J Acupunct Meridian Stud 2016;9(6):307e310

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Journal of Acupuncture and Meridian Studies

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RESEARCH ARTICLE

Effect of Needling at CV-12 (Zhongwan) on

Blood Glucose Levels in Healthy Volunteers:
A Pilot Randomized Placebo Controlled Trial
Sriloy Mohanty 1, A. Mooventhan 2,*, Nandi Krishnamurthy Manjunath 2

1
Department of Naturopathy, S-VYASA University, Bangalore, Karnataka, India
2
Department of Research and Development, S-VYASA University, Bangalore,
Karnataka, India
Available online 20 September 2016

Received: May 30, 2016 Abstract

Revised: Aug 20, 2016 Introduction: Acupuncture, a key part of traditional Chinese medicine, is used to relieve symp-
Accepted: Aug 24, 2016 toms of diabetes mellitus. The aim of this study was to evaluate the effect of needling CV-12
(Zhongwan) on blood glucose levels in healthy volunteers.
KEYWORDS Materials and methods: Thirty-six individuals were recruited and randomized into either the
acupuncture; acupuncture group or the placebo control group. The participants in the acupuncture
blood glucose; group were needled at CV-12 (4 cun above the center of the umbilicus), and those in the pla-
Zhongwan cebo control group were needled at a nonexisting “sham” point on the right side of the
abdomen (1 cun beside the CV-12)da nonacupuncture point. For both groups, the needle
was retained for 20 minutes without stimulation. Assessments were performed prior to and af-
ter the intervention. Statistical analysis was performed using the Statistical Package for the
Social Sciences, version 16.
Results: The result of this study showed a mild reduction in random blood glucose (RBG) levels
in the acupuncture group and a mild increase in RBG levels in the placebo control group.
However, these changes were not statistically significant both within and between groups.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://
creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any me-
dium, provided the original work is properly cited.
* Corresponding author. Department of Research and Development, S-VYASA University, #19, Eknath Bhavan, Kavipuram Circle,
Kempegowda Nagar, Bengaluru 560019, Karnataka, India.
E-mail: dr.mooventhan@gmail.com (A. Mooventhan).
pISSN 2005-2901 eISSN 2093-8152
http://dx.doi.org/10.1016/j.jams.2016.08.002
Copyright ª 2016, Medical Association of Pharmacopuncture Institute.
308
Conclusion: The result of this study suggests that although 20 minutes of needling at CV-12
without stimulation produced a mild reduction in RBG levels in healthy volunteers, it did
not produce a statistically significant result.
1. Introduction
Diabetes is a major public health problem that is
approaching epidemic proportions globally. The number of
people with diabetes is likely to increase up to 380 million
by 2025. Almost 80% of total adults with diabetes are from
developing countries. India leads the global top 10 coun-
tries in terms of the highest number of people with dia-
betes, and there is a growing incidence of diabetes at a
younger age [1].
Acupuncture at CV-12 (Zhongwan) has been widely used
in traditional Chinese medicine to relieve symptoms of
diabetes. Previous studies using electroacupuncture on only
CV-12 [2] and combining this with CV-4 (Guanyuan) [3,4],
SP-6 (Sanyinjiao), and ST-36 (Housanli) have produced a
hypoglycemic effect [2e4] with normalized insulin sensi-
tivity, ameliorating both insulin resistance and hyper-
insulinemia [3] in diabetic rats.
In a human study, CV-12din combination with
acupuncture points such as CV-4, CV-6 (Qihai), CV-10 (Xia-
wan), ST-24 (Huaroumen), ST-25 (Tianshu), TE-5 (Wailing),
SP-15 (Daheng), and KI-13 (Qixue)dwas shown to decrease
blood glucose levels and improve insulin resistance with no
adverse effects in obese Type 2 diabetic volunteers [5].
Other studies have focused on single needling at CV-12
[2], ST-36 [6], BL20 (Pishu) [7], and GB 26 (Daimai) [8] in a
rat model; however, there is lack of studies on human
volunteers. Hence, the aim of this study aims was to eval-
uate the effect of single point acupuncture at CV-12 on
blood glucose levels in healthy human volunteers.
2. Materials and methods
2.1. Participants
