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Zhang H, Wang L, Zheng Z, Han J, Li L, Yao W, Li Z, Luo G, Gao B, Shen J, Dong H, Lei C. The use of transcutaneous electrical acupoint stimulation to reduce opioid consumption in patients undergoing off-pump CABG: a randomized controlled trial. Perioper Med (Lond) 2024; 13:68. [PMID: 38970081 PMCID: PMC11225385 DOI: 10.1186/s13741-024-00427-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 06/22/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND High doses of long-acting opioids were used to facilitate off-pump coronary artery bypass grafting procedure, which may result in opioid-related adverse events after surgery. Transcutaneous electrical acupoint stimulation (TEAS) had been reported to be effective in reducing intraoperative opioids consumption during surgery. The aim of this study is to assess whether TEAS with difference acupoints can reduce the doses of opioid analgesics. METHODS This was a multicenter, randomized, controlled, double-blind trial. Patients underwent off-pump coronary artery bypass grafting under general anesthesia were enrolled. Eligible patients were randomly and equally grouped into sham acupuncture group (n = 105), regional acupoints combination group (n = 105), or distal-proximal acupoints combination group (n = 105) using a centralized computer-generated randomization system. Transcutaneous electrical acupoint stimulation was applied for 30 min before anesthesia induction. The primary outcome was the doses of sufentanil during anesthesia. Secondary outcomes included the highest postoperative vasoactive-inotropic scores within 24 h, intraoperative propofol consumption, length of mechanical ventilation, duration of cardiac care unit and postoperative hospital stay, incidence of postoperative complications, and mortality within 30 days after surgery. RESULTS Of the 315 randomized patients, 313 completed the trial. In the modified intention-to-treat analysis, the doses of sufentanil were 303.9 (10.8) μg in the distal-proximal acupoints group, significantly lower than the sham group, and the mean difference was - 34.9 (- 64.9 to - 4.9) μg, p = 0.023. The consumption of sufentanil was lower in distal-proximal group than regional group (303.9 vs. 339.5), and mean difference was - 35.5 (- 65.6 to - 5.5) μg, p = 0.020. The distal-proximal group showed 10% reduction in opioids consumption comparing to both regional and sham groups. Secondary outcomes were comparable among three groups. CONCLUSION Transcutaneous electrical acupoint stimulation with distal-proximal acupoints combination, compared to regional acupoints combination and sham acupuncture, significantly reduced sufentanil consumption in patients who underwent off-pump coronary artery bypass grafting surgery.
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Affiliation(s)
- Hui Zhang
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Lini Wang
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Ziyu Zheng
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Jiange Han
- Department of Anesthesiology, Tianjin Chest Hospital, Tianjin, China
| | - Lin Li
- Department of Anesthesiology, General Hospital of Northern Theater Command, Shenyang, China
| | - Wenlong Yao
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhijian Li
- Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Gang Luo
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Baobao Gao
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Jie Shen
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Hailong Dong
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China
| | - Chong Lei
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China.
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Foley C, Litscher G. A Biophysical Model for Cardiovascular Effects of Acupuncture-Underlying Mechanisms Based on First Principles. Med Acupunct 2022; 34:353-370. [PMID: 36644426 PMCID: PMC9805889 DOI: 10.1089/acu.2022.0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
According to recent translations by medical professionals of the foundational texts of Chinese Medicine, the acupuncture channel system can be reconciled with the neurovasculature. From there, the underlying mechanisms of the effects of acupuncture can be drawn from established physiology and known physical laws. A large body of research has been carried out using cardiovascular markers to measure the effects of acupuncture. Three of these parameters are re-viewed and explored anew in detail. The focus is on changes in microcirculation, blood pressure, and heart rate variability. The physiological mechanisms accounting for the observed changes are proposed to be ascending vasodilatation, resetting of the baroreceptor reflex, and re-organization of heart beating patterns around intrinsically assigned attractor sets.
