Electroacupuncture stimulation at San yin jiao, which activates both muscle and cutaneous afferent fibers, elicits a more pronounced rise in mean arterial blood pressure than stimulation at Zu san li (ST36) which mainly activates muscle afferent fibers. This effect was mediated by the nervous system as severance of the somatic nerves innervating the two acupoints prevented changes in mean arterial pressure (3). 

Acupuncture is an effective treatment for primary hypertension. The most commonly used points, in order, are Yong quan (KI1), Qu chi (LI11), Tai chong (LR3), Shen que (CV8), San yin jiao (SP6) and Nei guan (PC6) (4). 

Acupuncture at Nei guan (PC6), San yin jiao (SP6), Zu san li (ST36), Xin shu (BL15) Tai chong (LR3) and Shen men (HT7) can reduce the clinical symptoms associated with angina pectoris, this may be due to its ability to regulate plasma endothelin and nitric oxide (5).

A rat study looking at the neurological links with San yin jiao found that, ‘the sensory and motor neurons associated with acupoint SP6 distributed in L3-L6 dorsal root ganglions and spinal ventral horns of rats, concentrating in the L4 and L5 segments, and 24.1% sensory neurons show substance P-positive, suggesting a possible involvement of the primary substance P-positive sensory neurons in the transmission of acupuncture stimulation signals’ (6). 

Acupuncture at Da ling (PC7), Zhong zhu (SJ3), Yang ling quan (GB34), Zu san li (ST36), San yin jiao (SP6), Bai hui (DU20) Da du (SP2) and Tai bai (SP3) can benefit restless leg syndrome in Parkinson’s disease patients and also improves sleep quality and quality of life (7). 

Acupuncture has benefit for amyotrophic lateral sclerosis, the most comomnly chosen points are He gu (LI4, 67%), Zu san li (ST36, 67%), Qu chi (LI11, 52%), San yin jiao (SP6, 48%), and Yang ling quan (GB34, 45%) (8). 

The most frequently selected acupoints for Tourette’s syndrome are Tai chong (LR3), Bai hui (DU20), Feng chi (GB20), He gu (LI4), Si shen cong (EX-HN 1), San yin jiao (SP6) and Zu san li (ST36) (9).

San yin jiao is also among the most used points for Alzheimer’s disease, in order being Bai hui (DU20), Zu san li (ST36), Si shen cong (Extra), Tai xi (KI3), San yin jiao, Nei guan (PC6), for best outcomes acupuncture should be combined with medication (10). 

Electroacupuncture was applied at Nei guan and San yin jiao with manual acupuncture at Bai hui as the main points to see if acupuncture would give added benefit as well typical rehabilitation therapy for post stroke patients. It was found that patients who additionally had acupuncture (6 times a week for 2 weeks) had improved neural function, living ability, mental state and serum aquaporin-4 content, which is key for regulating oedema post stroke and may be part of the reason for the improved outcomes (11). This is the first time i’ve seen Aquaporin-4 investigated. You can look at the Nei guan page for lots of research on it being beneficial post stroke, especially around the cellular death pathways, but none looked at oedema directly. Perhaps the researchers thought San yin jiao would have additional fluid metabolic benefits given its TCM functions. 

Acupuncture points Baihui (GV 20), Shenting (GV 24), Sishencong (EX-HN 1), Zusanli (ST 36), Neiguan (PC 6) and Sanyinjiao (SP 6) are the most commonly used and form the basis of a core point prescription for post-stroke cognitive impairment (12). 

San yin jiao is among the points most commonly chosen for apoplexy sequelae, in order, they are He gu (LI4), Zu san li (ST36), Qu chi (LI11), Jian yu (LI15), San yin jiao (SP6), Yang ling quan (GB34), Lian quan (REN23), and Wai guan (SJ5) (13).

