Pressure Pain Threshold at Danzhong (CV17) as an Exploratory Correlate of Hwabyung Symptom Severity

Background: In traditional East Asian medicine, suppressed Qi is believed to contribute to pain. Building on this concept, Hwabyung is understood as a psychosomatic disorder which results from suppressed anger. Danzhong (CV17), a key acupoint on the Conception Vessel involved in regulating Qi, is commonly utilized to alleviate core Hwabyung-related symptoms such as chest tightness. This study aimed to evaluate the potential role of the pressure pain threshold (PPT) at CV17 for identifying Hwabyung-related psychosomatic distress and assessing symptom severity.Methods: This study was designed as a prospectively enrolled cross-sectional study. A total of 182 patients were classified as either diagnosed or undiagnosed with Hwabyung. All participants completed self-report questionnaires which assessed Hwabyung, depression, and anxiety. Subsequently, PPTs were measured at 3 sites: CV17, Neiguan (PC6), and a nonacupoint control site located 5 cm superior to CV17.Results: The area under the curve for the PPT at CV17 was 0.739, with a sensitivity of 0.560 and a specificity of 0.841 at the identified cutoff value. Although PPT at CV17 did not demonstrate superior classification performance compared with the control sites (p > 0.05), it was the only site that was significantly associated with Hwabyung symptom severity after controlling for Hwabyung diagnostic status (p = 0.043). PPTs at all sites were not significantly associated with the severity of depressive or anxiety symptoms.Conclusion: PPT at CV17 may represent an exploratory cross-sectional correlate of Hwabyung symptom severity. Prospective longitudinal studies are needed to determine its clinical utility for diagnosis and symptom monitoring.