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Electroacupuncture at Zusanli Prevents Severe Scalds-Induced Gut Ischemia and Paralysis by Activating the Cholinergic Pathway. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:787393. [PMID: 26448777 PMCID: PMC4581501 DOI: 10.1155/2015/787393] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 08/24/2015] [Accepted: 08/30/2015] [Indexed: 02/07/2023]
Abstract
Severe burn injuries may result in gastrointestinal paralysis, and barrier dysfunction due to gut ischemia and lowered vagus excitability. In this study we investigate whether electroacupuncture (EA) at Zusanli (ST36) could prevent severe scalds-induced gut ischemia, paralysis, and barrier dysfunction and whether the protective role of EA at ST36 is related to the vagus nerve. 35% burn area rats were divided into six groups: (a) EAN: EA nonchannel acupoints followed by scald injury; (b) EA: EA at ST36 after scald injury; (c) VGX/EA: vagotomy (VGX) before EA at ST36 and scald injury; (d) VGX/EAN: VGX before EAN and scald injury; (e) atropine/EA: applying atropine before scald injury and then EA at ST36; (f) atropine/EAN: applying atropine before scald injury and then EA at nonchannel acupoints. EA at the Zusanli point significantly promoted the intestinal impelling ratio and increased the amount of mucosal blood flow after scald injury. The plasma diamine oxidase (DAO) and intestinal permeability decreased significantly after scald injury in the EA group compared with others. However, EA after atropine injection or cervical vagotomy failed to improve intestinal motility and mucosa blood flow suggesting that the mechanism of EA may be related to the activation of the cholinergic nerve pathway.
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Hemodynamic changes in the brachial artery induced by acupuncture stimulation on the lower limbs: a single-blind randomized controlled trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2012:958145. [PMID: 23304231 PMCID: PMC3525317 DOI: 10.1155/2012/958145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Revised: 10/16/2012] [Accepted: 10/30/2012] [Indexed: 01/22/2023]
Abstract
Acupuncture is commonly performed at acupoints. No comparisons of quantitative physiological alterations in the brachial artery (BA) induced by the stimulation of different acupoints in the lower limbs have been performed in humans. Therefore, we investigated changes in blood flow volume (BFV) in the BA as an indicator of the physiological effects induced by stimulation at 3 points. Seventy-five healthy participants aged 33 ± 9 years (mean ± SD) were enrolled and randomly assigned to 3 groups; they received stimulation at 3 different points located on the lower limbs: ST36, LR3, and a non-acupoint. Stimulation was performed bilaterally with manual rotation of the needles. Using ultrasonography, BFV was measured continuously from rest to 180 seconds after stimulation. LR3 stimulation significantly increased BFV compared to that before needle insertion. Meanwhile, stimulation at ST36 and the non-acupoint significantly decreased BFV compared to that before needle insertion. Stimulation at LR3 elicited a significant increase in BFV compared to that at ST36 and the non-acupoint. The results suggest that the stimulation of different points on the lower limbs causes distinct physiological effects on BFV in the BA.
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Haemodynamic changes in the superior mesenteric artery induced by acupuncture stimulation on the lower limbs. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:908546. [PMID: 22675391 PMCID: PMC3366235 DOI: 10.1155/2012/908546] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Revised: 02/09/2012] [Accepted: 03/19/2012] [Indexed: 11/18/2022]
Abstract
Acupuncture is commonly performed on acupoints. A comparison of quantitative physiological alterations induced by stimulation on different acupoints has never been performed in the superior mesenteric artery (SMA) in humans. Therefore, we investigated changes in blood flow volume (BFV) in the SMA as an indicator of physiological effects induced by stimulation on 3 points. Thirty healthy participants aged 29 ± 10 years (mean ± SD) were enrolled. All participants underwent stimulations on 3 points located in the lower legs: ST36, LR3, and a non-acupoint. Control pertains to a condition with no-stimulation. Stimulation was performed bilaterally with manual rotation of the needles. BFV was measured by ultrasonography before insertion and 10, 20, 30, and 60 minutes after stimulation. Following acupuncture on ST36, BFV increased significantly 20 and 30 minutes after stimulation, compared to BFV before insertion (P < 0.05). Following stimulation on LR3 and the non-acupoint, no significant differences in BFV could be found. Relative to the no-stimulation group, stimulation on LR3, and the non-acupoint, stimulation on ST36 elicited a significant increase in BFV (P < 0.05). The results suggest that stimulation on the different points causes distinct physiological effects in BFV in the SMA.
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Bai Y, Wang J, Wu JP, Dai JX, Sha O, Tai Wai Yew D, Yuan L, Liang QN. Review of evidence suggesting that the fascia network could be the anatomical basis for acupoints and meridians in the human body. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2011; 2011:260510. [PMID: 21584283 PMCID: PMC3092510 DOI: 10.1155/2011/260510] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Revised: 02/04/2011] [Accepted: 02/28/2011] [Indexed: 11/18/2022]
Abstract
The anatomical basis for the concept of meridians in traditional Chinese medicine (TCM) has not been resolved. This paper reviews the evidence supporting a relationship between acupuncture points/meridians and fascia. The reviewed evidence supports the view that the human body's fascia network may be the physical substrate represented by the meridians of TCM. Specifically, this hypothesis is supported by anatomical observations of body scan data demonstrating that the fascia network resembles the theoretical meridian system in salient ways, as well as physiological, histological, and clinical observations. This view represents a theoretical basis and means for applying modern biomedical research to examining TCM principles and therapies, and it favors a holistic approach to diagnosis and treatment.
