在中国，针灸已经有了2000多年的历史，并且拥有合法的地位，从《宪法》到《中药法》都在保护中医药包括针灸的发展，政策、医疗环境都很好。从国内角度来看，针灸同传统医学的发展一样，迎来了一个天时地利人和的大好发展时机，总体呈现四大趋势。

Acupuncture and moxibustion have become the most widely used alternative medical therapy in the world, but the international trend of acupuncture and moxibustion has also brought many challenges and opportunities to the development of acupuncture and moxibustion discipline. This paper summarizes the latest progress in the research of acupuncture and moxibustion and the challenges faced by the discipline of acupuncture and moxibustion, and systematically expounds the development opportunities brought about by the internationalization of acupuncture and moxibustion.

The paper reviews and analyzes the history tradition of acupuncture in different times and places, and argues that Chinese acupuncture is a tradition that has changed greatly over times in accordance with particular social and cultural conditions. In the Qin-Han times, theories and practices of acupuncture were practical and diverse; in the Jin-Yuan period, it was framed by Confucian theory. In modern times, scientization was the main ideological trend in acupuncture and its theory reform was implemented; since the 1950s, acupuncture has been going back to a traditional way, but in clinic, quite part of acupuncturists have been really practical, i.e. adopting modern methods. In the west, scientific acupuncture and traditional acupuncture are rising, and practitioners are producing their own theories. The tradition of acupuncture is constantly changing, no matter in the past, present or future.

The basic concepts of traditional Chinese medicine acupuncture are rooted in the traditional Chinese medicine theory and have special characteristics that are different from modern medicine. Based on an investigation and analysis of the origin, development and evolution of the core concepts of acupuncture and moxibustion, such as meridians, acupoints, acupuncture and moxibustion, this paper argues from a hermeneutics and history piont of view that the concept of acupuncture has its own physical structure foundation or intuitive basis and has evolved into an abstract law for expressing specific human body surface stimulating effects.

This research starts from a retrospect of evolution and history of acu-moxa instruments and attempts to give an explanation of the hidden motivation, with an emphasis on its influences to the development of acu-moxa techniques, theoretical construction, as well as international transmission. Firstly, with an clarification of the contents and reasons, the scope of acumoxa instruments is defined. Secondly, based on an literature review, the application, innovation and modern situation of acumoxa instruments are summarized chronologically. With a new logic of statement, the hidden ideological, intellectual and social background is exhibited. Finally, three questions are discussed in detail:Were there any extractable tendencies during different periods of development of these instruments? What were the objective motivations that resulted in the evolution and creativity of these instruments? What kind of influences might be brought to the discipline of ‘acu-moxa’ by the evolution and development of these instruments? By answering these questions, we open up to several ideas about Chinese medicine in the dialogue between tradition and modern times, as well as in the whole environment of globalization.

Taking the heat-sensitive phenomenon in clinical moxibustion as the starting point, the paper has explored the laws of occurrence of the phenomenon, traced the original definition of acupoints, put forward the theory of acupoint sensitization, innovated the HSM technology and evaluated its efficacy based on evidence, conducted basic research, built a new theoretic system of heat-sensitive moxibustion, and finally opened up a new world of heat-sensitive functional regulation of human body surface. Moreover, this paper makes an attempt to explain that improving clinical efficacy is the eternal research theme of acupuncture clinicians, and inheritance and innovation are the main directions of maintaining and promoting the characteristics and advantages of acupuncture & moxibustion. Meanwhile, it also attempts to explain the general law of clinical research of TCM:originating from the clinical-based on the classic-inheriting & innovating-improving the efficacy-improving the theoryapplying to the clinic.

