Electrodermal activity as a possible physiological marker for acupuncture.

Change in amplitude of skin potential is one of the physiological indicators of electrodermal activity (EDA) and has been associated with the onset of a variety of sensory, cognitive and emotional stimuli. This study investigated the EDA physiological response to manual acupuncture. A group of 60 healthy female volunteers were recruited into the study of which 30 were randomly assigned to a control group (no acupuncture) and 30 to the experimental group (received acupuncture). The experimental group attended three sessions in which acupuncture intervention consisting of unilateral manual stimulation of acupuncture points LU7 and KD6. Results showed that the insertion, stimulation and withdrawal of the acupuncture needles were associated with significant changes in EDA. The insertion of the needle was associated with the highest change in skin potential while the three consecutive manipulations of the needles showed a decline in EDA amplitude, thought to be consistent with physiological habituation. Anxiety level and previous familiarity with acupuncture did not influence outcomes. It is postulated that the change in EDA during needle insertion is non-specific to the type and the function of acupuncture points; however, EDA response may be associated with the precise location of the acupuncture point. If further studies confirm such findings, then EDA may become a valuable physiological marker for the acupuncture phenomenon.

The need for traditional Chinese medicine morbidity research.

Traditional Chinese medicine (TCM) has long justified its practice on empirical phenomenology. Questions remain, however, as to the legitimacy of this approach and its relevance to TCM practice and educational developments in the 21st century. General medical practice (GMP) has used practice-based data collected over the past 25 years to develop relevant medical curriculum and enhance patient care. As TCM becomes ever more incorporated into Western educational and health systems, it too must concern itself with providing a solid evidence base to be used in enhancing patient care and educational curriculum. Computer generated data related to patient problems or problem complexes abstracted from TCM clinical records can provide the basis for practitioner development and the enhancement of training programs that will lead to improvements in patient care. Such locally valid and representative data can also be used to inform research programs, public policy and evidence-based commissioning. The key to developing such systems is standardising TCM terminology and data collection protocols.

Reporting traditional Chinese medicine morbidity--A University of Technology, Sydney, project with an emphasis on developing standards for testing and reporting data.

OBJECTIVES: Morbidity in Traditional Chinese Medicine (TCM) research is an emerging field. Few studies have been published, and there is a lack of international standards for data collection and reporting. Based on the experience of developing a computerized system for patient data collection at the University of Technology, Sydney, (UTS) Acupuncture Clinic (Sydney, Australia), and reporting results from that database, a start can be made toward developing guidelines for reporting similar results from TCM clinical audits. METHODS: This study reports on data relating to 5735 patients who had undergone 29,697 treatments. Patient information is collected by a computerized database recording International Classification of Primary Care (ICPC) reason for encounter (RFE) and symptom for encounter (SFE) data and TCM tongue, pulse, diagnostic, and treatment data. Data coding is automated, and systems for reliability testing and error reporting were developed. RESULTS: UTS data has a 2.7% error rate and is within international standards of 5% error. Sixty-one-point three percent (61.3%) of patients were female and of these, 59.45 were 25-44 years of age. Musculoskeletal disorders are the most common presentation (41.4%) of all RFE, followed by general disorders (13.1%) and digestive disorders (8.1%). CONCLUSIONS: International standards must be set for TCM morbidity data collection methods and reporting. It is hoped that the methods described and reported in this paper are an initial step in the setting of such standards and that they will be adopted by other researchers. In particular, methods for testing and reporting data reliability must be adopted if TCM morbidity studies are to maintain any credibility.

A study of the relative precision of acupoint location methods.

OBJECTIVE: This study examined the relative precision of four methods of acupoint location: two traditional methods (directional and proportional) and two contemporary methods (elastic and ruler). DESIGN: Seventy-two (72) subjects attempted to locate a fictitious acupoint (FP) with repeated attempts and the resulting coordinates were recorded. LOCATION: The research was carried out at the Acupuncture Clinic of the University of Technology, Sydney (UTS). SUBJECTS: The 72 subjects were selected from undergraduates of the Bachelor of Health Science in Acupuncture course. RESULTS: Analysis of the results found no significant difference in precision between the two traditional methods, nor between the two contemporary methods. However, the contemporary methods were both shown to be significantly more precise than the traditional methods (F(3,120) = 11.74, p < 0.0001). CONCLUSIONS: Based on the scatter size resulting from the use of each method, the surface area of the acupoint would need to range from almost 13 cm(2) for the directional method to less than 3 cm(2) for the ruler method if 95% of the subjects were to locate the acupoint successfully. Implications and recommendations for research and education are discussed.

Anxiety as a factor influencing physiological effects of acupuncture.

PURPOSE: This study investigated the influence of manual acupuncture on heart rate variability and the role which anxiety can play in modifying physiological outcomes. METHOD: Analysis of heart rate variability (HRV) was used as a sensitive and a reliable indicator of the balance between sympathetic and parasympathetic regulation of the heartbeat. Two groups of healthy female subjects were recruited into the study. The control group (n=30) attended one experimental session where no acupuncture treatment was used. The experimental group (n=30) attended three sessions in which unilateral manual stimulation of acupuncture points LU7 and KD6 was performed. RESULTS: The stimulation of the acupuncture points LU7 and KD6 was not associated with significant changes in HRV. Previous familiarity with acupuncture did not influence the outcomes but level of anxiety had a strong impact on physiological outcomes. Stimulation of LU7 acupuncture point counterbalanced naturally occurring sympathetic increase over time and had relaxing and harmonizing effect on the heart rhythm without influencing subjective perception of increased anxiety. Stimulation of KD6 acupuncture point had sympathetic influence on HRV in subjects with low "trait" anxiety and this influence was nullified by simultaneous stimulation of LU7 acupuncture point. CONCLUSIONS: It seems likely that the level of anxiety can modify HRV during acupuncture treatment and up to 40 min after the treatment. Psychological factors such as anxiety level should be considered as having important influence on physiological response to acupuncture.