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Objective To investigates the effect of acupuncture on sensitization of Zusanli(ST36)in rats with different functional states by using healthy and knee osteoarthritis model rats.Methods Male SD rats were randomly divided into control,model,model-acupuncture and blank-acupuncture group,with 7 rats in each group.KOA rat model was prepared by intra-articular injection of 1 mg·50 μL-1 monoiodoacetic aci(MIA)in model group and model-acupuncture group.On the second day of modeling,acupuncture treatment was performed on the left Zusanli of the model acupuncture group and the blank-acupuncture group,once everyday for 20 min,5 times as a course of treatment,2 days between courses.The general condition,knee joint diameter,plantar thermal pain threshold and Lequesne MG score of rats was observed before modeling and after acupuncture.Observing the morphology of knee joint cartilage to judge whether the model is successful,measuring the mechanical pain threshold of Zusanli to investigate the acupoint sensitization,observing and counting the morphology of skin mast cells in the acupoint area,and detecting the expression of skin calcitonin gene-related peptide(CGRP)in the acupoint area.Results The mechanical pain threshold of Zusanli after acupuncture in model group and blank-acupuncture group decreased significantly after modeling(P<0.01,P<0.05),compared with the control group,the change rate of mechanical pain threshold in model group and blank-acupuncture group increased significantly(P<0.05),compared with the model group,the mechanical pain threshold of Zusanli in the model-acupuncture group decreased significantly(P<0.01).Compared with the control group,the fluorescence intensity of CGRP protein in the skin tissue of Zusanli in the model group increased significantly(P<0.01),MC degranulation rate increased significantly(P<0.05),and there was no significant difference in the fluorescence intensity of CGRP protein of Zusanli in the blank-acupuncture group(P>0.05),MC degranulation rate increased obviously(P<0.01),CGRP protein of Zusanli in the model-acupuncture group was significantly reduced compared with the model group(P<0.01),and there was no significant difference in the degranulation rate of MC(P>0.05).Conclusion Acupoint sensitization can occur in different functional states of rats.Zusanli(ST36)of KOA model rats can be sensitized,and acupuncture stimulation can make Zusanli sensitization caused by disease disappear.Under physiological conditions,acupuncture stimulation can induce similar sensitization phenomenon.
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[Objective]To explore the phenomenon and regularity of acupoint sensitization for major depressive disorder(MDD)based on bibliometric methodology and data mining technology,and to provide scientific ideas for the clinical diagnosis and treatment of MDD.[Methods]Eight electronic databases and one ancient book were comprehensively searched and available literature was retrieved.Bibliometric methodology and data mining technology were applied to summarize the phenomenon and regularity of acupoint sensitization for MDD,and to explore the related theoretical mechanisms.[Results]A total of 29 literature related to acupoint sensitization of MDD was included.Acupoint sensitization of MDD involved in multiple forms,including heat sensitization,chemical sensitization,pain sensitization,and so on,and the testing means were diverse.The most common sensitized acupoint was Baihui(GV20).Among these acupoints,sensitization often simultaneously occurred in Baihui(GV20)and Neiguan(PC7),Baihui(GV20)and Taichong(LR3).The acupoints and sensitization could be divided into 4 effective clusters.The meridian involved with high sensitization frequency was governor vessel.Sensitization mainly occurred in the head-face-neck area.[Conclusion]The sensitization phenomenon of MDD has many types,However,there are few related studies at present.The phenomenon of acupoint sensitization involving acupoint,meridians,and location are relatively broad.There might be a close relationship between high-frequency sensitized acupoints and common acupoints for clinical treatment,which may be related to the effect of different acupoints and the etiology and pathogenesis of MDD.
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On the base of the paradigms of clinical studies on modern moxibustion by identifying the acupoint sensitization, the records of ancient literature in successive dynasties were collected on "identifying the sensitization" of acupoints in acupuncture. In association with acupoint detection of acupuncture recorded in current textbooks, a novel concept, "exerting acupuncture by identifying the acupoint sensitization" is proposed. Acupoint sensitization is the common initial link of effect achieved by both acupuncture and moxibustion. Hence, on the basis of the routine acupoint selection by differentiating syndrome, the state of acupoint must be considerably emphasized in either acupuncture or moxibustion. The clinical curative effect may be improved by selecting the sensitized points and identifying sensitization. This novel mode of diagnosis and treatment focuses on identifying acupoint sensitization by unifying acupuncture with moxibustion and in coincidence with the modern clinical characteristics of either acupuncture or moxibustion.