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Affiliation(s)
- Clare Foley
- Biophysicist and Licensed Acupuncturist (MSc. Biophysics, NP, Ac. Lic.), Dublin, Ireland
| | - Gerhard Litscher
- Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine, Research Unit for Complementary and Integrative Laser Medicine, Department of Anesthesiology and Intensive Care Medicine, Traditional Chinese Medicine (TCM) Research Center Graz, Medical University of Graz, Graz, Austria
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Jia S, Wang Q, Li H, Song X, Wang S, Zhang W, Wang G. The Relationship Between Blood Perfusion in the Lower Extremities and Heart Rate Variability at Different Positions. Front Physiol 2021; 12:656527. [PMID: 34483950 PMCID: PMC8414887 DOI: 10.3389/fphys.2021.656527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 07/23/2021] [Indexed: 11/13/2022] Open
Abstract
Previous studies have explored the relationship between the complexity of local blood flow signals and heart rate variability (HRV) under different thermal stimulations. However, the relationship between the complexity of local blood flow signals and HRV in different positions is not clear. In this study, healthy participants were placed in different body positions. The bilateral blood flux and ECG were monitored, and refined composite multiscale entropy (RC MSE) and refined composite multiscale fuzzy entropy (RC MFE) were used to measure the complexity of the local blood flux. The sample entropy was calculated to evaluate the HRV complexity. The change of body position did not affect the time domain or frequency domain of HRV, but did reverse the blood flux laterality of the lower extremities. Furthermore, there was a negative correlation between the complexity of right-side blood flux and sample entropy of HRV when the participant was in the -10 degrees position. These results provide a new perspective of the relationship between skin blood flux signals and cardiac function.
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Affiliation(s)
- Shuyong Jia
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qizhen Wang
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hongyan Li
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaojing Song
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Shuyou Wang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Weibo Zhang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Guangjun Wang
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
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Benito-Martínez E, Senovilla-Herguedas D, de la Torre-Montero JC, Martínez-Beltrán MJ, Reguera-García MM, Alonso-Cortés B. Local and Contralateral Effects after the Application of Neuromuscular Electrostimulation in Lower Limbs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239028. [PMID: 33287409 PMCID: PMC7730668 DOI: 10.3390/ijerph17239028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/25/2020] [Accepted: 11/30/2020] [Indexed: 11/16/2022]
Abstract
Neuromuscular electrostimulation (NMES) has been used mainly as a method to promote muscle strength, but its effects on improving blood flow are less well known. The aim of this study is to deepen the knowledge about the local and contralateral effects of the application of symmetric biphasic square currents on skin temperature (Tsk). An experimental pilot study was developed with a single study group consisting of 45 healthy subjects. Thermographic evaluations were recorded following the application of NMES to the anterior region of the thigh. The results showed an increase in the maximal Tsk of 0.67% in the anterior region of the thigh where the NMES was applied (p < 0.001) and an increase of 0.54% (p < 0.01) due to cross-education effects, which was higher when the NMES was applied on the dominant side (0.79%; p < 0.01). The duration of the effect was 20 min in the dominant leg and 10 min in the nondominant one. The application of a symmetrical biphasic current (8 Hz and 400 μs) creates an increase in the maximal Tsk at the local level. A temperature cross-education effect is produced, which is greater when the NMES is applied on the dominant side. This could be a useful noninvasive measurement tool in NMES treatments.