Electroacupuncture at San yin jiao and Guan yuan (REN4) was tested sensence accelerated mouse prone 8 to see if it benefited the hypothalamus-pituitary-ovary axis.  Estradiol levels were increased in San yin jiao and Guan yuan groups. In contrast, gonadotropin releasing hormone, leutenising hormone and follicle stimulating hormone levels were reduced. San yin jiao group was superior than Guan yuan group on increasing estradiol and declining gonadotropin releasing hormone levels. Spatial learning and memory were also improved but only by San yin jiao. This is important as the prevalence of Alzheimer’s disease is significantly higher in women due to dysregulation of the HPO axis, perhaps purely lower oestrogen levels. Acupuncture could be a safe and effective was to manage and mitigate this (14). 

Similarly EA at SP6 and REN4 was shown to regulate the HPO axis, up-regulating uterus estradiol levels, and down-regulating pituitary follicle stimulating hormone and luteinizing hormone contents and hypothalamic gonadotropin releasing hormone levels in ovariectomized rats, which may contribute to its efficacy in relieving climacteric syndrome in clinic (15). 

Electroacupuncture at ST36 and SP6 can mitigate the adrenal cortical inhibition induced by etomidate and can reduce the secretion of catecholamines during surgery (16).

Another study found that in a rat model electroacupuncture at Zu san li and San yin jiao can improve surgical trauma-induced HPA disorders, which is probably related to its effects in upregulating corticotropin-releasing factor mRNA expression and downregulating Ucn 1 mRNA expression in the hypothalamus (17).

He gu is amongst the most commonly used points for post operative nausea and vomiting. In order of the top then, they are Nei guan (PC6), Zu san li (ST36), He gu (LI4), Zhong wan (REN12), Shang ju xu (ST37), San yin jiao (SP6), Tai chong (LR3), Yang ling quan (GB34), Qu chi (LI11) and Xia ju xu (ST39) (18). 

He gu is in the top 6 most used points for hyperthyroidism with and without exophthalamus. The points are San yin jiao (SP6), Nei guan (PC6), Zu san li (ST36), Shui tu (ST10), He gu (LI4), Tai chong (LR3) and Feng chi (GB20), Shang tian zhu (Extra), He gu (LI4), San yin jiao (SP6), Cuan zhu (BL2), Yang bai (GB14), respectively (19). 

Electroacupuncture at Zu san li and San yin jiao can greatly increase intestinal motility by increasing myoelectrical activity in the small intestine. This effect was observed in rats after 30 minutes of stimulation and was markedly superior to the sham acupuncture control (20). 

Electroacupuncture at San yin jiao, or Zu san li, can reduce the hepatic damage from thioacetamide, showing benefits across focalized inflammation, apoptosis, piecemeal-necrosis, necrosis and portal-inflammation to hematoxylin and eosin analysis and fibrosis expansion and collagen bridges (21). 

San yin jiao’s effect on the gastrointestinal tract (GIT) was compared with Zu san li. Rats were injected with a radioactive isotope to measure uptake in the GIT. It was shown that Zu san li had a stimulating effect on the digestive system by leading to higher levels of uptake than control, whilst San yin jiao seemed to be inhibitory by reducing uptake (22).  

San yin jiao is in the top 5 most commonly used points for dyspepsia the others were Zu san li (ST35) Zhong wan (REN12), Shang wan (REN13) and Xia wan (REN10), Nei guan (PC6) was also very commonly used (23). 

Acupuncture at Zu san li and San yin jiao can improve digestive distress after gastric surgery. This was shown by significantly less time to the passing of the first flatus 59 vs 86hrs. It was also shown that sero-enzyme activity was raised 200-300% after the operation, which is evidence of cellular trauma. Those who received acupuncture saw the resumption of normal sero-enzyme levels much more quickly than those who did not receive acupuncture and may be part of the mechanism involved (24). 

Acupuncture at San yin jiao, Zu san li, Nei guan and Shen shu can help regulate insulin resistance, leading to lower Fasting plasma glucose, fasting insulin and increasing the insulin sensitivity index. It also reduced C peptide and Akt2 mRNA expression which may have been part of the mechanism behind the metabolic changes (25). 

Electroacupuncture at San yin jiao, Tai chong (LR3) and Zu san li could relieve hepatic pathological changes in liver cirrhosis rats. The food-intake amount and propulsive rate of the small intestine were increased, the liver index and portal vein diameter were down-regulated and induced changes of the liver tissue such as cirrhosis, fibroplasias, pseudo-lobulation, fibroplasias, diffusive inflammatory cell infiltration, etc. were relatively milder in the acupuncture group, rather than in the medication group (26).

