Acupuncture Therapy for Neurological Diseases (eBook)

All editors and authors of this book are members of the Institute of Acupuncture Research at Shanghai Medical College of Fudan University (Former Shanghai Medical University), one of the earliest Institutions in China, which is specialized in research on acupuncture effects and the mechanisms. This Institute is also one of the WHO Collaborating Centers for Traditional Medicine. In the past 50 years, scientists in this Institute have comprehensively studied acupuncture effects on neurological disorders and the underlying mechanisms. This book is the first monograph of this Institute and will summarize the major studies performed in this Institute and extend the informative discussions to all disciplines related to the scope of this book, including the most recent results from this Institute. Some authors are members of neurobiological labs in USA at the same time and the book covers also those studies of other researchers in the view of modern neuroscience. 

Title Page 2
Copyright Page 3
1 History of Modern Acupuncture Research in China 10
1.1 Acupuncture and Traditional Chinese Medicine 10
1.1.1 The Channels and Collaterals 12
1.1.2 Acupoints 13
1.1.3 General Principles of Acupuncture Treatment 13
1.2 Modern Developments in Acupuncture Treatment 14
1.3 Acupuncture Research at Shanghai Medical University 16
1.3.1 Relationship Between the Meridian-Points and Peripheral Nerves 16
1.3.2 Acupuncture Analgesia and Acupuncture Anesthesia 17
1.3.2.1 Effect of acupuncture on pain perception on normal subjects 17
1. Effect of acupuncture on normal volunteers 17
2. Effect of sham acupuncture on normal subjects 17
1.3.2.2 Clinical features of acupuncture anesthesia on patients 18
1.3.2.3 Neurohumoral mechanism of acupuncture analgesia 20
1. Peripheral neuropathway of acupuncture feeling 20
2. Central neuromodulatory mechanism of acupuncture analgesia 22
1.3.2.4 Endogenous opioid peptides and acupuncture analgesia 23
1. Release of endogenous opioid peptides by acupuncture 23
2. Antagonism of acupuncture analgesia by naloxone 24
3. Effect of orphanin FQ on acupuncture analgesia 25
1.3.2.5 Combination of acupuncture with therapeutic drugs 25
1. Selection of drugs affecting acupuncture analgesia 25
2. Development of acupuncture-balanced anesthesia 26
3. Mechanism of acupuncture analgesia and drugs synergism 26
1.3.3 Therapeutic Effects and Mechanisms of Acupuncture on Neurological Disorders 28
1. Acupuncture and epilepsy 28
2. Acupuncture and cerebral ischemia 29
3. Acupuncture and cardiovascular diseases 30
4. Acupuncture and neuroimmune disorders 30
5. Acupuncture and woman’s reproductive disorders 31
1.4 Concluding Remarks 32
References 33
2 Neuroanatomic Basis of Acupuncture Points 41
2.1 Introduction 41
2.2 Phenomena of Meridians and Acupoints 42
2.2.1 Theory of Meridians, Collaterals, and Acupoints 42
2.2.2 Relatively Specific Effects of Acupoints 44
2.2.3 Unique Physiological Features of Acupoints 45
2.2.4 Relatively Specific Anatomical Structures of Acupoints 46
2.3 Neuroanatomic Structure of Acupoints 48
2.3.1 Gross Anatomical Observation of Meridians and Acupoints 49
2.3.2 General Histological Features of Acupoints 63
2.3.3 Microanatomic Examination of Acupoints 67
2.3.4 Morphological Basis of Sensation of Acupuncture at Acupoints 69
2.3.5 Other Morphologic Research on Acupoint 71
2.4 Neural Connection Between Meridian-Point and Viscus 72
2.4.1 Segmental Nerve Innervation Between Meridian-Points and Viscera 74
2.4.2 Convergence of Afferent Signals of Meridian-Points and Viscera in the Central Nervous System 78
2.5 Afferent Nerve Fibers and Afferent Pathway of Acupuncture Signal 80
2.5.1 Acupuncture Signal and Afferent Nerve Fibers 80
2.5.2 Acupuncture Signal Transmission Pathway 81
2.6 Concluding Remarks 82
References 83
3 Neural Transmission of Acupuncture Signal 90
3.1 Introduction 91
3.2 Initiation of Acupuncture Signal 93
3.2.1 Acupoint-Selection Impact on the Pattern of Brain-Area Activity 93
3.2.2 Acupuncture Modality: Manual or Electrical? 94
3.2.3 Wave Forms, Frequency, Intensity, and Timing 95
3.2.4 Transduction of Acupuncture Signal in the Afferent Nerves 96
3.3 Integration of Acupuncture Signal in the Central Nervous System 98
3.3.1 Integration of Nociceptive and Acupuncture Signals in the Spinal Cord and the Gate Control Theory 100
3.3.2 Effects of Brainstem and Descending Control on Acupuncture Analgesia 101