Subject(s)
Acupuncture Points , Acupuncture Therapy , MoxibustionABSTRACT
OBJECTIVE@#To investigate the changes of skin temperature, blood infusion and inflammatory cytokines of cutaneous tissue in the sensitized area of colitis model rats, as well as the relationship between sensory and sympathetic nerves and the formation of sensitized area, and to initially reveal the partial physical-chemical characteristics of the sensitized area in the colitis model rats.@*METHODS@#Thirty-five male SD rats were randomly divided into a control group (n=10), a model group (n=18) and a guanethidine group (n=7). 5% dextran sulfate sodium (DSS) was adopted for 6-day free drinking to establish colitis model in the model group and the guanethidine group. On day 6 and 7, in the guanethidine group, guanethidine solution (30 mg/kg) was injected intraperitoneally for sympathetic block. On day 7, after injection of evans blue (EB) solution, the EB extravasation areas on the body surface were observed to investigate the distribution and physical-chemical characteristics of the sensitized area. The control area was set up, 0.5 cm away from the sensitized area, and with the same nerve segment innervation. Disease activity index (DAI) score of rats was compared between the normal group and the model group, and the morphological changes in the colon tissue were investigated with HE method. Using infrared thermal imaging technology and laser speckle flow imaging technology, skin temperature and blood infusion were determined in the sensitized area and the control area of the rats in the model group. Immunofluorescence technique was adopted to observe the expression levels of the positive nerve fibers of substance P (SP), calcitonin gene-related peptide (CGRP) and tyrosine hydroxylase (TH), and the correlation with blood vessels; as well as the expression levels of SP positive nerve fibers/tryptase+ mast cells, and tryptase+ mast cells/5-hydroxytryptamine (5-HT) in skin tissue in the sensitized area and the control area of the rats in the model group. MSD multi-level factorial method and ELISA were applied to determine the contents of pro-inflammatory and anti-inflammatory cytokines (e.g. TNF-α, IL-1β, IL-6, IL-4 and IL-10) and anti-inflammatory substance corticosterone (CORT).@*RESULTS@#Sensitization occurred at the T12-S1 segments of the colitis model rats, especially at L2-L5 segments. Compared with the normal group, DAI score was increased in the rats of the model group (P<0.05), and the colonic mucosal damage was obvious, with the epithelial cells disordered, even disappeared, crypt destructed, submucosal edema and a large number of inflammatory cells infiltrated. In comparison with the control area, the skin temperature and blood infusion were increased in the sensitized area of the model group (P<0.05, P<0.01); as well as the expression levels of the positive nerve fibers of SP, CGRP and TH of skin tissue (P<0.05), which was specially distributed in peripheral vessels, the expression levels of SP positive nerve fibers/tryptase+ mast cells, and tryptase+ mast cells/5-HT of the skin tissue were all expanded (P<0.05) in the sensitized area of the model group. Compared with the model group, the number of sensitized areas was reduced in the guanethidine group (P<0.05). In comparison with the control area of the model group, in the sensitized area, the contents of pro-inflammatory cytokines, e.g. TNF-α, IL-1β and IL-6, and the anti-inflammatory substance CORT of skin tissue were all increased (P<0.05); and the contents of IL-6 and TNF-α were negatively correlated with CORT (P<0.05).@*CONCLUSION@#The sensitized areas on the body surface of colitis rats are mainly distributed in the L2-L5 segments. Sensory and sympathetic nerves are involved in the acupoint sensitization, and the sensitized areas may have the dynamic changes in pro-inflammatory and anti-inflammatory substances.