Acupuncture at tai bai, with Taixi (KI3), Tai chong (LR3), Tai bai (SP3), San yin jiao (SP6), Shen shu (BL23), Gan shu (BL18), Pi shu (BL20), Guanyuan (REN4), is stronger for perimenopausal syndrome than Baihui (DU20), Guanyuan (REN4), Shen shu (BL23), Tai xi (KI3), Sanyin jiao (SP6). Both groups improved the Kupperman score and serum estradiol (E2), follicle stimulating hormone (FSH) and luteinizing hormone (LH), but the yuan source and shu point group had a stronger effect (27). 

Further to this, the most commonly used points and basis for a point protocol for perimenopausal symptoms was San yin jiao, Shen Shu (BL23), Guan yuan (REN4), Bai hui (DU20), Shen men (HT7) (28). 

Electroacupuncture of He gu (LI4) and San yin jiao (SP6) at 15 Hz, 30 Hz and 2 Hz/ 50 Hz can effectively up-regulate serum estradiol, prostaglandin E2 and estradiol/progesterone levels and down-regulate serum progesterone content in pregnancy rats, which may contribute to its effect in promoting labor (29).

Transcutaneous electrical nerve stimulation at He gu and San yin jiao can benefit the first stage of pregnancy by reducing pain, shortening the time till dilation, and reducing the need for oxytocin (30).

Electroacupuncture at He gu and San yin jiao (SP6) for 25 minutes benefits medical abortions, reducing pain levels and shortening foetal sac discharge duration (31). Another study showed He gu and San yin jiao can reduce post medical abortion symptoms and reduce abdominal pain (32). 

He gu, vs San yin jiao and Xue hai (SP10), is the more effective point for reducing pain in dysmenorrhagic rats, reducing writhing and uterine contractions (33). 

A systematic review and meta-analysis of single point acupuncture (or acupressure) at San yin jiao for primary dysmenorrhea, with 19 studies and 1171 patients (9 studies for acupressure, 10 for puncture), showed both are effective for reducing pain, though, curiously acupressure may be more effective if applied by a practitioner, not by oneself, and electroacupuncture was more effective than manual acupuncture (34). 

Electroacupuncture of San yin jiao (SP6) can reduce malondialdehyde content and upregulate beta-endorphin level of the uterus in rats with dysmenorrhea, which may contribute to its analgesic effect in relieving dysmenorrhea by clearing away oxygen free radicals and raising analgesic substance in the uterus (35). 

The effect of EA at SP6 on dysmenorrhea could also be closely associated with its functions in upregulating spinal kappa-opiod receptor expression in the dorsal horn of the spinal cord and enkephalin and beta-endorphin contents in the periaqueductal gray of the midbrain (36). 

Transverse needling of San yin jiao appears to be more effective for dysmenorrhea vs perpendicular needling. Reducing the perceived pain levels and anxiety levels, this may have been due to changes in the resistance index of the uterine ateries. No changes were noted between the two groups pulsility index or systolic-diastolic peaks ratio of the uterine arteries nor heart rate or blood pressure (37). 

Just to further muddy the waters, this study showed acupuncture at San yin jiao, Xuan zhong (GB39) (as a control) and a non acupuncture point (as a placebo) gave similar pain killing results for primary dysmenorrhea. The effect did not seem to be mediated by changes in prostaglandins, as non was observed across the groups for plasma PGE2, PGF2a, TXB2, or 6-keto PGF1a levels and the ratios of PGF2a/PGE2 , and TXB2/6-keto PGF1a (38)

Acupuncture at San yin jiao is as effective as Meflemenic acid at reducing period pain (39). 

San yin jiao is among the most commonly used points for premature ovarian failure, the other points are Guanyuan (CV 4), Shenshu (BL 23), Zhongji (CV 3), Pishu (BL 20), Taixi (KI 3) and Ganshu (BL 18) and local extra points like Zi gong (40). 

Acupuncture at San yin jiao, Guan yuan, Zhong ji and Zi gong are the most commonly used points and the basis of a protocol for infertility (41). 

