Study Of Acupuncture Action On Local And Central Modulating Mechanisms

Part one: Physiological Study on the Microcirculation ofAcupuncture PointObjective: To observe the blood flow rate of acupuncture point and control point of four meridians.Methods: Blood flow rate of 12 acupoint of Large Intestine Meridian, Pericardium Meridian, Spleen Meridian and Gallbladder Meridian and relevant control point were measured by Laster Doppler Flowmeter (Perimed, Sweden) on 20 healthy volunteers. Average value of Blood flow rate of acupoint and relevant control point were observed and compared.Results: Blood flow rate of 12 acupoints are significant higher than that of control points (P<0.01).Conclusion: The high blood flow rate is the character of acupoint. Part two: Study on Influence of Acupuncture on tcPaO₂ and tcPaCO₂ of Distal AcupointObjective: To study the effect of acupuncture at Hehu (LI 4) and relevant control point on tcPaO₂ and tcPaCO₂ of diastal acupoint of Quchi (LI 11).Methods: tcPaO₂ and tcPaCO₂ of acupoint of Quchi and relevant control point were measured by Laster Doppler Flowmeter (Perimed, Sweden) while acupuncture at Hehu and relevant control point on 20 healthy volunteers. Average value of tcPaO₂ and tcPaCO₂ of acupoint of Quchi and relevant control point before acupuncture and after acupuncture for 1 minute, 5 minute and 10 minute were observed and compared.Results: (1) After acupuncturing at Hehu for 1 minute, there was no statistical difference for tcPaO₂ and tcPaCO₂ of Quchi acupoint compare with the value of tcPaO₂ and tcPaCO₂ before acupuncture. 5 minutes late, the value of tcPaO₂ of Quchi acupoint was significant higher than before acupuncture (P<0.01) and the value of tcPaCO₂ of Quchi acupoint was significant lower than before acupuncture (P<0.05). 10 minutes late, the value of tcPaO₂ of Quchi acupoint remain the level of 5minutes but still higher than that of beginning(P<0.01). 10 minutes late, the value of tcPaCO₂ of Quchi acupoint decreased compared with that of 5 minutes, but there was no statistical difference between before acupuncture and 10 minutes late. (2) Acupuncturing at Hehu for 1 minute, there was no statistical difference for tcPaO₂ and tcPaCO₂ of control point beside Quchi acupoint compare with the value of tcPaO₂ and tcPaCO₂ before acupuncture. 5 minutes late, the value of tcPaO₂ of control point was significant higher than before acupuncture (P<0.01) and the value of tcPaCO₂ of Quchi acupoint was significant lower than before acupuncture (P<0.05). 10 minutes late, the value of tcPaO₂ of control point decreased, and there was no statistical difference between before acupuncture and 10 minutes late. 10 minutes late, the value of tcPaCO₂ of control point increased, and there was no statistical difference between before acupuncture and 10 minutes late. (3) Acupuncturing at control point beside Hehu acupoint for 1minute, 5 minutes and 10minutes, there was no statistical difference for tcPaO₂ and tcPaCO₂ of Quchi.Conclusion: tcPaO₂ and tcPaCO₂ of diastal acupoint and relevant control point along meridian were changed by acupuncture at Hegu acupoint. While tcPaO₂ and tcPaCO₂ of diastal acupoint and relevant control point along meridian were not changed by acupuncture at control point beside Hegu acupoint. The change of tcPaO₂ and tcPaCO₂ may connect with increasing blood stream and metabolism by stimulating acupoint. The change of tcPaO₂ and tcPaCO₂ of acupoint remained more longer than control point. So we conclude that meridian really exists and the phenomena of propagated sensation along meridian exist.Part Three: Effect of Acupuncture Sanyinjiao(SP 6) on Brain Carbohydrate metabolism with PET Imaging of the Brain1. PET Brain functional Images Research of Paients with PrimaryDysmenorrheaObjective: To investigate the central modulating mechanisms on primary dysmenorrhea.Methods: ¹⁸F-FDG positron emission tomograph (PET) imaging of whole brian was performed from thirteen paients with primary dysmenorrhea during pain on menstruation and twelve healthy women. The change areas of the cerebral glycometabolism were obtained by using Statistical Parametric Mapping(SPM).Results: The increaseing glycometabolism brain areas of the paients with primary dysmenorrhea are as follow: right Middle Frontal Gyrus, bilateral Dorsolateral Prefrontal Cortex , bilateral Orbital Gyru, bilateral Orbitofrontal, bilateral Anterior Cingulate, bilateral primary somatosensory cortex, bilateral supplementary motor area, bilateral primary motor cortex.The increasing areas are mostly related to pain. The decreaseing glycometabolism brain areas were bilateral Temporal Gyrus, bilateral insula, bilateral Caudate Tail, left Parahippocampal Gyrus, bilateral Corpus Callosum, left Hypothalamus, bilateral Posterior Cingulate, and left cuneus.The decreasing areas are mostly related to emotion.Conclusion Dysmenorrhea actived areas involved in pain. Many brain areas