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Affiliation(s)
- Yu Bai
- Department of Anatomy, Southern Medical University, Guangzhou 510515, China
| | - Jun Wang
- Department of Anatomy, School of Medicine of Shenzhen University, Shenzhen 518060, China
| | - Jin-peng Wu
- Department of Anatomy, Southern Medical University, Guangzhou 510515, China
| | - Jing-xing Dai
- Department of Anatomy, Southern Medical University, Guangzhou 510515, China
| | - Ou Sha
- Department of Anatomy, School of Medicine of Shenzhen University, Shenzhen 518060, China
| | - David Tai Wai Yew
- Department of Anatomy, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Lin Yuan
- Department of Anatomy, Southern Medical University, Guangzhou 510515, China
| | - Qiu-ni Liang
- Department of Anatomy, School of Medicine of Shenzhen University, Shenzhen 518060, China
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Pfab F, Winhard M, Nowak-Machen M, Napadow V, Irnich D, Pawlik M, Bein T, Hansen E. Acupuncture in critically ill patients improves delayed gastric emptying: a randomized controlled trial. Anesth Analg 2010; 112:150-5. [PMID: 21081772 DOI: 10.1213/ane.0b013e3181fdfac8] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Malnutrition remains a severe problem in the recovery of critically ill patients and leads to increased in-hospital morbidity and in-hospital stay. Even though early enteral nutrition has been shown to improve overall patient outcomes in the intensive care unit (ICU), tubefeed administration is often complicated by delayed gastric emptying and gastroesophageal reflux. Acupuncture has been successfully used in the treatment and prevention of perioperative nausea and vomiting. In this study we evaluated whether acupuncture can improve gastric emptying in comparison with standard promotility drugs in critically ill patients receiving enteral feeding. METHODS Thirty mechanically ventilated neurosurgical ICU patients with delayed gastric emptying, defined as a gastric residual volume (GRV) >500 mL for ≥ 2 days, were prospectively and randomly assigned to either the acupoint stimulation group (ASG; bilateral transcutaneous electrical acupoint stimulation at Neiguan, PC-6) or the conventional promotility drug treatment group (DTG) over a period of 6 days (metoclopramide, cisapride, erythromycin). Patients in the ASG group did not receive any conventional promotility drugs. Successful treatment (feeding tolerance) was defined as GRV <200 mL per 24 hours. RESULTS Demographic and hemodynamic data were similar in both groups. After 5 days of treatment, 80% of patients in the ASG group successfully developed feeding tolerance versus 60% in the DTG group. On treatment day 1, GRV decreased from 970 ± 87 mL to 346 ± 71 mL with acupoint stimulation (P = 0.003), whereas patients in the DTG group showed a significant increase in GRV from 903 ± 60 mL to 1040 ± 211 mL (P = 0.015). In addition, GRV decreased and feeding balance (defined as enteral feeding volume minus GRV) increased in more patients in the ASG group (14 of 15) than in the DTG group (7 of 15; P = 0.014). On treatment day 1, the mean feeding balance was significantly higher in the ASG group (121 ± 128 mL) than in the DTG group (-727 ± 259 mL) (P = 0.005). Overall, the feeding balance improved significantly on all days of treatment in comparison with the DTG group. Patients in the DTG group did not show an increase in feeding balance until day 6. CONCLUSIONS We introduce a new protocol for acupuncture administration in the critical care setting. We demonstrated that this protocol was more effective than standard promotility medication in the treatment of delayed gastric emptying in critically ill patients. Acupoint stimulation at Neiguan (PC-6) may be a convenient and inexpensive option (with few side effects) for the prevention and treatment of malnutrition in critically ill patients.
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Affiliation(s)
- Florian Pfab
- Department of Anesthesiology, University Hospital Regensburg, Regensburg, Germany
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Bai Y, Yuan L, Soh KS, Lee BC, Huang Y, Wang CL, Wang J, Wu JP, Dai JX, Palhalmi J, Sha O, Yew DTW. Possible applications for fascial anatomy and fasciaology in traditional Chinese medicine. J Acupunct Meridian Stud 2010; 3:125-32. [PMID: 20633527 DOI: 10.1016/s2005-2901(10)60023-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2010] [Accepted: 04/13/2010] [Indexed: 10/19/2022] Open
Abstract
Research using medical imaging instruments such as computed tomography and magnetic resonance imaging has led to the proposal that the fascial network distributed over the human body is the anatomical basis for the acupoints and meridians of traditional Chinese medicine. Therefore, we put forward a new theory of anatomy called fascial anatomy. In fascial anatomy, a human body is divided into two major systems. One is the supporting-storing system of unspecialized connective tissues. The other is a functional system. An undifferentiated non-specific connective tissue network, with the participation of the nervous and the immune systems, constitutes the supporting-storing system of the human body. The various differentiated functional cells in the body that are supported and surrounded by the supporting-storing system constitute the functional system. The discipline that studies the supporting-storing system and the mutual relationship between this system and the functional system in a living human body is called fasciaology. The establishment of fascial anatomy and fasciaology opens a new research field in anatomy; consequently, fasciaology will play a significant role in biological medicine and traditional Chinese medical research, as well as future clinical practice.