Subject(s)
Animals , Male , Rats , Anti-Inflammatory Agents , Calcitonin Gene-Related Peptide/metabolism , Colitis/metabolism , Cytokines/metabolism , Guanethidine , Interleukin-6 , Rats, Sprague-Dawley , Serotonin , Skin Temperature , Substance P/genetics , Tryptases , Tumor Necrosis Factor-alphaABSTRACT
OBJECTIVE@#To explore the characteristics and rules of acupoint sensitization phenomena based on knee osteoarthritis (KOA), one of the clinical dominant diseases of acupuncture-moxibustion.@*METHODS@#In combination with literature and expert experiences, the acupoints with the highest use frequency in treatment of KOA were screened, e.g. Heding (EX-LE 2), Liangqiu (ST 34), Mingmen (GV 4), Neixiyan (EX-LE 4), Ququan (LR 8) and Dubi (ST 35). In 814 patients with KOA and 217 healthy subjects, the acupoint temperature, mechanic pain threshold and pressure pain threshold were detected separately. Using machine learning method, the sensitization was judged at each acupoint.@*RESULTS@#Compared with healthy subjects, the acupoint temperature was increased and the mechanic pain threshold and pressure pain threshold were reduced in KOA patients (P<0.05). Besides, the cut-off value was presented to distinguish whether the acupoint was sensitized or not. The results of machine learning showed that the highest prediction accuracy of acupoint sensitization was 86.7% (Shenshu [BL 23]) and the lowest one was 73.9% (Heding [EX LE 2]). The prediction accuracy at the third clinical stage trial was higher, the highest was 93.3% (Ququan [LR 8]) in KOA patients.@*CONCLUSION@#It is confirmed that the acupoint sensitization reflects the characteristics of disease and is correlative with the conditions of illness, which may provide the reference for the auxiliary diagnosis and condition assessment of KOA.
Subject(s)
Humans , Acupuncture Points , Acupuncture Therapy , Moxibustion , Osteoarthritis, Knee/therapy , Treatment OutcomeABSTRACT
Although acupuncture has spanned thousands of years in the history of traditional medicine, still some basic questions are not clarified. Acupuncture is the theory based on long time medical practice of the ancient sage, combined with objectivesymptom and medical expertise from diseases, and being applied for the instruction in clinic. In this way, acupoint is discovered by doctors in the practice of disease treatment other than a natural occurrence in the healthy population. And acupoint specificity is attached to the target organ involved in pathological condition. In our opinion, acupoint originates from somatic referred area reactive to visceral disorders. And accordingly, referred hyperesthesia of the somatic area is phenomenon of acupoint sensitization. Acupoint is the situ having health code formed in the biological evolution. Corresponding acupoint of a given organ is the alarmer for the state of health, and also is the trigger for self-healing where acupuncture can work as a gating-button. Therefore, acupoint must be accompanied with diseases in that it is reinforced by, relayed on, responsive to and neutralize by the pathological course. In conclusion, acupoint cannot exist without the disease. In another word, acupoint will be unshown, or be functionally hidden, under physiological condition.
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Humans , Acupuncture , Acupuncture Points , Acupuncture Therapy , Medicine, Traditional , PhysiciansABSTRACT
OBJECTIVE@#To observe the distribution characteristics and rules of pain sensitivity points on body surface in patients with knee osteoarthritis (KOA).@*METHODS@#A total of 916 patients with KOA were selected in this study, the pain sensitivity points of local site of knee joint were probed by thumb palpation. Tape was used to measure the distance between the pain sensitivity points and the most nearby acupoints. The Wagner tenderness measuring instrument was used to measure the tenderness threshold of pain sensitivity points.@*RESULTS@#A total of 3618 pain sensitivity points were probed, among them, 3338 pain sensitivity points were sensitized. The minimum sensitization degree was 1.00, the maximum sensitization degree was 3.39, while the average sensitization degree was (2.16±0.60). Pain sensitivity points were distributed 0.37-1.73 @*CONCLUSION@#The pain sensitivity points of patients with KOA may be the expansion effect of acupoint areas in the disease states, pain sensitivity points are more likely to appear on the medial side of knee joint.
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Humans , Acupuncture Points , Knee Joint , Osteoarthritis, Knee/therapy , Pain ThresholdABSTRACT
OBJECTIVE: To observe the distribution characters of Evans Blue (EB) exudation spots in the abdominal area in acute intestinal mucosal injury (AIMI) rats by using latitude and longitude grid counting and multivariate statistical analysis and to explore the feasibility of these methods. METHODS: Twenty-four SD rats were randomly divided into blank control, 7.5%, 10%, and 12.5% mustard oil groups (n=6 rats in each group). The AIMI model was established by mustard oil enema, followed by injection of EB (0.1 mL/100g) into the tail vein. At 5, 10, 15, 20 and 25 h after EB injection, the rats under anesthesia were fixed in supine position for observing and photographing the abdominal subcutaneous EB exudation spots. The H.E. staining was used to observe histopathological changes of colonic mucosa. The longitude and latitude grids of the abdominal region were constructed (by taking the midpoint of the superior sternum as the origin) to determine the position of the blue spots. That the coordinate grids of the two regions can be connected geometrically is termed as "characteristic region". The data were processed by using multivariate statistical analysis. RESULTS: ① H.E. staining showed edema and inflammatory cell infiltration after colonic enema of different concentrations of mustard oil. ② Clustering analysis indicated that the distribution of exudation points in the "characteristic grid" had no temporal variation trend, and was not related with the concentration of mustard oil (P>0.05). ③ Factor analysis and contour analysis about the exudation spots of EB at 7.5% concentration showed that the "characteristic region Ⅱ" of different factors presented a tendency of time-dependent exudation, i.e. reduction of exudation degree along with time (P<0.05), and it is located near "Tianshu" acupoint. ④At 5 h after injection of EB, the 8 "characteristic regions" presented an EB-concentration-dependent tendency (reduction in exudation degree along with the increase of EB-concentration), among which the exudation degree of region C (near "Tianshu" acupoint) of the abdomen was higher (P<0.05). CONCLUSION: The multivariate statistical analysis method can be used to identify the abdominal "characteristic regions" of exudation spots of EB in rats with AIMI, and the characteristic region has acupoint sensitization characteristics related to the time and severity of mucosal injury.
