Korean Journal of Acupuncture

Society for Meridian and Acupoint (경락경혈학회)
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A New Method For Measuring Acupoint Pigmentation After Cupping Using Cross Polarization

교차편광 촬영술(Cross Polarization Photographic Technique)를 이용한 부항요법의 배수혈 피부 색소 침착 변화 측정 평가

  • Kim, Soo-Byeong (Eastern & Western Biomedical System Laboratory, Department of Biomedical Engineering, College of Health Science, Yon-Sei University) ;
  • Jung, Byungjo (Biomedical Optics Laboratory, Department of Biomedical Engineering, College of Health Science, Yon-Sei University) ;
  • Shin, Tae-Min (Medical Computer System Laboratory, Dept of Biomedical Engineering, College of Health Science, Yon-Sei University) ;
  • Lee, Yong-Heum (Eastern & Western Biomedical System Laboratory, Department of Biomedical Engineering, College of Health Science, Yon-Sei University)
  • 김수병 (연세대학교 보건과학대학 의공학부 동서의료시스템연구실) ;
  • 정병조 (연세대학교 보건과학대학 의공학부 생체의광학연구실) ;
  • 신태민 (연세대학교 보건과학대학 의공학부 의용컴퓨터시스템연구실) ;
  • 이용흠 (연세대학교 보건과학대학 의공학부 동서의료시스템연구실)
  • Received : 2013.12.06
  • Accepted : 2013.12.16
  • Published : 2013.12.27
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Abstract

Objectives : Skin color deformation by cupping has been widely used as a diagnostic parameter in Traditional Korean Medicine(TKM). Skin color deformation such as ecchymoses and purpura is induced by local vacuum in a suction cup. Since existing studies have relied on a visual diagnostic method, there is a need to use the quantitative measurement method. Methods : We conducted an analysis of cross-polarization photographic images to assess the changes in skin color deformation. The skin color variation was analyzed using $L^*a^*b^*$ space and the skin erythema index(E.I.). The meridian theory in TKM indicates that the condition of primary internal organs is closely related to the skin color deformation at special acupoints. Before conducting these studies, it is necessary to evaluate whether or not skin color deformation is influenced by muscle condition. Hence, we applied cupping at BL13, BL15, BL18, BL20 and BL23 at Bladder Meridian(BL) and measured blood lactate at every acupoint. Results : We confirmed the high system measurement accuracy, and observed the diverse skin color deformations. Moreover, we confirmed that the $L^*$, $a^*$ and E.I. had not changed after 40 minutes(p>0.05). The distribution of blood lactate levels at each part was observed differently. Blood lactate level and skin color deformation at each part was independent of each other. Conclusions : The negative pressure produced by the suction cup induces a reduction in the volumetric fraction of melanosomes and subsequent reduction in epidermal thickness. The relationship between variations of tissue and skin properties and skin color deformation degree must be investigated prior to considering the relationship between internal organ dysfunction and skin color deformation.

목적 : 부항요법은 국소적 부위를 진공상태로 유지시키는 과정 중 유두층 안의 표피혈관을 파괴됨에 따라 발생하는 색소, 응결, 자반, 수포, 압통 반응 등을 살피어 오장육부의 기능이상을 진단하고 있다. 시각에 의존하는 주관적인 혈색소 판별로 인한 진단방법에서 벗어나 정량적으로 측정 및 분석이 가능하기 위하여 교차편광 촬영술을 접목하였으며, 새로운 혈색소 평가 가능성을 확인하고자 하였다. 방법 : 족태양방광경의 좌/우 폐수(BL13), 심수(BL15), 간수(BL18), 신수(BL23) 총 10개에 80 kPa 의 음압으로 1분 동안 자극하였다. 교차편광 촬영술을 이용하여 부항 자극 직전과 60분 이후까지 2분마다 이미지를 획득하였다. 획득한 이미지에서 $L^*a^*b^*$ space로 변환하여 분석하였으며, RGB space에서 홍반지수 (E.I: erythema index)를 계산하여 분석하였다. 또한 부항 자극 전 각 경혈에서 젖산 농도를 측정하여 색 지표들간의 관계성 분석을 통하여, 근육의 상태와 부항 자극으로 유도된 피부 색 변화와의 관계를 확인하고자 하였다. 결과 : 교차편광 촬영술을 이용하여 획득한 이미지에서의 $L^*$, $a^*$ 그리고 E.I 모두 부항 자극에 따른 피부 색 변화를 정량적으로 나타낼 수 있는 유의한 지표임을 확인하였다. 부항 자극 40분 후에 피부 색 변화가 더 이상 관찰되지 않았다. 또한 각 경혈에서의 젖산 농도와 피부 색 변화 정도와 유의한 차이가 없음을 확인하였다. 결론 : 설진을 포함하여 한의학적 색 진단을 하기 위한 방법으로 교차편광 촬영술 활용 가능성을 확인하였다. 또한 $L^*$, $a^*$ 그리고 E.I 모두 색 지표로서 유의성을 확인하였다. 향후, 장부 기능 이상과 혈색소 반응간의 상관성을 확보하기 위한 연구가 진행하기 전에, 음압 도중 발생하는 조직 내 다양한 반응과 혈색소 반응간의 관계를 확보하고자 하는 노력이 우선적으로 진행되어야 한다.