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Affiliation(s)
- Elisa Benito-Martínez
- San Juan de Dios School of Nursing and Physical Therapy, Comillas Pontifical University, 28350 Madrid, Spain; (E.B.-M.); (D.S.-H.); (J.C.d.l.T.-M.); (M.J.M.-B.)
| | - Diego Senovilla-Herguedas
- San Juan de Dios School of Nursing and Physical Therapy, Comillas Pontifical University, 28350 Madrid, Spain; (E.B.-M.); (D.S.-H.); (J.C.d.l.T.-M.); (M.J.M.-B.)
| | - Julio César de la Torre-Montero
- San Juan de Dios School of Nursing and Physical Therapy, Comillas Pontifical University, 28350 Madrid, Spain; (E.B.-M.); (D.S.-H.); (J.C.d.l.T.-M.); (M.J.M.-B.)
| | - María Jesús Martínez-Beltrán
- San Juan de Dios School of Nursing and Physical Therapy, Comillas Pontifical University, 28350 Madrid, Spain; (E.B.-M.); (D.S.-H.); (J.C.d.l.T.-M.); (M.J.M.-B.)
| | - María Mercedes Reguera-García
- SALBIS Research Group, Faculty of Health Sciences, Campus of Ponferrada, University of León, 24401 Ponferrada, Spain;
| | - Beatriz Alonso-Cortés
- SALBIS Research Group, Faculty of Health Sciences, Campus of Ponferrada, University of León, 24401 Ponferrada, Spain;
- Correspondence:
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Acupuncture Points and Perforating Cutaneous Vessels Identified Using Infrared Thermography: A Cross-Sectional Pilot Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:7126439. [PMID: 31015854 PMCID: PMC6448333 DOI: 10.1155/2019/7126439] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/20/2019] [Accepted: 03/07/2019] [Indexed: 11/17/2022]
Abstract
Aims To evaluate the presence of perforating cutaneous vessels (PCV) in different lower limb acupuncture points (AP) using thermography. Material and Methods An analytical cross-sectional study was performed on the two lower limbs (n=6) of volunteer subjects. In total, 144 AP and 144 control points (CP) were analysed, one for each AP. First, the AP and CP were located on each individual. Subsequently, both the real and thermographic images were created. In the real images, the location of the AP and the established CP were highlighted with boxes. FLIR Tools Plus and Physio Thermal Imaging software were used to merge the real image with the AP and the CP and to merge the thermographic image with the PCV. By superimposing both images, we were able to verify the presence of PCV among the AP and CP. Results PCV were identified in 87.5% of the 144 AP examined and in 18.1% of the respective CP. All the AP had a higher percentage of PCV compared to their respective CP, with statistically significant differences in all points, except for ST33 and ST34. The probability of finding PCV in AP was 11 times higher than the probability of not finding it. Discussion Thermography may serve as a useful tool in the assessment and treatment of patients using acupuncture. The presence of PCV in the area of the acupuncture needle insertion could partially influence the effects generated by the acupuncture technique from the vascular autonomic point of view. Conclusions There is a high proportion of PCV in the AP area located in the lower limb.
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Changes in Nitric Oxide Releases of the Contralateral Acupoint during and after Laser Acupuncture at Bilateral Same-Name Acupoints in Human. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:5763458. [PMID: 29358966 PMCID: PMC5735645 DOI: 10.1155/2017/5763458] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 09/24/2017] [Accepted: 10/04/2017] [Indexed: 12/22/2022]
Abstract
Objective The purpose of the study was to examine the effects of laser acupuncture (LA) at right Neiguan (RPC6)/left Neiguan (LPC6) acupoints on the releases of nitric oxide (NO) in the treated and contralateral/nontreated PC6, compared to the nonacupoint control area. Methods 24 mW LA at RPC6, LPC6, and nonacupoint in 22 healthy subjects for 40 min: sterilized dialysis tube was taped to the nontreated PC6/nonacupoint during the treatment and immediately taped to the treated and nontreated PC6/nonacupoint after LA removal. NO-scavenging compound was injected into the tube for 40 min to absorb the molecular which was tested by spectrophotometry in a blinded fashion. Results LA-induced NO releases over PC6 acupoints for the nontreated and treated sides all significantly increased after LA removal, but for the nontreated acupoints they did not change during LA stimulation. LA at RPC6 induced the more release of the NO at contralateral side than stimulating LPC6, but not on nonacupoints. The results suggest that LA-induced NO release over contralateral acupoint and NO release resulting from the lateralized specificity all are different and specific to the acupoint within different time course. Conclusions LA-evoked NO release over acupoints could improve the neurogenic, endothelial activity of the vessel wall to further facilitate microcirculation.
