abdominal diagnosis, and diagnosis of the primary and secondary sho. METHODS: An inter-rater reliability study was conducted. Two (2) TMT practitioners separately conducted a TMT examination and completed an assessment form, choosing from a range of possible responses relating to pulse characteristics, abdominal diagnosis, and diagnosis of primary sho and secondary sho. The kappa coefficient was used as a measure of inter-rater reliability of the outcome variables. RESULTS: Sixty-two (62) Australians (22 males, 40 females) aged 20-65 years participated (mean age 49.2 +/- 12.2 years). Level of agreement for pulse diagnosis was 57%, 61%, and 77% for pulse depth, speed, and strength, respectively. For abdominal diagnosis, the level of agreement for involvement of the Lung, Kidney, Spleen, and Liver abdominal regions was 58%, 53%, 35%, and 10%, respectively. The overall level of agreement on primary sho diagnosis was 48% and for secondary sho diagnosis, 44%. CONCLUSIONS: Overall, there was a reasonable level of agreement on basic pulse characteristics and on abdominal diagnosis for two of the abdominal regions. Level of agreement on primary and secondary sho diagnosis suggests room for improvement. Further studies are required in order to gain a greater understanding of the reliability of diagnosis in TMT.