Observation of Microvascular Perfusion in the Hegu (LI4) Acupoint Area after Deqi Acupuncture at Quchi (LI11) Acupoint Using Speckle Laser Blood Flow Scanning Technology.

The aim of this study was to investigate the traditional meridian theory using speckle laser blood flow scanning technology to observe microcirculation of the Hegu acupoint area after acupuncture stimulation on distant points. An observational study was conducted to observe the microvascular perfusion of Hegu (LI4) and control points after acupuncturing Quchi (LI11). Thirty healthy volunteers (mean age 31.6 ± 8.7 years) received deqi acupuncture on Quchi (LI11, right side), and simultaneously changes in microvascular perfusion of Sanjian (LI3), Hegu (LI4), Yangxi (LI5), and two control points were observed before, during, and after needling using a MOOR speckle laser. The results showed that the changes in microvascular perfusion of the observed points are not regular. After correction, the experiment showed that the blood perfusion on 3 meridian acupoints was increased while the perfusion on 2 control points was decreased following acupuncture stimulation, the changes at Hegu (LI4) being the statistically most significant ones. Deqi acupuncture can help in regulating the body's blood flow, with a certain degree of meridian specificity.

The influence of different methods of acupuncture on skin surface perfusion.

OBJECTIVE: To compare the effects on the body surface of different kinds of placebo/sham acupuncture with that of traditional needling sensation acupuncture. METHODS: Point Neiguan (PC 6) of 29 healthy subjects, 19 males and 10 females, was stimulated with needling sensation, shallow, placebo and deep acupuncture at the non-acupoint. After stimulation with different methods of acupuncture, the change in perfusion of the micrangium in the skin surface around the elbow joint, with Point Quze (PC 3) as its center, was observed with laser Doppler blood-flow imaging. RESULTS: Judging from the absolute value of perfusion of the skin surface micrangium, several methods of acupuncture can cause change in blood flow. The ratio of blood-flow perfusion in the meridian area in and around Quze declined before and after needling insertion in needling sensation acupuncture and shallow acupuncture. This observation did not occur in placebo and non-acupoint acupuncture. Needling sensation acupuncture at an acupoint can relatively reduce the perfusion of the micrangium in the projective area of the meridian where the acupoint is located on the body surface (P < 0.05), indicating the specificity of meridians. CONCLUSIONS: Stimulation of an acupoint or a point on the body surface with any type of acupuncture can cause change in blood flow in the skin near the needling point. However, the biological mechanism underlying this phenomenon needs to be further explored.

Comparison of the effects of traditional box-moxibustion and eletrothermal Bian-stone moxibustion on volume of blood flow in the skin.

OBJECTIVE: To investigate and compare the effects of Electrothermal Bian-stone moxibustion and traditional box-moxibustion on capillary blood perfusion in the body surface. METHODS: Twenty healthy subjects, 18 females and 2 males, aged averagely 36 years, were enrolled in this experiment. The traditional box-moxibustion and electrothermal Bian-stone moxibustion were respectively given on the hypogastrium around Guanyuan (CV 4), and the changes of local capillary blood perfusion in the body surface were investigated with Laser Doppler Perfusion Imaging (LDPI). RESULTS: The traditional box-moxibustion was superior to the electrothermal Bian-stone moxibustion in the transient increasing effect in whole body and the long-term increasing effect in the local area of moxibustion on capillary blood perfusion; but for both methods, the increasing effect on the capillary blood perfusion in the local area of moxibustion was same. CONCLUSION: Electrothermal Bian-stone moxibustion can not completely take the place of the traditional box-moxibustion; but for some disorders with local pain, they possibly have the same effects.

[Diuretic effect of injecting furosemide into low hydraulic resistance point Shuifen along the conception meridian in pigs with acute edema].