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Laterality and coherence analysis of Laser Doppler Flowmetry signals in bilateral Nèi guān (内关 PC 6): a potential non-invasive method to assess microdrculatory changes of people in different ages. WORLD JOURNAL OF ACUPUNCTURE-MOXIBUSTION 2017. [DOI: 10.1016/s1003-5257(17)30099-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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8
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Li F, He T, Xu Q, Lin LT, Li H, Liu Y, Shi GX, Liu CZ. What is the Acupoint? A preliminary review of Acupoints. PAIN MEDICINE 2015; 16:1905-15. [PMID: 25975413 DOI: 10.1111/pme.12761] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 02/02/2015] [Accepted: 03/03/2015] [Indexed: 12/23/2022]
Abstract
BACKGROUND According to traditional Chinese medicine (TCM) theory, acupoints are specifically chosen sites of acupuncture manipulation, and also the basis for studying the mechanism of acupuncture. Stimulating different acupoints on the body surface could provide various therapeutic benefits. However, what is the acupoint? This question is not clear. REVIEW SUMMARY We focuse on examining the function of acupoints from different perspectives, including the local and the systemic effects of stimulating acupoints. For example, acupoints may release certain substances or incur some changes, which could adjust the function of organs, maintain homeostasis. Furthermore, the therapeutic effects of verum acupoints versus sham acupoints were discussed. However, due to insufficience in evidence and in current methodologies, research into mechanisms of acupuncture is still incomplete. CONCLUSION This review might explain, to some extent, what an acupoint is. Further research into the identity of acupoints is warranted, and multidisciplinary methods using novel technologies may yield significant advances over existing knowledge.
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Affiliation(s)
- Fang Li
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, 23 Meishuguanhou Street, Dongcheng District, Beijing, 100010, China.,Graduate school, Tianjin University of Traditional Chinese Medicine, No. 312, Anshan West Road, Nankai District, Tianjin, 300193, China
| | - Tian He
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, 23 Meishuguanhou Street, Dongcheng District, Beijing, 100010, China
| | - Qian Xu
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, 23 Meishuguanhou Street, Dongcheng District, Beijing, 100010, China
| | - Li-Ting Lin
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, 23 Meishuguanhou Street, Dongcheng District, Beijing, 100010, China.,Graduate school, Tianjin University of Traditional Chinese Medicine, No. 312, Anshan West Road, Nankai District, Tianjin, 300193, China
| | - Hui Li
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, 23 Meishuguanhou Street, Dongcheng District, Beijing, 100010, China.,Graduate school, Tianjin University of Traditional Chinese Medicine, No. 312, Anshan West Road, Nankai District, Tianjin, 300193, China
| | - Yan Liu
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, 23 Meishuguanhou Street, Dongcheng District, Beijing, 100010, China.,Graduate school, Tianjin University of Traditional Chinese Medicine, No. 312, Anshan West Road, Nankai District, Tianjin, 300193, China
| | - Guang-Xia Shi
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, 23 Meishuguanhou Street, Dongcheng District, Beijing, 100010, China
| | - Cun-Zhi Liu
- Acupuncture and Moxibustion Department, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, 23 Meishuguanhou Street, Dongcheng District, Beijing, 100010, China
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Acupuncture Regulates the Heart Rate Variability. J Acupunct Meridian Stud 2015; 8:94-8. [DOI: 10.1016/j.jams.2014.10.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Revised: 09/30/2014] [Accepted: 10/14/2014] [Indexed: 11/21/2022] Open
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Zegarra-Parodi R, Snider EJ, Soo Park PY, Degenhardt BF. Laser Doppler Flowmetry in Manual Medicine Research. J Osteopath Med 2014; 114:908-17. [DOI: 10.7556/jaoa.2014.178] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Abstract
Laser Doppler flowmetry (LDF) is commonly used in combination with reactivity tests to noninvasively evaluate skin sympathetic nerve activity and skin microvascular function. In manual medicine research, LDF has been used as a marker for global peripheral sympathetic nervous system function, but these results should be considered with caution because skin sympathetic nerve activity physiology is often overlooked. Another limitation of LDF in manual medicine research is the processing of LDF recordings. Two methods have been suggested: the time-domain analysis and the frequency-domain analysis. Standardization is required for data collection and processing in either domain to accurately interpret these changes in skin blood flow that occur after manual procedures. For physiologic studies using LDF, the authors recommend the use of noninvasive reactivity tests (positive controls) to evaluate the different mechanisms involved in overall skin blood flow changes and to compare the magnitude of these changes with those specifically elicited by manual procedures.