Keywords

References

  1. Yoo SS, Tausk F. Cupping: East meets West. Int J Dermatol. 2004 ; 43(9) : 664-5. https://doi.org/10.1111/j.1365-4632.2004.02224.x
  2. Kouskoukis CE, Leider M. Cupping. The art and the value. Am J Dermatopathol. 1983 ; 5(3) : 235-9. https://doi.org/10.1097/00000372-198306000-00007
  3. Chirali IZ. The cupping procedure. In Traditional Chinese Medicine Cupping Therapy. London : Churchill Livingstone. 1999 : 73-86.
  4. Oh JK, Kim SS. Effect of negative therapy at back meridian points on blood gas components and immune functions in male college students. The Journal of Korean Oriental Medicine. 1999 ; 2(1) : 75-83.
  5. Farhadi K, Schwebel DC, Saeb M, Choubsaz M, Mohammadi R, Ahmadi A. The effectiveness of wet-cupping for nonspecific low back pain in Iran: a randomized controlled trial. Complement Ther Med. 2009 ; 17(1) : 9-15. https://doi.org/10.1016/j.ctim.2008.05.003
  6. Kim JI, Lee MS, Lee DH, Boddy K, Ernst E. Cupping for treating pain: a systematic review. Evid Based Complement Alternat Med. 2011 ; 2011 : 467014.
  7. Duo X. 100 cases of intractable migraine treated by acupuncture and cupping. J Tradit Chin Med. 1999 ; 19(3) : 205-6.
  8. Zhang Z. Observation on therapeutic effects of blood-letting puncture with cupping in acute trigeminal neuralgia. J Tradit Chin Med. 1997 ; 17(4) : 272-4.
  9. Chen D, Jiang N, Cong X. 47 cases of acne treated by prick-bloodletting plus cupping. J Tradit Chin Med. 1993 ; 13(3) : 185-6.
  10. Xu S, Wang L, Cooper E, Zhang M, Manheimer E, Berman B, et al. Adverse events of acupuncture: a systematic review of case reports. Evid Based Complement Alternat Med. 2013 ; 2013 : 581203.
  11. Bae EJ, Seo SH, Kye YC, Ahn HH. A quantitative assessment of the human skin surface using polarized light digital photography and its dermatologic significance. Skin Res Technol. 2010 ; 16(3) : 270-4.
  12. Robertson AJ, Toumba KJ. Cross-polarized photography in the study of enamel defects in dental paediatrics. J Audiov Media Med. 1999 ; 22(2) : 63-70.
  13. Anderson RR. Polarized light examination and photography of the skin. Arch Dermatol. 1991 ; 127(7) : 1000-5. https://doi.org/10.1001/archderm.1991.01680060074007
  14. Taylor S, Westerhof W, Im S, Lim J. Noninvasive techniques for the evaluation of skin color. J Am Acad Dermatol. 2006 ; 54(5 Suppl 2) : S282-90. https://doi.org/10.1016/j.jaad.2005.12.041
  15. Ahn HH, Kim SN, Kye YC. Digital camera images obtained using a light-emitting diode illuminator and their dermatological applications. Skin Res Technol. 2006 ; 12(1) : 11-7. https://doi.org/10.1111/j.0909-725X.2006.00134.x
  16. Alaluf S, Atkins D, Barrett K, Blount M, Carter N, Heath A. The impact of epidermal melanin on objective measurements of human skin colour. Pigment Cell Res. 2002 ; 15(2) : 119-26. https://doi.org/10.1034/j.1600-0749.2002.1o072.x
  17. Barel AO, Clarys P, Alewaeters K, Duez C, Hubinon JL, Mommaerts M. The Visi-Chroma VC-100: a new imaging colorimeter for dermatocosmetic research. Skin Res Technol. 2001 ; 7(1) : 24-31. https://doi.org/10.1034/j.1600-0846.2001.007001024.x
  18. Wagner JK, Jovel C, Norton HL, Parra EJ, Shriver MD. Comparing quantitative measures of erythema, pigmentation and skin response using reflectometry. Pigment Cell Res. 2002 ; 15(5) : 379-84. https://doi.org/10.1034/j.1600-0749.2002.02042.x
  19. Takiwaki H, Miyaoka Y, Kohno H, Arase S. Graphic analysis of the relationship between skin colour change and variations in the amounts of melanin and haemoglobin. Skin Res Technol. 2002 ; 8(2) : 78-83. https://doi.org/10.1034/j.1600-0846.2002.00333.x
  20. Ha S, Lee M, Lee O, Lee G, Kim J, Moon J, et al. A study of a method for distribution analysis of skin color. Skin Res Technol. 2009 ; 15(2) : 200-13. https://doi.org/10.1111/j.1600-0846.2009.00355.x