A total of 36 healthy volunteers whose ages ranged from 18
years to 24 years were recruited from a residential college
based on the following inclusion and exclusion criteria. The
inclusion criteria called for male and female volunteers
who were 18 years and above, and were willing to partici-
pate in the study. The exclusion criteria were as follows:
individuals with a history of any systemic and mental
illness, regular use of medication for any diseases, needle
phobia, chronic smoking, and alcoholism. The study pro-
tocol was approved by the institutional ethics committee,
and a written informed consent was obtained from each
participant.
2.2. Study design
This is a pilot randomized placebo-controlled trial, in which
all participants were randomly assigned into either the
acupuncture group or the placebo control group. The
S. Mohanty et al.
acupuncture group received needling at CV-12 and the
placebo control group received needling at a non-
acupuncture point for 20 minutes. Data assessment was
performed prior to and after the intervention.
2.3. Randomization
All participants were allotted with random numbers. The
first volunteer was allocated to a group on the basis of a flip
of a coin, then the next volunteer was assigned to the
opposite group, in a randomization ratio of 1:1. Thus, all
members of the group had an equal chance to be in either
group. This randomization was performed by one of the
authors, who was involved in intervention but was not
involved in any part of the investigation.
2.4. Blinding/masking
All participants were blind to the acupuncture (CV-12) and
the placebo control points. The investigator who assessed
the blood glucose was blind to the acupuncture and placebo
control groups.
2.5. Assessments
2.5.1. Random blood glucose
The random blood glucose (RBG) level was assessed be-
tween 10:30 and 11:30 A.M. using a portable ACCU-CHEK,
Performa Nano machine (Roche Diagnostics India Pvt. Ltd,
Mumbai, India). Assessments were performed prior to and
after the intervention for both groups.
2.6. Intervention
2.6.1. Acupuncture group
The participants received traditional Chinese medicine-
style of acupuncture. Needling was performed at CV-12 (4
cun above the center of the umbilicus) [9] at a depth of 0.5
cun. The participants were informed about the procedure,
sensations of needle insertion, and response sought. The
needle was left out without any stimulation. We used 0.5-
cun filiform locally manufactured cupper needle with
0.38 mm diameter and 13 mm length. The participants
received only one session of acupuncture for a duration of
20 minutes. The participants did not receive any treat-
ments other than acupuncture. Needling was administered
by one of the authors who is institutionally qualified with 2
years’ experience in clinical acupuncture.
2.6.2. Placebo control group
The participants in this group received needling in the right
side of the abdomen 1 cun lateral to CV-12 where there is
no known acupuncture point.
Effect of Needling at CV-12 in RBG Levels
Table 1 Demographic variables of acupuncture (n Z 18)
and placebo control groups (n Z 18).
Variables Acupuncture Placebo control
group group
Age (y) 19.61  1.975 19.22  1.517
Sex 9 males/9 females 9 males/9 females
Height (cm) 161.78  11.855 164.00  9.628
Weight (kg) 54.94  8.003 56.28  8.372
Body mass index 21.40  3.520 20.90  2.288
(kg/m2)
All values are expressed as mean  standard deviation, except
for values of sex.
2.7. Data analysis
All data were checked for normality using Kolmogor-
oveSmirnov and ShapiroeWilk tests. Statistical analysis was
performed using Student paired t test (within groups) and
analysis of variance (between groups) was carried out using
Statistical Package for the Social Sciences (SPSS) for Win-
dows, Version 16.0, Chicago, SPSS Inc.
3. Results
Of 41 volunteers, five did not meet the inclusion criteria
and were subsequently excluded from the study. All
recruited participants (n Z 36) were randomly divided into
either the acupuncture (n Z 18) or the placebo control
group (n Z 18). Needling was performed at CV-12 and at
the right side of the abdomen 1 cun lateral to CV-12 in the
acupuncture and placebo control groups, respectively.
Baseline and posttest assessments were done prior to and