J Am Osteopath Assoc.2014;114(12):908-917 doi:10.7556/jaoa.2014.178
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Affiliation(s)
- Rafael Zegarra-Parodi
- From the A.T. Still Research Institute at A.T. Still University in Kirksville, Missouri (Mr Zegarra-Parodi and Drs Snider and Degenhardt) , and the Department of Neurobehavorial Sciences (Dr Snider) at the A.T. Still University–Kirksville College of Osteopathic Medicine in Missouri (ATSU-KCOM). Student Doctor Park is a third-year osteopathic medical student at ATSU-KCOM
| | - Eric J. Snider
- From the A.T. Still Research Institute at A.T. Still University in Kirksville, Missouri (Mr Zegarra-Parodi and Drs Snider and Degenhardt) , and the Department of Neurobehavorial Sciences (Dr Snider) at the A.T. Still University–Kirksville College of Osteopathic Medicine in Missouri (ATSU-KCOM). Student Doctor Park is a third-year osteopathic medical student at ATSU-KCOM
| | - Peter Yong Soo Park
- From the A.T. Still Research Institute at A.T. Still University in Kirksville, Missouri (Mr Zegarra-Parodi and Drs Snider and Degenhardt) , and the Department of Neurobehavorial Sciences (Dr Snider) at the A.T. Still University–Kirksville College of Osteopathic Medicine in Missouri (ATSU-KCOM). Student Doctor Park is a third-year osteopathic medical student at ATSU-KCOM
| | - Brian F. Degenhardt
- From the A.T. Still Research Institute at A.T. Still University in Kirksville, Missouri (Mr Zegarra-Parodi and Drs Snider and Degenhardt) , and the Department of Neurobehavorial Sciences (Dr Snider) at the A.T. Still University–Kirksville College of Osteopathic Medicine in Missouri (ATSU-KCOM). Student Doctor Park is a third-year osteopathic medical student at ATSU-KCOM
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Abstract
Background: As an important modality of Traditional Chinese Medicine, acupuncture has been widely accepted by the Western world in the past 4 decades because of this modality's efficacy and safety. A vast amount of acupuncture research has been done. However, the mechanisms of acupuncture actions are still elusive. It is believed that the effects of acupuncture treatment begin from the moment of needle insertion. Methods: This review focuses on the acupuncture points and the three major reactions at the acupuncture points when needling is performed. These initial reactions may be the beginning of the healing process that initiates downstream effects through neuronal and humoral pathways. In addition to the physical reactions, this article also discusses the possibility of the effects of acupuncture on the healing process through a holistic pathway. Conclusions: Needling is the first step of traditional acupuncture therapy. Needling reactions- neuronal, biophysical, and biochemical-are the beginning of healing. The messengers of the three reactions involved may include neurotransmitters, cytokines, hormones, and inflammatory factors. Healing may be potentiated through these messengers in neuronal and humoral pathways. The reactions manifest as erythema and De Qi-both of which are common phenomena used as positive signs in acupuncture treatment. Acupuncture may also play a role in the healing process through the holistic pathway, which needs further study.