Acupuncture at Zhong ji (REN3), Guan yuan (REN4), Zi gong (EX-CA1), San yin jiao (SP6), Tai xi (KI3), Xue hai (SP10) and Zu san li (ST36) significantly increased the number of retrieved mature oocytes and the fertilization rate in patients with poor ovarian reserve who were aged > 37 years or in those who underwent more than one controlled ovarian hyperstimulation cycle (42)

Acupuncture is beneficial for polycystic ovarian syndrome with San yin jiao (SP6) and Zu san li (ST36) or San yin jiao (SP6) and Guan yuan (REN4) being the most commonly used then additional points added depending on the TCM diagnosis (43). 

Acupuncture at San yin jiao was compared to Wei wan xia shu (Extra) for non-insulin resistant poly cystic ovarian syndrome. Both were found to be beneficial at regulating the endocrine aspects of the syndrome (luteinizing hormone, follicle stimulating hormone, testosterone) as well as ovulation rates, but Wei wan xia shu was better at increasing insulin sensitivity and preventing insulin resistance (44).

Acupuncture at He gu, Zu san li, or San yin jiao can significantly benefit rats with gastric carcinectomy’s immune function. Any combination of the above acupuncture points leads to considerable increases in serum IgG, IgM, IgA, C3, C4, CD4+, CD8+ and CD4+/CD8+, whilst reducing CD8+ level. The effects of ST36 + LI4 + SP6 were slightly better than those of the other 6 EA combination of the above acupuncture points. (45).

Acupuncture at Baihui (DU20), Tan zhong (REN17), Qi hai (REN6), Guan yuan (REN4), Zu san li (ST36), He gu (LI4), Tai chong (LR3) and San yin jiao (SP 6) can benefit chronic fatigue syndrome patients improving physical and mental fatigue and total scores. However, warming needling at Bai hui (DU20), Qi hai (REN6), Guanyuan (REN4) and Zu san li (ST36) led to better outcomes on physical and total scores as well as patient satisfaction (46).

A very interesting study looked at the levels of tumor necrosis tactor alpha and C reactive protein levels in healthy individuals before and after acupuncture at 5 differnt locations, San yin jiao, Zu san li, Da zhui, Qu chi and a sham point. There were no statistical significant differences before and after acupuncture and between the groups, except that at the sham point C reactive protein levels reduced. It was a very small study and small changes were observed between the groups and before and after, so perhaps if it was done with enough people more conclusions could be drawn. It also lends credence to the theory that acupuncture is good at regulating the system back to normal across many difference biomechanical pathways, but it won’t make thinks better than baseline in healthy normal people, hence why not much changes were observed in inflammatory markers of healthy individuals, at least this is a possible theory for some processes (47).

Electroacupuncture and Shen men and San yin jiao is more effective than using just one of these points for insomniac patients with anxiety or depression. They improve mental health scores, reduce the level of dopamine which is an excitatory neuropeptide and can be excessive or dysregulated in insomnia and anxiety patients. They also reduce serum norepinephrine, another excitatory neuropeptide that can be problematic in the above conditions (48). 

Electroacupuncture at Nei guan (PC6), Shen men (HT7), Zu san li (ST36), San yin jiao (SP6), Jia ji (EX-B 2) at T5 and L2 can ease methamphetamine withdrawals as help the anxiety and depression that can be associated with the effects building week on week when treatments are given three times a week (49).

The acupuncture prescription of ashi points, Da du (SP2), Tai chong (LR3), Tai bai (SP3), Nei ting (ST44), San yin jiao (SP6), Zu san li (ST36) and Yin ling quan (SP9) on the affected side, and Tai chong (LR3) and Zu san li (ST36), San yin jiao (SP6) and Yinlingquan (SP 9) were connected to electroacupuncture respectively, can help relieve acute gouty arthritis when combined with a low dose of the analgesic diclofenac sodium. This effect was seen across pain scores, joint tenderness and joint swelling and was comparable to high doses of the analgesic alone, meaning acupuncture could be combined to reduce medication and the side effects it can lead to (50). 

Tai bai is the second most commonly used point for gouty arthritis, behind only tai chong and ahead of san yin jiao (51). 