The efficacy of acupuncture is recognized worldwide. However, how to pass on thousands of years treatment experience, standardize acupuncture stimulation techniques, especially how to determine the optimal dosage of acupuncture stimulation in clinical practice, has been a conundrum in acupuncture research, application and even its dissemination across the world. At present, there has been significant progress in the research of de qi. De qi can be evaluated quantitatively and its mechanism is basically clarified. The correlation between de qi and clinical outcomes has been recently confirmed through our clinical trial of treating Bell's palsy by acupuncture with de qi. Our study has found that acupuncture with de qi can significantly improve the function of facial muscles and quality of life of Bell's palsy patients. For the first time, our study highly integrates traditional de qi and modern evaluation methods, and has attracted considerable international media coverage. This study provides an example for the further in-depth research in traditional Chinese medicine and objective evaluation of the efficacy of acupuncture. Keywords acupuncture; de qi; efficacy evaluation; Bell's palsy

Since the eastward spread of Western culture, our medical community has consistently striven for"convergence"of Chinese medicine and Western medicine. After hundreds of years of exploration, the trend of integration is becoming clearer in recent years, and interdisciplinary integration has been the key to leading medicine to a deeper and higher level. As the leading discipline in traditional Chinese medicine, reform and innovation of apparatus of acupuncture and moxibustion will be the key point to promoting the modernization of Chinese acupuncture and moxibustion, which will boost medical science and technology innovation, interdisciplinary cooperation and collaborative development.

This paper discusses the dominant diseases of acupuncture and moxibustion and its trend of development. At present, the concept of acupuncture and moxibustion disease spectrum involes curative efficacy disease spectrum and evidence-based acupuncture and moxibustion disease spectrum, and they have different dominant disease types. In accordance with the principle of evidence-based acupuncture and moxibustion disease spectrum, this paper searches systematic reviews and meta-analysis of acupuncture and moxibustion published in Chinese medical journals, and concluds 68 dominant diseases of acupuncture and moxibustion. Based on the result and the mechanism characteristics of acupuncture, the development trend of dominant diseases of acupuncture and moxibustion is predicted. In addition to the advantage of curative effects, acupuncture and moxibustion also have advantages in diagnosis, operation, safety and cost effective, which are not available in other medical categories.

The research of traditional Chinese medicine (TCM) is a circle that starts from ‘bed to bench’ then comes back from bench to bed. As a branch of TCM, acupuncture needs to be studied further. In this paper we explore the clinical research of acupuncture through discussing a series trials of acupuncture for constipation. We perform bservational studies as the first step for acupuncture to preliminarily observe its efficacy and safety. Based on the observational study, we carry out randomized controlled trial (RCT) to select the optimal prescription of acupoints, and obtain an acupuncture regimen with the best efficacy and easiest manipulation. Afterwards, we implement a superiority RCT to clarify the therapeutic efficacy of acupuncture by comparing it with placebo needle. Finally, we conduct a non-inferior RCT to explore the clinical application value of acupuncture by comparing it with the ‘gold standard’ if needed.

By taking the randomized controlled trials (RCTs) of acupuncture published in the Journal of the American Medical Association (JAMA) as an example, in this study the reports of acupuncture RCTs are analyzed and the problems are found out as follows:1) true acupuncture is less than optimal; 2) sham acupuncture is not inert; 3) participating acupuncturists are less experienced; 4) conclusions are generalized; 5) trial object is ambiguous; and 6) main outcomes don't match therapeutic regimen. In combination with the characteristics of acupuncture therapy and in response to the aforementioned problems the authors put forward the following suggestions:1) clearly putting forward research objectives in the design stage; 2) choosing appropriate control intervention; 3) setting up criteria for acupuncturist participation; 4) optimizing acupuncture therapeutic regimen; 5) determining clinical outcomes that can be solved by intervention so as to ensure rationalization of outcomes; and 6) defining trial conclusion. The clinical research methods of acupuncture should be stepwise explored and developed so as to enable them to more tightly accord with the characteristics of acupuncture and promote a sound development of acupuncture discipline.

