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Re: Smartphone‐controlled patch electro‐acupuncture versus conventional pain relief during colonoscopy: a randomized controlled trial

We express our strong interest in the captioned article by Joan et al. who investigated the efficacy of smartphone-controlled patch electro-acupuncture as a substitute for pain relief during colonoscopy. We appreciate their study design and device application. However, we have the following concerns and suggestions from the point of view of a practitioner. First, the standardized international acupuncture nomenclature must be adopted to properly present abbreviations for meridians. Such international communication is possible only if a common language is used by all concerned. Thus, the Zusanli acupoint mentioned in the article should be professionally known as ST36 instead of S36, as Zusanli is the meridian point in the stomach meridian. Second, the locations of Zusanli acupoint were inaccurate. The authors stated that Zusanli acupuncture point is located below the knee, one-finger breadth lateral to the anterior crest of the tibia, three-finger breadth inferior to the hollow that is formed below the patella, and lateral to the patellar ligament when the knee is flexed. According to international standards, ST36 is located on the tibialis anterior muscle, on the line connecting ST35 (Dubi) with ST41 (Jiexi), 3B-cun inferior to ST35 (Fig. 1). In reality, B-cun is called proportional bone (skeletal) cun for short. The length and width between two points of particular joints are equally divided into such units. One unit is regarded as one cun. Therefore, three-finger breadth is not equal to 3B-cun. That is, the acupoint described in the article is not necessarily located on the 3B-cun inferior to ST35 and on the line connecting ST35 with ST41. On the basis of traditional Chinese medicine theory, the accuracy of acupoint location directly influences the therapeutic effect of acupuncture. Hence, the results of this study are dubious. In sum, describing the International Standard Code of acupoint and the location of points in the acupuncture clinical trials is important to improve the credibility of the final conclusion.