  21. Waller JM, Zedek DC. How informative are dermatopathology requisition forms completed by dermatologists? A review of the clinical information provided for 100 consecutive melanocytic lesions. J Am Acad Dermatol. 2010 ; 62(2) : 257-61. https://doi.org/10.1016/j.jaad.2009.06.049
  22. Robert IH, Samuel EL, Thomas PS. Blood: principles and practice of hematology. USA : Lippincott Williams & Wilkins. 2003.
  23. Childers MA, Franco W, Nelson JS, Aguilar G. Laser surgery of port wine stains using local vacuum pressure: changes in skin morphology and optical properties(Part I). Lasers Surg Med. 2007 ; 39(2) : 108-17. https://doi.org/10.1002/lsm.20456
  24. Kim YJ, Kim DH, Yeom SC, Lim BC, Choi YS, Lee GH, et al. Experimental Study on the Pressure Characteristics in the Cupping Therapy. The Journal of Korean Acupuncture & Moxibustion Society. 2008 ; 25 : 121-30.
  25. Zhao XX, Tong BY, Wang XX, Sun GL. Effect of time and pressure factors on the cupping mark color. Zhongguo Zhen Jiu. 2009 ; 29(5) : 385-8.
  26. Briggaman RA, Wheeler CE Jr. The epidermal-dermal junction. J Invest Dermatol. 1975 ; 65(1) : 71-84. https://doi.org/10.1111/1523-1747.ep12598050
  27. Kiistala U, Mustakallio KK. In-Vivo separation of epidermis by production of suction blisters. Lancet. 1964 ; 1(7348) : 1444-5.
  28. Koga M. Epidermal grafting using the tops of suction blisters in the treatment of vitiligo. Arch Dermatol. 1988 ; 124(11) : 1656-8. https://doi.org/10.1001/archderm.1988.01670110016003
  29. Awad SS. Chinese cupping: a simple method to obtain epithelial grafts for the management of resistant localized vitiligo. Dermatol Surg. 2008 ; 34(9) : 1186-92. https://doi.org/10.1111/j.1524-4725.2008.34257.x
  30. Bouclin R, Charbonneau E, Renaud JM. Na+ and K+ effect on contractility of frog sartorius muscle: implication for the mechanism of fatigue. Am J Physiol. 1995 ; 268(6 Pt 1) : C1528-36.
  31. Broch-Lips M, Overgaard K, Praetorius HA, Nielsen OB. Effects of extracellular HCO3(-) on fatigue, pHi, and K+ efflux in rat skeletal muscles. J Appl Physiol(1985). 2007 ; 103(2) : 494-503. https://doi.org/10.1152/japplphysiol.00049.2007
  32. Overgaard K, Nielsen OB, Clausen T. Effects of reduced electrochemical Na+ gradient on contractility in skeletal muscle: role of the Na+-K+ pump. Pflugers Arch. 1997 ; 434(4) : 457-65. https://doi.org/10.1007/s004240050421
  33. Overgaard K, Nielsen OB, Flatman JA, Clausen T. Relations between excitability and contractility in rat soleus muscle: role of the Na+-K+ pump and Na+/K+ gradients. J Physiol. 1999 ; 518(Pt 1) : 215-25. https://doi.org/10.1111/j.1469-7793.1999.0215r.x
  34. Kristensen M, Albertsen J, Rentsch M, Juel C. Lactate and force production in skeletal muscle. J Physiol. 2005 ; 562(Pt 2) : 521-6. https://doi.org/10.1113/jphysiol.2004.078014
  35. Jurkat-Rott K, Fauler M, Lehmann-Horn F. Ion channels and ion transporters of the transverse tubular system of skeletal muscle. J Muscle Res Cell Motil. 2006 ; 27(5-7) : 275-90. https://doi.org/10.1007/s10974-006-9088-z
  36. Jacques SL, Naruikar VA, Anderson R. The optics of stretching skin and use during clinical laser treatments. Progress report, prepared for distribution at American Academy of Dermatology, 2005 Feb. 18-22; New Orleans, LA.
  37. Hendriks FM, Brokken D, van Eemeren JT, Oomens CW, Baaijens FP, Horsten JB. A numerical-experimental method to characterize the non-linear mechanical behaviour of human skin. Skin Res Technol. 2003 ; 9(3) : 274-83. https://doi.org/10.1034/j.1600-0846.2003.00019.x
  38. Franco W, Childers M, Nelson JS, Aguilar G. Laser surgery of port wine stains using local vacuum [corrected] pressure: changes in calculated energy deposition(Part II). Lasers Surg Med. 2007 ; 39 (2): 118-27. https://doi.org/10.1002/lsm.20464

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