OBJECTIVE: To observe whether injection of medicine into low hydraulic resistance point along meridian brings about higher medicinal effect and to explore the efficacy of the theory that meridians are made up of channels featuring low hydraulic resistance by observing the diuretic effect of injecting furosemide or saline into the low hydraulic resistance point Shuifen (CV 9), vein and Zusanli (St 36) respectively. METHODS: Acute edema was induced in pigs by rapid intravenous injection of 2 000 ml normal saline. The pigs were divided into four groups: Shuifen (CV 9) injection of half dose furosemide group (SFF group), intravenous injection of full dose furosemide group (VF group), Zusanli (St 36) injection of full dose furosemide group (ZSLF group), and Shuifen (CV 9) injection of half dose normal saline group (SFS group). The accumulated urine quantity and the urine quantity generated in every 15-minute period were measured in each group respectively, every 15 minutes after injection, and the measurement lasted for two hours at one experiment. Each group involved eight times of experiments with one pig used for one experiment, which means the whole observation involved 32 times of experiments. RESULTS: The accumulated urine quantities observed in both SFF group and VF group were higher than those in the ZSLF group and the SFS group all through the measurement, showing significant differences during the period from the 15th minute to the 45th minute (P<0.05). But no significant difference was observed between the SFF group and the VF group during the whole 2-hour measurement (P>0.05). Analysis of urine quantity generated in every 15-minute period showed that diuretic effect climaxed during the 15th minute to the 30th minute in both SFF group and VF group. By contrast, ZSLF group reached diuresis climax during the 45th minute to 60th minute and no diuresis climax was observed in the SFS group all through the measurement. CONCLUSION: Injection of medicine into low hydraulic resistance point along meridian generates faster and more powerful medicinal potency, and this is likely to be applied to clinical practice. The theory that meridians are channels featuring low hydraulic resistance is important to the elucidation of meridians.

[Discussion on the model organism in acupuncture and meridians researches].

Using model organism to replace human subjects for experimental objects is an important part in basic research on acupuncture therapy. In the process of experimental research, the first thing is that if the animal model is suitable for revealing the underlying mechanism of acupuncture intervention, if it is relatively close to structures of the human body. In addition, some factors such as being easy to feed, larger in the volume and body-surface, lesser in fur, stable in the germline and reasonable in the cost should be considered. In current acupuncture study, most experiments were carried out in mice and rats, some were conducted in rabbits and cats, fewer conducted in larger animals like mini-pigs and monkeys. Due to being smaller in both body size and superficial area in the mouse and rat, soft and comate skin in the rabbit and cat, difficult breeding for cattle and horse, experimental studies of acupuncture-meridians are in fact not ideal in these animals. Mini-pig has a larger body size and body surface, being similar to the human body in the skin structure and easy to breed, and the monkey is mostly close to the human in the gene and body size, and is thus an ideal model organism for acupuncture research. Because acupoint and meridians have their space specificity, the usage of larger animal as the model organism is necessary.

[Low back pain of cold-damp pattern treated with electric-thermal Bian-stone therapy and traditional moxibustion: a randomized controlled trial].

OBJECTIVE: To compare the difference in the efficacy on low back pain of cold-damp pattern between electric-thermal Bian-stone therapy and moxibustion box therapy. METHODS: Forty-one cases of low back pain of cold-damp pattern were randomized into an electric-thermal Bian-stone therapy group (group A, 26 cases) and a box moxibustion therapy group (group B, 15 cases). In the group A, the electric-thermal Bian-stone was placed over Shenshu (BL 23) and Weizhong (BL 40). The temperature of stone was adjusted in accordance with patient's comfort. In the group B, moxibustion box was used over Shenshu (BL 23) and Weizhong (BL 40). The treatment was given once every day or every two days. Ten treatments made one session. The symptom and physical signs score of low back pain and the score of cold-damp syndrome were observed before and after treatment in the patients. RESULTS: The symptom and physical signs score of low back pain and the score of cold-damp syndrome were all improved in the two groups (all P < 0.01). The changing rate of symptom and physical signs and syndrome were (37.04 +/- 32.68)% and (22.85 +/- 29.95)% in the group A, and were (47.29 +/- 22.08)% and (23.89 +/- 22.53)% in the group B, respectively, without significant difference in comparison between the two groups (all P > 0.05). CONCLUSION: The efficacy on low back pain of cold-damp pattern treated with the electric-thermal Bian-stone therapy is similar to that of moxibustion box therapy. This therapy is characterized as more convenient, safer operation and less pollution.

