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Zusanli (Chinese: 足三里, ST36) is an acupoint, a point of the skin that is stimulated, with various techniques, in the practice of acupuncture. It is located below the knee, on the tibialis anterior muscle, along the stomach meridian.

A Japanese diagram explaining how to find the zusanli acupoint, which is located 4 fingers below the tibialis anterior muscle

Therapeutic uses and scientific validation[edit]

Acupuncture of Zusanli induces local serotonin release.[1] Furthermore, the stimulation of this acupoint is shown to decrease inflammation, as evidenced by decreased cytokines (including interleukin 6) and inhibition of edema in a rat model of inflammation involving carrageenan injection.[2] Zusanli activation also improves insulin sensitivity [3] and cerebral blood flow (an effect mediated by nitric oxide),[4] while it decreases sympathetic nerve activity and arterial pressure.[5] An analgesic effect, mediated in part by nitric oxide as well, through the upregulation of inducible nitric oxide synthase (iNOS),[6] an increase in endogenous opiates,[7][8] muscarinic cholinergic receptors and serotonin receptors 5-HT1a and 5-HT3, was repeatedly evidenced.

The stimulation of Zusanli decreases the locomotor activity elicited by nicotine administration and decreases Fos-like immunoreactivity in the basal ganglia (e.g., the striatum, particularly the nucleus accumbens) in a rat model of nicotine sensitisation.[9] Those changes in the basal ganglia also improve the alcohol withdrawal syndrome in similar experimental conditions.[10]

See also[edit]


  1. ^ Dimitrov, N; Atanasova, D; Tomov, N; Sivrev, D; Lazarov, N (2017). "Acupuncture causes serotonin release by mast cells". Romanian Journal of Morphology and Embryology. 58 (3): 961–968. PMID 29250675.
  2. ^ Chae Y, Hong MS, Kim GH, et al. (2007). "Protein array analysis of cytokine levels on the action of acupuncture in carrageenan-induced inflammation". Neurol. Res. 29 Suppl 1: S55–8. doi:10.1179/016164107X172365. PMID 17359642. S2CID 12011843.
  3. ^ Chang SL, Lin KJ, Lin RT, Hung PH, Lin JG, Cheng JT (2006). "Enhanced insulin sensitivity using electroacupuncture on bilateral Zusanli acupoints (ST 36) in rats". Life Sci. 79 (10): 967–71. doi:10.1016/j.lfs.2006.05.005. PMID 16762373.
  4. ^ Hsieh CL, Chang QY, Lin IH, et al. (2006). "The study of electroacupuncture on cerebral blood flow in rats with and without cerebral ischemia". Am. J. Chin. Med. 34 (2): 351–61. doi:10.1142/S0192415X06003886. PMID 16552844.
  5. ^ Michikami D, Kamiya A, Kawada T, et al. (2006). "Short-term electroacupuncture at Zusanli resets the arterial baroreflex neural arc toward lower sympathetic nerve activity". Am. J. Physiol. Heart Circ. Physiol. 291 (1): H318–26. doi:10.1152/ajpheart.00975.2005. PMID 16501021.
  6. ^ Kim EH, Park HJ, Lee H, et al. (2007). "Analgesic effects by electroacupuncture were decreased in inducible nitric oxide synthase knockout mice". Neurol. Res. 29 Suppl 1: S28–31. doi:10.1179/016164107X172257. PMID 17359637. S2CID 42991048.
  7. ^ Kim SK, Moon HJ, Na HS, et al. (2006). "The analgesic effects of automatically controlled rotating acupuncture in rats: mediation by endogenous opioid system". The Journal of Physiological Sciences. 56 (3): 259–62. doi:10.2170/physiolsci.SC002706. PMID 16839460.
  8. ^ Jung JY, Yang HR, Jeong YJ, et al. (2006). "Effects of acupuncture on c-Fos expression in brain after noxious tooth stimulation of the rat". Am. J. Chin. Med. 34 (6): 989–1003. doi:10.1142/S0192415X06004466. PMID 17163588.
  9. ^ Chae Y, Yang CH, Kwon YK, et al. (2004). "Acupuncture attenuates repeated nicotine-induced behavioral sensitization and c-Fos expression in the nucleus accumbens and striatum of the rat". Neurosci. Lett. 358 (2): 87–90. doi:10.1016/j.neulet.2003.12.121. PMID 15026155. S2CID 30993311.
  10. ^ Kim JH, Chung JY, Kwon YK, et al. (2005). "Acupuncture reduces alcohol withdrawal syndrome and c-Fos expression in rat brain". Am. J. Chin. Med. 33 (6): 887–96. doi:10.1142/S0192415X0500348X. PMID 16355445.