Tai bai is able to improve gout and hyperuricemia, when combined with other Yuan/source points, by reducing serum uric acid, xanthine oxidase, and the kidney index, though front Mu points appear to be more effective (52). 

Acupuncture at Zhong liao (BL33), Hui yang (BL35), Shen shu (BL23) and San yin jiao (SP6) can help patients with chronic pelvic pain. Improving quality of life, reducing pain and improving physical and mental scores as well as showing favourable long term effects (53). 

Acupuncture may be able to prevent osteopenia, as shown in ovariectomized rats. With the point combination of Zu san li and San yin jiao being more effective than Pi shu (BL20) and Shen shu (BL23) in bone anabolic regulation. Higher bone mineral density and bone ash weight were shown as well as lower deoxypyridinoline, the urinary marker of bone resorption. The researchers also noted, ‘microarchitecture and bone morphometry of lumbar vertebrae and tibiae, such as bone volume, trabecular thickness, trabecular number, mineralizing surface, bone formation rate, mineral apposition rate, number of nodes and number of node-terminus struts, also showed the same improvement’ (54).

Acupuncture can be a useful treatment for diabetic peripheral neuropathy, especially if treated early. San yin jiao is the second most used point for this, behind Zu san li (ST36) and ahead of Qu chi (LI11), He gu (LI4) and Tai xi (KI3) (55)

Acupuncture has been used for millenia for erectile dysfunction. Research used datamining tools to discover the most commonly used acupoints and found, in order, Guan yuan (REN4), Shen shu (BL23), San yin jiao (SP6), Ming men (DU4), Zu san li (ST36), Zhong ji (REN3), Ci liao (BL32), Qi hai (REN6), Tai xi (KI3) and Tai chong (LR3) were the ten ten. San yin jiao, Qi hai and guan yuan were the highest confidence combination (56). 

Acupuncture at San yin jiao, as part of two different point combinations can improve male fertility by increasing sperm motility and regulate seminal plasma acid phosphatase levels (57).

San yin jiao and Shen men (HT7) are the most commonly used points and Bai hui (DU20), Si shen cong (Ex-HN 1), San yin jiao (SP6) and Shen men (HT7) is the basis for a point protocol (58). 

A systematic review, involving 4 studies and 288 patients found single acupoint stimulation of SP 6 could improve sleep quality, lengthen deep sleep and REM duration of patients with insomnia, though the quality of studies was low (59). 

Manual acupuncture at Bai hui (DU20) and Shen men (HT7) or at Bai hui and San yin jiao can improve the sleep disorder in insomnia rats, which may be related to its effects in increasing the levels of pineal melatonin protein, and melatonin receptor 1 and melatonin receptor 2 mRNAs in hypothalamic suprachiasmatic nucleus (60).

It was a bit hard to know where to categorize this study, but given previous points I had done I went with the stress response. Anyway, some researchers managed to get funding to test the response in rats to ‘weightlessness’ by ‘tail suspending’ them. It is unclear how they got funding for this. And what benefit would be realised from it. Perhaps they are preparing for mass space travel. It’s a weird spin on the study as rats hate being in the suspended tail state, which is usually used to test prolonged stress and leads to despair in rats. Anyway, they tested electroacupuncture at Nei guan vs San yin jiao and found that electroacupuncture can regulate, ‘5-HT in hypothalamus in tail-suspension rats, inhibit the hyperactivity of the HPA axis, in which EA at “Sanyinjiao” (SP 6) had more significant effects than “Neiguan” (PC 6), but no obvious effects on NE and DA were observed.’ (61).

Electroacupuncture of Wei zhong (BL40), San yin jiao (SP6) and Yin ling quan (SP9), individually, can significantly raise intravesical pressure and bladder adenosine triphosphate content in urine retention rabbits, which may contribute to its effect in improving urinary retention (62).

Acupuncture at San yin jiao, for rats with overactive bladder after cystostomy (post catheterisation) increases the capacity pressure, bladder capacity, detrusor pressure, urinary output and urination rate. It also increases bladder output and urinary output in normal rats and appears to increase the other metrics, though not more so than control (63).

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