related to emotion were changed too, so emotion factor may paly an important role in dysmenorrhea.2. Research on PET Brain functional Images of Acupuncture atSanyinjiao(SP 6)Objective: To investigate the central modulating mechanisms on acupuncture at SP6.Methods: We performed positron emission tomography (PET) imaging in healthy female volunteers to map the CNS pathway for real acupuncture at SP6. ¹⁸F-FDG PET imagings of whole brain were performed from six subjects twice for a first false acupuncture and a second real acupuncture. The change brain areas of the increasing and decreasing glucose metabolism were obtained by using Statistical Parametric Mapping (SPM) analysis.Results: The increasing glucose metabolic brain areas of acupuncture at SP6 were contralateral primary somatosensory cortex , contralateral primary motor cortex ,bilateral supplementary motor area (SMA), contralateral pre-SMA, bilateral anterior cingulate, bilateral dorsolateral prefrontal cortex and contralateral medial prefrontal cortex. The decreasing glucose metabolic brain areas were lingual gyrus, hippocampus and parahippocampal gyrus.Conclusions: Brain may be the foundation of treating diseases by acupuncture. The acupuncture signal transmits to brain which integrates the acupuncture message with body's and accordingly regulates the body's physiology.3. Effect of Acupuncture Sanyinjiao(SP 6) on Brain Carbohydratemetabolism in Patients with Primary DysmenorrheaObjective To investigate the central modulating mechanisms on the treatment of puncturing the acupoint SP 6 in patients with primary dysmenorrhea.Methods: ¹⁸F-FDG positron emission tomograph imaging of whole brian was performed from six patients with primary dysmenorrhea during two stimulation paradigms: pseudo-acupuncture and real acupuncture at SP6. The change areas of the cerebral glycometabolism were obtained by using statistical parametric mapping(SPM). Meanwhile we assessed the pain intensity before and after pseudo-acupuncture and real acupuncture with 0-10 numerical pain intensity scale.Results: No differences in the value of pain before and after pseudo-acupuncture (P >0.05). The value of pain after acupuncture significant lower than before acupuncture (P<0.01) .Most of the activated brain areas are shared with areas activated in pain states as described in the literature. The brian areas of increasing glycometabolism were ipsilateral Lentiform Nucleus(Globus Pallidus, Putamen),ipsilateral cerebellum, ipsilateral insula, bilateral Thalamus, ipsilateral paracentral lobule, bilateral Amygdala, contralateral midbrain, bilateral second somatosensory cortex, ipsilateral Hippocampus, ipsilateral anterior cingulate, contralateral mammillary body. The brian areas of decreasing glycometabolism were limited in small cerebral cortex.Conclusion: Acupuncture SP6 significantly relieved the pain of patients. The treatment of puncturing SP6 in patients with Primary Dysmenorrhea appears to mainly act by activating area also involved in pain. This indicates that acupuncture could relief pain by unbalancing the equilibrium of distributed pain-related central net-works. Neuroendocrine may be acted in therapy. 4. Different Cerebral Response to Acupuncture on Patients with PrimaryDysmenorrhea and Normal Subjects — Evidence from PET StudiesObjective: To observe the effect of brain carbohydrate metabolism while acupuncture at Sanyinjiao (SP6) on in healthy female volunteers and the patients with primary dysmenorrheal.Methods: ¹⁸F-FDG positron emission tomography (PET) imaging of whole brain was performed from six healthy female volunteers and six patients with primary dysmenorrhea during two stimulation paradigms: pseudo-acupuncture and real acupuncture at SP6. The change areas of the cerebral glycometabolism were obtained by using statistical parametric mapping (SPM). The change brain areas of carbohydrate metabolism of two group were compared by the results of SPM analysis.Results: (1) The same actived brain areas: the carbohydrate metabolism of S I and M I increased. (2) The different brain areas: â‘ The carbohydrate metabolism of SII increased in patients of primary dysmenorrheal while there was no change in healthy volunteers. (2)The carbohydrate metabolism of anterior cingutate( ACC)in two groups are all increased, but the parts in ACC are different. â‘¢Acupuncture on patients with primary dysmenorrheal increased the metabolism of limbic system, while acupuncture on healthy volunteers increased the metabolism of cerebral cortex.â‘£The carbohydrate metabolism of cerebellum increased in patients of primary dysmenorrheal by acupuncture stimulating while there was no change in healthy volunteers.Conclusion: Acupuncture at the same acupoint in both healthy volunteers and patients of primary dysmenorrheal results in different actived brain areas of carbohydrate metabolism. IT shows that acupuncture has the effect of dual-direction regulation.