Recently, in the United States and other western countries an intense debate around whether or not the nonacupuncturists including the physiotherapists and the chiropractors could use dry-needling technique to treat myofascial pain syndrome. The debate is not only a controversy around the business interest and legal right, but also an academic dispute on the acupuncture theory in some extent. Both the tendency for dry-needling to be independent from traditional acupuncture and the initiation of western medical acupuncture strongly challenge the theoretical system of traditional acupuncture originated from China. Via reviewing the fact of the debate, the different points of view from two sides and the potential academic challenge occurred in the internationalization of acupuncture, a new reconsideration on the definition of acupuncture and an idea to reconstruct a new science-based theory of acupuncture were discussed.

"Every disease is caused by qi" was recorded in Sù Wèn·Jǔ tòng lùn, which has been one of the important theoretical basis for TCM clinical understanding of disease and its prevention for thousands of years. The paper argues that disorder of qi movement is the basic pathogenesis of disease occurrence, and emotional factors and mental psychology are important internal causes of disease. The concept "every disease being caused by qi" has important guiding significance for clinical acupuncture and moxibustion. In the process of acupuncture diagnosis and treatment, one should pay attention to "regulating qi" and "regulating the spirit", which is the fundamental guarantee for acupuncture to achieve good results.

Based on the current theoretical construction and clinical development of traditional Chinese medicine and acumoxa, this paper conducts an in-depth analysis on the differences between acu-moxa and oral traditional Chinese medicine in theory and method, as well as the advantage and prospect of their combination. It is found that there are differences between acupuncture and oral traditional Chinese medicine in terms of cut-in mode, mechanism of effect and perspective of differentiation and treatment. Combined application of acupuncture and oral traditional Chinese medicine can complement each other's shortcoming and has great clinical advantage. This paper also points out that external treatment of traditional Chinese medicine is an important research direction of combination of acu-moxa and traditional Chinese medicine.

Psychosomatic medicine applies the principle of psychosomatic correlation to health keeping as well as disease prevention and treatment. With the establishment of the bio-psycho-social medical model, it is realized by modern medicine that psychological factors have an impact on the occurrence and development of most human diseases. The application of psychosomatic therapies, however, is still limited in the modern medical system. In the theoretical system of Chinese medicine, the philosophy of combining body with spirit has a long history. Among a great variety of acupuncture schools, the five-element acupuncture is known as a typical one, which has unique features in diagnosis and treatment of psychosomatic diseases. It is a natural healing therapy under the instruction of the great harmony between nature and human as well as the holistic idea of human body. From the perspective of the five elements, the dominant element of patients is identified, and the characteristics of temperament, character, emotion, words and deeds of people like those of the five elements are taken from the characteristics of seasonal changes in nature, forming the basic framework for classification of the five elements of people. It emphasizes the mutual influence of mind and body, attaches importance to the internal cause of disease (internal injury due to emotional disorder), and the treatment sequence is from inside to outside. The treatment focuses on the corresponding meridians of the dominant element to stimulate the self-healing ability of the human body, and at the same time cures the spirit and mind, fully reflecting the holistic view of traditional Chinese medicine. The five-element acupuncture is a unique therapy for both physical and mental healing, which deserves wide dissemination and application.

Since the Spring Autumn and Warring States Period, acupuncture and moxibustion has expieerneced an evolution of three systems:system of traditional acupuncture and moxibustion, system of modern acupuncture and moxibustion, and system of post-modern acupuncture and moxibustion, with each system being closely related to multi-disciplinary research in its times. Modern acupuncture and moxibustion is the result of multi-disciplinary researches on the therapy of anatomy, physiology, biochemistry and molecular biology and neurobiology, while meridian study involves a wider range of disciplines. Post-modern acupuncture and moxibustion can be understood as systematic acupuncture and moxibustion, which through multi-disciplinary research introspects the deficiency of reductionism in modern science and applies systematic science to acupuncture and moxibustion science. New innovation of acupuncture and moxibustion resolutely needs multi-disciplinary research.