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Affiliation(s)
- Heming Zhu
- Department of Integrative Health Sciences, Maryland University of Integrative Health , Laurel, MD
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12
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Bilateral hegu acupoints have the same effect on the heart rate variability of the healthy subjects. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 2014:106940. [PMID: 25057272 PMCID: PMC4099173 DOI: 10.1155/2014/106940] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 06/12/2014] [Indexed: 11/21/2022]
Abstract
Background. The specificity of acupuncture points (acupoints) is one of the key concepts in traditional acupuncture theory, but the question of whether there is adequate scientific evidence to prove or disprove specificity has been vigorously debated in recent years. Acupoint laterality is an important aspect of acupoint specificity. Data is particularly scarce regarding the laterality of the same channel, namesake acupoint located on opposite sides of the body. Our previous study results suggest that Neiguan acupoint (PC6) has the laterality. The aim of this study was to investigate whether Hegu (LI4) also has laterality from the perspective of heart rate variability. Methods. A total of twenty-eight healthy female volunteers were recruited for this study and were randomly separated into the group I (n = 14) and the group II (n = 14) according to the register order. In the group I, left LI4 was stimulated in the first epoch and the right LI4 was stimulated in the second epoch. In the group II, right LI4 was stimulated in the first epoch and left LI4 was stimulated in the second epoch. Electrocardiogram was recorded and heart rate variability was analyzed. Results. The results show that there were no significant differences of heart rate variablity between the group I and the group II in the time domain and in the frequency domain. Conclusions. Bilateral Hegu acupoints have the same effect on the heart rate variability of the healthy subjects.
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Pilot study of acupuncture point laterality: evidence from heart rate variability. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:476064. [PMID: 24371461 PMCID: PMC3863465 DOI: 10.1155/2013/476064] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 11/06/2013] [Accepted: 11/06/2013] [Indexed: 11/17/2022]
Abstract
The specificity of acupuncture points (acupoints) is one of the key concepts in traditional acupuncture theory, but the question of whether there is adequate scientific evidence to prove or disprove specificity has been vigorously debated in recent years. Laterality, or the tendency for acupoints on the right or left side of the body to produce different physiological effects, is an important aspect of acupoint specificity. Data is particularly scarce regarding the laterality of the same channel, same-named acupoint located on opposite sides of the body. The aim of this study was to investigate whether Neiguan (PC6) has laterality. A total of eighteen healthy female volunteers were recruited for this study. Electrocardiograms were recorded and heart rate variability was analyzed before, during, and after PC6 was stimulated on either the left or the right side. The results show that during acupuncture, there were significant differences in the standard deviation of RR intervals (STDRR), root mean square of successive differences between RR intervals (RMSSD), and total power between the left PC6 stimulation group and the right PC6 stimulation group, which indicates that PC6 may have laterality.