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In the pathological conditions, the human body induces somatic sensory exchanges and takes neurogenic inflammatory reactions according to referred visceral organ. Acupoint possesses both diagnosing and treating functions according to the acupuncture theory. The sensitization of acupoint refers to a pathophysiological dynamic change which is manifested predominately as a neurogenic inflammatory reaction in the specific area(s) of the body surface under pathological conditions. Furthermore, the process of acupoint from "silent" (physiological status) to "active" (pathological status) is generally represented by the dynamic changes of acupoint location, size and physicochemical environment. These responses of acupoint sensitization simultaneously activate self-healing system in the body and eventually induce the curative effects.
Subject(s)
Humans , Acupuncture Points , SensationABSTRACT
OBJECTIVE@#To observe the correlation between referred pain distribution and acupoint sensitization in patients with intestinal diseases.@*METHODS@#In clinical research, 443 patients from 8 hospitals were recruited, including the outpatients and inpatients of Crohn's disease (=143), ulcerative colitis (=108), chronic appendicitis (=87) and other intestinal diseases (=105). The site with tenderness on the body surface and the morphological changes of local skin were observed and recorded in the patients. Using a sensory tenderness instrument, the pain threshold at the sensitization point was measured in 60 patients with ulcerative colitis. In animal experiment, SD rats were used and divided into a enteritis group (=8), in which the enteritis model were established, and a control group (=3), in which no any intervention was given. After the injection of Evans blue (EB) at caudal vein, the blue exudation points on the body surface were observed and the distribution rule was analyzed statistically.@*RESULTS@#The referred pain on the body surface in the patients with intestinal diseases was mainly located in the lower abdomen (93.9%, 416/443), the lumbar region (70.9%, 314/443) and the lower legs (33.0%, 146/443). The diameter of tenderness region was 1.5 to 2.5 cm. Compared with the region without sensitization, the pain threshold of the sensitization point in the patients with ulcerative colitis was reduced significantly (<0.001). The referred pain on the body surface in the patients with appendicitis was located in the right lower abdomen (97.7%, 85/87), the waist and back (54.0%, 47/87) and the right lower limbs on the medial side (71.3%, 62/87). The tenderness region was 1 to 2 cm in diameter and was irregular in form. After modeling of enteritis in the rats, the EB exudation points were visible from T to L.@*CONCLUSION@#Intestinal diseases induce referred pain on the body surface where is the same as or adjacent to the location of the spinal segment corresponding to the affected intestinal section. These sensitization regions are related to the locations of acupoints.