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Affiliation(s)
- Yu Bai
- Department of Anatomy, Southern Medical University, Guangzhou, China
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Hsiu H, Huang SM, Chao PT, Jan MY, Hsu TL, Wang WK, Wang YYL. Microcirculatory characteristics of acupuncture points obtained by laser Doppler flowmetry. Physiol Meas 2007; 28:N77-86. [PMID: 17906382 DOI: 10.1088/0967-3334/28/10/n01] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Acupuncture points (acupoints) form part of the meridian system that constitutes the most fundamental concept in oriental medicine, but their physiological basis has not been clarified. In this study we employed laser Doppler flowmetry (LDF) to extract the microcirculatory characteristics of acupoints and their surrounding tissues, and we interpreted the results from the viewpoint of microcirculatory physiology. Three groups of measurements were performed focusing on the following two important acupoints in oriental medicine in healthy volunteers (n = 13 for group A and n = 9 for groups B and C, respectively): Hoh-Ku (Li4, on the hand) and Ching-Ku (B64, on the foot). The two groups of measurements around Hoh-Ku (Groups A and B) were so designed as to examine the effect of the direction of the nonacupoint away from the acupoint, whereas comparison between the Hoh-Ku and the Ching-Ku measurements was to verify whether the phenomenon was consistent in the upper and the lower extremities. We found that the mean LDF signals were significantly larger at the acupoints than in their surrounding tissues (all p < 0.05), which indicates a larger blood supply into the microvascular beds of acupoints. The results indicate that the physical properties of the vascular structure of acupoints may affect the perfusion resistance, and thereby modulate the microcirculatory perfusion in accordance with tissue needs. This finding facilitates the localization of acupoints, helps in identifying the connection between microcirculatory physiology and responses to acupoint stimulation, and introduces an objective research method for understanding the mechanisms that underlie oriental medicine.
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Affiliation(s)
- Hsin Hsiu
- Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan, Republic of China.
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Hsiu H, Huang SM, Chao PT, Hsu WC, Hsu CL, Jan MY, Wang WK, Wang YYL. Study on the microcirculatory blood velocity of acupoint monitored by laser Doppler signal. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2007; 2007:959-962. [PMID: 18002117 DOI: 10.1109/iembs.2007.4352451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Meridian system composed of acupoints is the most fundamental concept to build oriental medicine. In this study, we employ LDF measurement to compare the microcirculatory blood velocity of acupuncture point and its surrounding tissues. Measurements were performed around an important acupoint in oriental medicine, Hoh-Ku (Li4, on the hand), in healthy volunteers. The study presented has shown that the acupoints have significantly slower mean blood velocity than their surrounding tissues (p all < 0.005). This finding facilitates the detection of the position of acupuncture point and helps us to provide a possible connection between microcirculatory physiology and the underlying mechanism of acupoints.
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Affiliation(s)
- Hsin Hsiu
- Department of Electrical Engineering, Yuan Ze Univieristy, Taoyuan, Taiwan.
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Abstract
Increasingly, individuals are turning to complementary therapies to reduce or cope with chronic pain. Acupuncture, one of the oldest complementary therapies, originated from China more than 2500 years ago. It has steadily gained popularity in the United States over the last few decades as a modality for pain relief among both practitioners and patients. A 1997 National Institutes of Health consensus conference concluded that acupuncture needling releases endorphins and other neurotransmitters in the brain and should be considered as an appropriate pain treatment option. This article will provide an overview about acupuncture principles, discuss current clinical evidence, and identify acupuncture resources to optimize practice for chronic pain management.
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Affiliation(s)
- Ladan Eshkevari
- Department of Anesthesia Pain Services, Georgetown University Hospital, Georgetown University School of Nursing and Health Studies, 1920 12th Street NW #2, Washington, DC 20009, USA.
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Critical Care Nurses’ Desire to Use Complementary Alternative Modalities (CAM) in Critical Care and Barriers to CAM Use. Dimens Crit Care Nurs 2003. [DOI: 10.1097/00003465-200305000-00009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Abstract
People experiencing blunt thoracic trauma may sustain multiple rib fractures, flail chest, cardiac or pulmonary contusions, injury to the great vessels, sternal fractures, clavicular fractures, neck injuries, and lacerations of the liver and/or spleen. Long-term sequelae from blunt chest trauma include chest wall deformities, persistent dyspnea, and cardiac, neurologic, or esophageal complications. Chronic pain, depression, and loss of functional status are also frequent components of recovery from trauma.
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Affiliation(s)
- T P Yeo
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
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