Introducing a computer-assisted, digital tongue-imaging device for standardization of traditional tongue diagnosis.

BACKGROUND: In Traditional Chinese Medicine (TCM) tongue diagnosis and pulse diagnosis are the major diagnostic methods up till now. As western research has tended to focus on acupuncture, attempts to standardize the classic diagnostic methods have been few. METHODS: A digital camera with a ring flash was fixed in a frame, so that the tongue-lens-distance and illumination were kept constant. A pilot study testing the inter-methods reliability, test-retest reliability, and interrater reliability of 2 observers was conducted: the tongues (1 ×) as well as the tongue images (2 ×) from 76 patients from our ward were assessed with a standardized rating list in a randomized order by both observers, who were mutually blinded. As primary outcome measure we used agreement beyond chance (Cohen's kappa). RESULTS: The colors of the tongue body / the tongue coating were the main criteria for the authentic reproduction of the tongue in our images. Inter-methods reliability for the color of the tongue body/coating was kappa 0.35 / 0.34 (p < 0.001) for observer 1 and 0.59 / 0.57 (p < 0.001) for observer 2. Test-retest reliability for the color of the tongue body / the tongue coating was kappa 0.53 / 0.48 (p< 0.001) for observer 1 and 0.65 / 0.62 (p < 0.001) for observer 2. Interrater reliability was generally low. CONCLUSIONS: The introduced device represents a first step towards standardization of tongue diagnosis. However, inter-methods as well as test-retest reliability vary between observers and different morphological characteristics.

Quantification of DeQi sensation by visual analog scales in healthy humans after immunostimulating acupuncture treatment.

Acupuncture is the most popular component of traditional Chinese medicine in Western countries. However, the mechanisms of its effects remain unclear. The therapeutic effect of acupuncture appears when a sensation of DeQi is achieved. We previously reported that repeated, but not single acupuncture treatment affected leukocyte circulation and blood pressure in healthy young humans. The objective of this study was to quantify DeQi sensation by using visual analog scales (VASs) and, to test whether DeQi induction is an important factor for the therapeutic effects of acupuncture in the same cohort. After either acupuncture or sham-acupuncture (placebo) treatment, a questionnaire containing five individual VASs was given to subjects to evaluate their DeQi sensation, including numbness, pressure, heaviness, warmth, and radiating paraesthesia, respectively. A separate VAS to measure their levels of anxiety during the treatment was also included. Our results showed that acupuncture significantly induced higher VAS values for numbness, pressure, warmth, and radiating paraesthesia, but not for heaviness than the placebo across three treatment sessions. Additionally, acupuncture did not induce higher anxiety levels than the placebo. These data confirm that VAS is an objective and reliable way to quantify DeQi sensation and, indicate that DeQi is unique to verum acupuncture treatment. Furthermore, either acupuncture-induced therapeutic effects or DeQi sensation should not be attributed to the stress-mediated effects. In summary, the induction of DeQi in each treatment session is an important factor for the physiological outcomes of repeated acupuncture treatment, and VASs offer objective, an easy and reliable way to assess it.

Repeated acupuncture treatment affects leukocyte circulation in healthy young male subjects: a randomized single-blind two-period crossover study.

Acupuncture is the most popular component of traditional Chinese medicine in western countries, which has been widely used in the treatment of numerous medical conditions, e.g., pain, emesis or asthma. However, the effects of acupuncture on neuroendocrine and immune functions in humans remain unclear. Therefore, the present study was performed to analyse whether acupuncture treatment affects leukocyte circulation as well as plasma levels of cortisol and norepinephrine in humans. Ten healthy young male subjects were enrolled in a randomized single-blind two-period crossover study. Each period contained three sessions of either acupuncture or sham acupuncture (placebo) treatment. After randomisation, the group 1 (n=5) received acupuncture treatment at acu-points ST36, LI11, SP10, and GV14, while sham acupuncture was performed for group 2 (n=5). Two weeks later, each group received the alternative treatment. Blood samples were taken before needling, 10 min after, and 30 min after removing the needles in the first and the third session. In addition, blood pressure and heart rate were determined simultaneously. Although acupuncture treatment did not affect leukocyte circulation in peripheral blood after the first session, we observed a significant decrease in leukocyte and lymphocyte values after the third session. In contrast, cortisol and norepinephrine plasma levels remained unchanged by acupuncture. These data indicate that repeated acupuncture treatment can affect leukocyte circulation in healthy humans by still unknown mechanisms.

Is there a BOLD response of the visual cortex on stimulation of the vision-related acupoint GB 37?

PURPOSE: To determine whether or not acupuncture of guangming (GB 37) produces a significant response of the visual cortex detectable by means of functional magnetic resonance imaging (fMRI). MATERIALS AND METHODS: This study investigates the activation of the visual cortex elicited by a soft and an intensified stimulation of GB 37, an acupoint documented to influence vision-related disorders. Three different paradigms were carried out to detect any possible modulation of the Blood Oxygenation Level Dependent (BOLD)-response in the visual cortex to visual stimulation through acupuncture. RESULTS: The percentage signal changes in the visual stimulation cycles did not significantly differ before vs. during acupuncture. CONCLUSION: Whereas no BOLD-response correlating with acupuncture was detected in the visual cortex, BOLD-signal-changes in response to needle twisting were detected in different cortical areas. Further studies are necessary to clarify whether these clusters correlate to inevitable somatosensory stimulation accompanying acupuncture or represent an acupuncture-specific response.