Subject(s)
Animals , Humans , Rats , Acupuncture Points , Colitis, Ulcerative , Intestinal Diseases , Pain Threshold , Pain, Referred , Diagnosis , Therapeutics , Rats, Sprague-Dawley , SensationABSTRACT
OBJECTIVE: To observe the correlation between the referred pain regions of stable angina pectoris (SAP) and the acupoints in coronary heart disease (CHD) patients and to investigate the rule of regional sensitized point distribution in rats. METHODS: A total of 1 046 CHD patients with SAP from 8 hospitals in China were recruited in the present study. The tenderness was palpated along the left and right chest, back, shoulder, upper limb, etc. by a specially-assigned researcher in each hospital. Among them, 77 patients accepted pain threshold (PT) measurement by using a hand-held esthesiometer. In animal experiments, 14 SD rats were subjected to occlusion of the left anterior descending branch of the left coronary artery for 4 h for establishing myocardial ischemia (MI) model, and other 4 normal rats were used as the sham-operation control group. Four hours after MI, all the rats accepted tail venous injection of 5% Evans blue (50 mg/kg) for examining the distribution of the blue dye exudation spots at the body surface where the mechanical PT was also detected by a von Frey. RESULTS: In 1 046 CHD patients, 987 (94.36%) were found to have at least one tenderness spot. The tenderness spots were found at the left chest (87.47%), right chest (13.67%), left arm (ulnar side, 41.30%), right upper limb (4.68%), left shoulder back (30.21%), right shoulder back (7.07%), etc., accompanied with rash or pigmentation, subcutaneous induration, cord-like tissue contracture, skin sag, etc. The mechanical PT level was significantly lower at the tenderness spots of the left upper limb than at non-tender points of the right upper limb in CHD patients (P<0.001). Tenderness and cutaneous abnormal changes in angor pectoris patients distributed mostly on the left chest, back, shoulder and upper limb, and some also on the right. Tender points scattered on, near or outside acupoints. A similar distribution of the blue exudation spots and lower mechanical PT spots were found in MI rats, but not in sham-MI rats. CONCLUSION: In the case of MI, a regular "referred sensitization" response frequently occurs in the dermatomere area innervated by the corresponding segments (T 1-T 5) in both CHD patients and MI rats, which may be closely associated with the formation of acupoints in ancient China.
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We retrieve and analyze the articles on body surface temperature of acupoints in the recent 50 years. Surface temperatures have been compared between acupoints and nonacupoints, and among acupoints in different states. The impacts of interventions for acupoint temperature are explored, including acupuncture,moxibustion and cupping, etc. We summarize the features and the rules of acupoint skin temperature. It is considered that there exists distribution rule for healthy people's acupoint skin temperature. That means acupoints have higher surface temperature than nonacupoints. In the same meridian the nearer acupoints close to the head and trunk, the higher the temperature is. The difference in symmetrical acupoints temperatures between the left and right side is about 0.5℃. In the different meridians the skin temperatures of adjacent acpoints are similar. The changes of acupoint's skin temperature in illness can be used as the auxiliary diagnosis. Acupuncture, moxibustion and cupping can produce acupoints stimulating, metabolism improving,balance, acupoint temperature regulating. Thus,diseases are relieved. The specificity and regularity that acupoint's skin temperature presents may be one of the manifestations of the acupoint specificity, also it is an important starting point of the research on acupoint sensitization. The further studies should consider different diseases and modern biological engineering techniques, so that more rules of acupoints temperature can be found by more sensitive and objective temperature measurements as well as experimental and the mathematical models.
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<p><b>OBJECTIVE</b>To judge whether algesia sensitization of some acupoints is existed and whether the acupoint algesia sensitization area is expanded in the patients of intestinal cancer.</p><p><b>METHODS</b>Totally, 30 patients of intestinal cancer and 30 healthy subjects were included. The electronic Von Fray was used to determine the pressure-pain thresholds at 13 acupoints relevant with gastrointestinal disorders and the reference points at the sites 1and 2lateral to those points as well as the sites at the corresponding nerve segments. Compared with the pressure-pain thresholds at the reference points of the different segments, the relative value was calculated. The changes were analyzed in the pressure-pain thresholds at the relevant acupoints on the body surface in the patients of intestinal cancer as compared with the relative pressure-pain thresholds in the healthy volunteers.</p><p><b>RESULTS</b>The pressure-pain thresholds at Zusanli (ST 36), Shangjuxu (ST 37), Xiajuxu (ST 39), Quchi (LI 11) and Dachangshu (BL 25) in the patients of intestinal cancer were all significantly reduced as compared with those of the healthy subjects (<0.05,<0.01,<0.001). At the non-acupoint sites 1and 2lateral to those acupoints as well as at the sites of the same segments, the pressure-pain thresholds were reduced significantly as compared with the control group (<0.05,<0.01,<0.001). Particularly, the sensitization zone of Yinlingquan (SP 9) focused on the acupoint, the site 1lateral to it as well as the non-acupoint sites of the same segments (<0.01,<0.001).</p><p><b>CONCLUSION</b>The acupoint sensitization is displayed at Zusanli (ST 36), Shangjuxu (ST 37), Xiajuxu (ST 39), Quchi (LI 11), Dachangshu (BL 25) and Yinlingquan (SP 9) and the sensitization area is expended in the patients of intestinal cancer.</p>