after the intervention. Demographic (Table 1) and the
baseline blood glucose levels (Fig. 1) were comparable, and
there were no significant changes between the groups.
Even though the result of this present study showed mild
reduction in RBG levels in the acupuncture group and mild
increase in the placebo control group, these changes were
not statistically significant both within and between groups
(Fig. 1).
4. Discussion
CV-12 is known as the stomach control point in Korean
medicine and is located on the abdominal wall associated
with the pancreas. Although it is located on the Conception
Vessel Meridian, it is considered a therapeutic point for
diseases of the digestive organs such as the stomach,
pancreas, and spleen [10]. For example, electric stimula-
tion at the CV-12 was used for treatment of diabetic rats
[2,10].
The results of this present study showed that a 20-
minute single session needling at CV-12 acupuncture point
without any stimulation (manual or electrical) produced a
mild reduction in RBG levels in healthy volunteers. At the
same time a 20-minutes single session of needling at the
placebo control point produced a mild increase in RBG
309
Figure 1 Baseline and post-test random blood glucose levels
of acupuncture (n Z 18) and placebo groups (nZ18).
levels in healthy individuals. However, these changes were
not statistically significant.
Only one session was administered on CV-12 to check for
the immediate effect on RBG. This may not be sufficient to
produce significant changes. Needling was performed
without stimulation, however, including either manual,
electrical, laser, or catgut embedding stimulation, which
might have produced a more significant effect in reducing
RBG. It should be noted that in previous studies on elec-
troacupuncture at CV-12 alone in diabetic rats [2] and in
combination with other acupuncture points in diabetic rats
[3,4] and human studies [5], laser irradiation on CV-12 along
with other points in metabolic syndrome [9], and catgut
embedding in CV-12 along with other acupuncture points in
diabetic rats [11] have been shown to reduce blood glucose
[2e5,11] and fasting insulin [9,11].
001As healthy individuals have normal physiological
functions and do not have abnormally elevated blood
glucose/reduced insulin levels, CV-12 might have not
influenced the blood glucose levels. In previous studies, the
hypoglycemic effect of CV-12 alone [2] and in combination
with other acupuncture points were reported mainly in
diabetic rats [3,4,11], and in diabetic patients but not in
healthy individuals [5]. Hence, we expect needling at CV-12
to be effective in participants with high blood glucose
levels; however, this needs to be confirmed in further
studies.
4.1. Strength of the study
This is the first randomized placebo controlled study to
evaluate the effect of CV-12 on RBG levels in healthy vol-
unteers. Both the participants and the investigator were
blind to the acupuncture and placebo control groups.
4.2. Limitations of this study
Sample size was not calculated based on the previous study.
The present study evaluated only the immediate effect
without stimulation and did not evaluate its short-term or
long-term effect with or without stimulation. Assessment of
variables such as fasting blood glucose, postprandial blood
310
glucose, glycosylated hemoglobin, and insulin levels was
not performed. Hence, long-term studies with either
manual or electric stimulation are required in a larger
sample size, and more variables such as fasting blood
glucose, postprandial blood glucose, HbA1C, and insulin
levels should be measured in order to better understand
the effect of CV-12 on blood glucose levels.
5. Conclusion
The result of this present study suggests that 20 minutes of
needling at CV-12 without stimulation produces a mild
reduction in RBG levels in healthy volunteers; however, it
did not produce a statistically significant result.
Disclosure statement
The authors declare that they have no conflicts of interest
and no financial interests related to the material of this
manuscript.
Acknowledgments
The authors thank Robert Mazure, Integrated Holistic Ther-
apies, London, UK, for his help in editing the manuscript.
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