Comparison of Acupuncture Effect on Blood Perfusion between Needling Nonacupoint on Meridian and Needling Nonacupoint off Meridian.

To verify the ancient theory of rather missing the acupoint than missing the meridian, acupuncture at nonacupoint on meridian and acupuncture at nonacupoint off meridian were performed, respectively. The blood perfusion (BP) on the calf around bladder meridian area was measured with a laser Doppler perfusion imager before, during, and after acupuncture. The whole scanning field was divided into seven subareas, and mean BP on each area was calculated. The ratio of mean BP between a subarea and a reference subarea was gotten, and then the change rate was calculated as ratio change rate (RCR). The results showed that RCR on bladder meridian area and around Chengshan (BL57) during or after acupuncture at nonacupoint on meridian was significantly higher than that at nonacupoint off meridian, which supports the ancient theory. Such differences may be attributable to some factors that can facilitate the signals transmission and produce a better acupuncture effect, such as richer nerve terminals, blood vessels, and mast cells which can produce stronger signals on the acupoints and the low hydraulic resistance channel along meridians which plays a role of signal transmitting channel to get a better effect of acupuncture.

Induction of Hyperalgesia in Pigs through Blocking Low Hydraulic Resistance Channels and Reduction of the Resistance through Acupuncture: A Mechanism of Action of Acupuncture.

According to the classic theory of Chinese medicine, pain is due to the blockage in meridian channels, and acupuncture was invented to treat pain by "dredging" the channels. To test the theory, a hyperalgesia model was made by injecting hydrogel into low hydraulic resistance channel (LHRC) in 12 anaesthetized minipigs. Tail-flick threshold and ear-flick threshold were measured using a thermal radiation dolorimeter, and relative flick threshold (RFT) was calculated. Hydraulic resistance (HR) was measured with a biological HR measuring instrument on low HR points on LHRC and on control points with higher HR located outside LHRC; readings were recorded before, during, and after acupuncture treatment. RFT decreased after blocking the LRHC and was still significantly decreased 2 days and 4 days afterwards. No significant changes occurred when injecting saline into the same points or injecting gel into points outside the channel. Subsequent acupuncture reduced HR on LRHC along meridians but had no significant effect on sites with higher HR located outside LHRC. One of the mechanisms of action of acupuncture treatment for chronic pain may be that acupuncture affects peripheral tissue by reducing the HR in LHRC along meridians, improving the flow of interstitial fluid and removing algogenic substances and thereby relieving pain.

Study on the Formation of Novel Threadlike Structure through Intravenous Injection of Heparin in Rats and Refined Observation in Minipigs.

Objective. To study if the novel threadlike structure (NTS) was caused by coagulation during injecting urethane intraperitoneally and the source of NTS. Methods. Twenty-two SD rats were anaesthetized by urethane injected intraperitoneally. Heparin was injected at 5 minutes before the anaesthesia from femoral vein in 11 rats, and saline was given in the other 11 rats randomly. Six Chinese minipigs were carried to look for NTS. One sample was taken to be stained by DAPI/Phalloidin and observed by a laser scanning confocal microscope. Results. In the group of heparin, 10 rats were found to have NTS with appearance rate of 90.9%, and 9 rats were found to have NTS with the appearance rate of 80.1%. Both groups have 1.81 average numbers of NTS in each rat without significant difference (P > 0.05). In the observation of pigs, the NTS was found to prolong from the serous membranes of abdominal wall and organ surface. Histological observation showed elongated nuclei and alignment which is similar to the characteristics of PVS. Conclusion. There is no strong evidence to say that the NTS on organ surface was caused by coagulation of blood. The source of NTS might be a prolonged structure from serous membrane in abdominal cavity during the development and more or less retained after birth.

[Impacts on skin blood flow under moving cupping along meridians in different directions].