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Shin KM, Kim JH, Lee S, Shin MS, Kim TH, Park HJ, Lee MH, Hong KE, Lee S, Choi SM. Acupuncture for lateral epicondylitis (tennis elbow): study protocol for a randomized, practitioner-assessor blinded, controlled pilot clinical trial. Trials 2013; 14:174. [PMID: 23768129 PMCID: PMC3685553 DOI: 10.1186/1745-6215-14-174] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 05/31/2013] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Lateral epicondylitis is the most frequent cause of pain around the elbow joint. It causes pain in the region of the elbow joint and results in dysfunction of the elbow and deterioration of the quality of life. The purpose of this study is to compare the effects of ipsilateral acupuncture, contralateral acupuncture and sham acupuncture on lateral epicondylitis. METHODS/DESIGN Forty-five subjects with lateral epicondylitis will be randomized into three groups: the ipsilateral acupuncture group, contralateral acupuncture group and the sham acupuncture group. The inclusion criteria will be as follows: (1) age between 19 and 65 years with pain due to one-sided lateral epicondylitis that persisted for at least four weeks, (2) with tenderness on pressure limited to regions around the elbow joint, (3) complaining of pain during resistive extension of the middle finger or the wrist, (4) with average pain of NRS 4 or higher during the last one week at a screening visit and (5) voluntarily agree to this study and sign a written consent. Acupuncture treatment will be given 10 times in total for 4 weeks to all groups. Follow up observations will be conducted after the completion of the treatment, 8 weeks and 12 weeks after the random assignment. Ipsilateral acupuncture group and contralateral acupuncture group will receive acupuncture on LI4, TE5, LI10, LI11, LU5, LI12 and two Ashi points. The sham acupuncture group will receive treatment on acupuncture points not related to the lateral epicondylitis using a non-invasive method. The needles will be maintained for 20 minutes. The primary outcome will be differences in the visual analogue scale (VAS) for elbow pain between the groups. The secondary outcome will be differences in patient-rated tennis elbow evaluation (PRTEE), pain-free/maximum grip strength (Dynamometer), pressure pain threshold, clinically relevant improvement, patient global assessment, and the EQ-5D. The data will be analyzed with the paired t-test and ANCOVA (P <0.05). DISCUSSION The results of this study will allow evaluation of contralateral acupuncture from two aspects. First, if the contralateral acupuncture shows the effects similar to ipsilateral acupuncture, this will establish clinical basis for contralateral acupuncture. Second, if the effects of contralateral acupuncture are not comparable to the effects of ipsilateral acupuncture, but are shown to be similar to the effects of the sham acupuncture, we can establish the basis for using the same acupoints of the unaffected side as a control in acupuncture clinical studies. TRIAL REGISTRATION This trial has been registered with the 'Clinical Research Information Service (CRIS)', Republic of Korea: KCT0000628.
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Affiliation(s)
- Kyung-Min Shin
- Department of Medical Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Joo-Hee Kim
- Department of Medical Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Seunghoon Lee
- Department of Medical Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Mi-Suk Shin
- Department of Medical Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Tae-Hun Kim
- Clinical research center, MokHuri Neck&Back Hospital, Seoul, South Korea
| | - Hyo-Ju Park
- Department of Medical Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Min-Hee Lee
- Department of Medical Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Kwon-Eui Hong
- Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Daejeon University, Daejeon, South Korea
| | - Seungdeok Lee
- Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Dongguk University, Gyeongju, South Korea
| | - Sun-Mi Choi
- Department of Medical Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
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15
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Evaluate laser needle effect on blood perfusion signals of contralateral hegu acupoint with wavelet analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:103729. [PMID: 23024689 PMCID: PMC3450915 DOI: 10.1155/2012/103729] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2012] [Revised: 08/01/2012] [Accepted: 08/03/2012] [Indexed: 12/15/2022]
Abstract
Our previous studies suggested that the MBF in contralateral Hegu acupoint (IL4) increased after ipsilateral Hegu acupoint was stimulated with manual acupuncture. In this study, twenty-eight (28) healthy volunteers were recruited and were randomly divided into Hegu acupoint stimulation group and Non-Hegu stimulation group. All subjects received the same model stimulation of the laser needle for 30 min in right Hegu acupoint and Non-Hegu acupoint, respectively. MBF of left LI4 was measured by the laser Doppler perfusion imaging system. The original data dealt with morlet wavelet analysis and the average amplitude and power spectral density of different frequency intervals was acquired. The results indicated that right Hegu stimulation with the laser needle might result in the increase of left Hegu acupoint MBF. 40 min later after ceased stimulation, the MBF is still increasing significantly, whereas the MBF has no significantly change in Non-Hegu stimulation group. The wavelet analysis result suggested that compared to Non-Hegu stimulation, stimulated to right Hegu acupoint might result in the increase of average amplitude in frequency intervals of 0.0095-0.02 Hz, 0.02-0.06 Hz, and 0.06-0.15 Hz, which might be influenced by the endothelial, neurogenic, and the intrinsic myogenic activity of the vessel wall, respectively.
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