OBJECTIVE: To compare the impacts on skin blood flow between moving cupping following the meridian running direction and that against the running direction. METHODS: JLG-2 meridian cupping drainage instru ment was used for moving cupping on the back along the Bladder Meridian running course in either single direction for 20 times. The cupping device was Bian stone cup, 44 mm in inner diameter, negative pressure from -0.03 to -0.04 MPa. PeriScan PIM II laser Doppler perfusion imager was used to observe the changes in skin blood flow on the running course of the Bladder Meridian with cup moved up and down and in the same region on the contralateral Bladder Meridian. Blood flow was measured before cupping, at the immediate time after cupping and 10 min after cupping separately. Fourteen healthy volunteers received the test. The measuring region was subdivided into a moving cupping area, an upstream area, a downstream area, a contralateral moving cupping area, a contralateral upstream area and a contralateral downstream area. The mean blood flow was calculated in each area. RESULTS: Blood flow was increased significantly in each area and was more apparently increased in the moving cupping area. In comparison of the changing rate of blood flow between cupping following the meridian running direction and that against the running direction, it was only found that the changing rate in the upstream area of moving cupping against the running direction was significantly higher than that following the running direction (P < 0.05). The differences were not statistically significant in comparison among the other areas. Additionally, the changing rates of blood flow in the upstream and downstream area of the Bladder Meridian were increased significantly as compared with the contralateral Bladder Meridian. CONCLUSION: The local effects are similar between moving cupping following the meridian running direction and that against the running direction. The abscopal effect of moving cupping against the running direction is superior to that following the running direction. It is suggested that the dual-directional moving cupping is applicable for the treatment of local disorders and the abscopal effect is better with moving cupping against the meridian running direction.

Pathological Changes in Internal Organs after Blocking Low Hydraulic Resistance Channels along the Stomach Meridian in Pigs.

Objective. The correlation between meridians and organs (Zang-fu) is an important aspect of meridian theory. The objective of this paper is to investigate the pathological changes in the organs resulting from blocking low hydraulic resistance channel (LHRC) along the stomach meridian by injecting gel in pigs so as to offer some insight into the correlation between meridians and internal organs. Methods. Four white piglets and twelve black minipigs were divided into four batches and were observed in different periods. Each batch included two pairs of pigs and each pair matched two pigs with similar conditions among which gel was injected into 6~8 low hydraulic resistance points along the the stomach meridian in the experimental pig and the same amount of saline was injected into the same points in the control pig. The state of stomach and intestine was observed 6~10 weeks after the blocking model was developed. Results. The results showed that there were bloated stomach or/and intestine in all the experimental pigs while there were normal states in seven control pigs except one dead during the experiment. Conclusion. The findings confirmed that the blockage of LHRC along the stomach meridian can influence the state of stomach and intestine, leading to a distension on stomach or/and intestine.

The distribution of transcutaneous CO2 emission and correlation with the points along the pericardium meridian.

This study aimed to understand energy metabolism distribution along the pericardium meridian and verify the correlation between the body surface (points), and classic meridian theory. A highly sensitive CO(2) instrument was used to measure the transcutaneous CO(2) emission at 13 points along the pericardium meridian line (12 points on the line and one point beyond the line) and 13 control points beside them. Results showed that the distribution of transcutaneous CO(2) emission is highly related to the position on the body. Transcutaneous CO(2) emission is significantly higher at P7 and P3, than the control points beside them. The points along the meridian and the points beside them were clustered with relative distance by SAS statistics software. Two distance matrixes were then obtained. The correlation coefficients between the points along the line and between the control points were calculated. The results showed that the 13(th) point beyond the line was far from the 12 points on the line (distance, 0.24), while acupoints on the line clustered earlier when compared with the non-acupoints. The average correlation coefficients among the acu-points was 0.65 which was significantly higher than 0.56, among the non-acupoints. No such characteristics were found among the control points. It was concluded that there is a strong correlativity of energy metabolism activity between the body surfaces along the meridian, and an even stronger correlativity between the acupoints on the meridian.

[Influence of mechanical pressure on the change of acupuncture-induced transcutaneous CO2 emission].

OBJECTIVE: To investigate conduction of acupuncture effect and the influence of mechanical pressing meridians on it. METHODS: In twenty healthy volunteers (8 males and 12 females, aged 29 years on average), by using a Frewil Q. F. apparatus, transcutaneous CO2 emission (TCE) was measured before, during and after acupuncture at Neiguan (PC 6), respectively. The locations being measured were Quze (PC 3) and four points including two non-acupoints along the Pricardium Meridian (Point A and B) and two non-acupoints apart from the Pericardium Meridian (Point C and D). Point A was located at the lower one fourth of the line connecting Tianquan (PC 2) and Quze (PC 3), and Point B located at the middle of the line connecting Ximen (PC 4) and Quze (PC 3). Point C was located 2 cm lateral on the ulnar side to Point A, and Point D located 2 cm lateral on the ulnar side to Point B. The above results were compared with those obtained after mechanical pressure of 1 kg (area 1 cm X 2 cm) applied on Ximen (PC 4) and Daling (PC 7), respectively, to observe their effect on TCE. RESULTS: During and after acupuncture at Neiguan (PC 6) without mechanical pressure, TCE at Quze (PC 3), point A and B increased significantly (P < 0.05), but not at point C and D (P > 0.05). While applying mechanical pressure at Ximen (PC 4), no significant increase was found on the three points during and after acupuncture. When applying pressure at Daling (PC 7), significant increases of TCE were also found at Quze (PC 3) and point A during acupuncture (P < 0.05), and a significant increase of TCE was found at point B after acupuncture with pressure keeping (P < 0.05). CONCLUSION: Acupuncture can enhance energy metabolism along meridians, and this effect can be blocked by mechanical pressure.

A discovery of low hydraulic resistance channel along meridians.

A hydro-mechanic model was put forward to study the fundamental nature of acupuncture meridians. The basic state of low hydraulic resistance was tested on humans and mini pigs using three methods. The first, a modified Guyton's method, proved that there was lower hydraulic resistance on meridians compared with nonmeridians. The second scanning method involved a single pressure transducer that can find the lowest resistance point in tissue, and the third method used two transducers and provided a more stable measurement. Using the latter method, low hydraulic resistance points were found very close to low impedance points along meridians. The transmission of artificial interstitial fluid pressure waves was measured to examine their connection to the low resistance points, with the result that a good connection between the points was confirmed. This means the points form channels along the meridians that we refer to as low hydraulic resistance channels. The channel was imaged through isotopic tracing and a migration of isotope (99m)Te could be found along the channel. The layer of the channel was detected by injecting Alcian blue and the track was found beneath the skin. All of the above experiments suggest the existence of a new type of channel in living tissues that has not yet been described in modern science, but coincides quite well with the Qi channel theory of traditional Chinese medicine.

[Experimental verification of "treating lumbar-back problems by puncturing Weizhong (BL 40)" with blood perfusion imaging technique].

OBJECTIVE: To verify the classic saying of "Treating lumbar-back problems by puncturing Weizhong (BL 40)" in acu-moxibustion learning and to explore its underlying mechanism. METHODS: Forty volunteer sublects were asked to accept twice tests respectively, i.e., acupuncture of Weizhong (BL 40) and Yanglingquan (GB 34), for observing changes of skin blood perfusion (SBP) at the low back part of the body by using a laser Doppler perfusion imager. The whole observed area (lower back) was divided into five sub-areas, left and right areas involving Line-one and Line-two of the Bladder Meridian. RESULTS: In comparison with pre-acupuncture, SBP of both BL40 and GB34 groups increased significantly from 4 minutes' retention of needles on to 12 mm after withdrawing acupuncture needle (P < 0.01), but no significant difference was found between two groups in SBP (P > 0.05). The change rates of SBP at Line-one and Line-two of the Bladder Meridian on the same side of the stimulated Weizhong (BL 40) were significantly higher than those of Yanglingquan (GB 34) (P < 0.05), but no significant changes were found on the opposite side (both Line-one and Line-two) of the Bladder Meridian. CONCLUSION: Acupuncture of both BL4O and GB34 can increase SBP at the low back of the body (involving the Bladder Meridian) on the same side, but the changing rate of SBP of BL4O is hiaher than that of GB34.