3.3.3 The Limbic System and Acupuncture Analgesia 103
3.4 Neurobiological Mechanism of Acupuncture in Autonomic Nervous System 104
3.4.1 Structure and Function of Autonomic Nervous System 105
3.4.2 Acupuncture Signal Regulating Activation of Autonomic Nervous System 106
3.4.3 Therapeutic Effects of Acupuncture Mediated Through Autonomic Nervous System 107
3.5 Concluding Remarks 109
References 109
4 Acupuncture-Induced Activation of Endogenous Opioid System 113
4.1 Introduction 113
4.2 Role of Endogenous Opioid System in Acupuncture 114
4.3 Acupuncture-Promoted Release of Endogenous Opioids 114
4.3.1 Central Release 115
4.3.2 Peripheral Circulation 115
4.3.3 Frequency-Dependent Release 116
4.4 Acupuncture-Induced Alteration in the Content of EOP in the Brain 117
4.5 Acupuncture-Enhanced Expression of Endogenous Opioids 119
4.6 Acupuncture and Opioid Receptors 120
4.6.1 Role of Opioid Receptor Subtypes in Acupuncture Effects 121
4.6.2 Acupuncture and Opioid Receptor Density 122
4.7 Concluding Remarks 123
References 124
5 Effect of Acupuncture on Neurotransmitters/ Modulators 129
5.1 Introduction 130
5.2 5-hydroxytryptamine 130
5.2.1 Acupuncture-Induced Increase in Central 5-Hydroxytry- ptamine Activity 131
5.2.2 Acupuncture Regulation of 5-Hydroxytryptamine Activity in Certain Physiological and Pathophysiologic Conditions 132
5.2.3 Acupuncture and 5-Hydroxytryptamine Receptors 132
5.3 Noradrenalin 133
5.3.1 Acupuncture Reduction of Noradrenalin Release and Content in the Brain 134
5.3.2 Effect of Endogenous Opioid Peptides on Noradrenalin During Acupuncture 134
5.3.3 Acupuncture and Noradrenergic Receptors 135
5.4 Dopamine 135
5.4.1 Acupuncture-Induced Alteration in Dopaminergic Activity 136
5.4.2 Effect of Other Neurotransmitters on Dopaminergic Activity during Acupuncture 136
5.4.3 Acupuncture and Dopaminergic Receptors 136
5.5 Acetylcholine 137
5.5.1 Acupuncture and Cholinergic Activity 137
5.5.2 Role of Acetylcholine in Acupuncture Effects 138
5.5.3 Acupuncture and Cholinergic Receptors 139
5.6 Amino Acids 139
5.6.1 Excitatory Amino Acids 139
5.6.2 Inhibitory Amino Acids 140
5.7 Other Neurotransmitters 141
5.7.1 Substance P 141
5.7.2 Prostaglandin 141
5.7.3 Cholecystokinin-Octopeptide-8 142
5.7.4 Somatostatin 142
5.7.5 Orphanin FQ 142
5.7.6 Neurotrophic Factors 143
5.7.7 Nitric Oxide 143
5.8 Concluding Remarks 144
References 145
6 Acupuncture-Drug Balanced Anesthesia 152
6.1 Introduction: From Acupuncture Analgesia to Acupuncture Anesthesia 152
6.2 From Acupuncture Anesthesia to Acupuncture-Drug Balanced Anesthesia 154
6.2.1 The Advantages of Acupuncture-Drug Balanced Anesthesia 154
6.2.2 The Main Cases of Acupuncture-Drug Balanced Anesthesia 155
6.2.2.1 Craniocerebral operation 155
6.2.2.2 Operations of heart, chest and larynx 156
6.2.2.3 The abdominal operations 158
6.3 Application of Acupuncture Anesthesia in Different Countries or Areas 159
6.4 Clinical and Experimental Research on Combination of Acupuncture with Drugs in Pain Treatment 162
6.5 Mechanism of the Synergistic Effect of Acupuncture- Drug Combination 163
6.6 Concluding Remarks 166
References 167
7 Acupuncture Analgesia in Clinical Practice 171
7.1 Introduction 171
7.2 Common Controls for Clinical Acupuncture 173
7.3 Types of Acupuncture Approaches 174
7.3.1 Manual Acupuncture 175
7.3.2 Electroacupuncture 175
7.4 Acupuncture Analgesia in Clinical Practice 178
7.4.1 Headaches 178
7.4.2 Chronic Low Back Pain 181
7.4.3 Knee Osteoarthritis 184
7.4.4 Chronic Neck Pain 186
7.4.5 Neuropathic Pain 188
7.4.6 Motor System Injuries 190
7.4.7 Fibromyalgia 191
7.4.8 Cancer Pain 191
7.4.9 Dental Pain 193
7.4.10 Phantom Limb Pain 194
7.5 Side Effects 194
7.6 Concluding Remarks 195
References 195
8 Neurochemical Basis of Electroacupuncture Analgesia on Acute and Chronic Pain 203
8.1 Introduction 203
8.2 EA analgesia on Acute and Chronic Pain 204
8.2.1 Neuropathic Pain 204
8.2.2 Inflammatory Pain 206
8.2.3 Cancer Pain 207
8.3 Neurochemical Mechanism Underlying EA Analgesia on Acute Pain 208
8.3.1 Endogenous Opioid Peptides 208
8.3.2 CCK-8 212
8.3.3 Glutamate 213
8.3.4 GABA 214
8.3.5 Serotonin (5-HT) 214
8.3.6 Noradrenaline 215
8.3.7 Dopamine 216
8.4 Neurochemical Basis of EA Analgesia on Chronic Pain 216
8.4.1 EOPs 217
8.4.2 Other Neuropeptides 218
8.4.3 Glutamate 219
8.4.4 Serotonin 222
8.4.5 EAA and Neuroinflammation 223
8.4.6 Neural Growth Factors and Neurotrophins 224
8.5 Concluding Remarks 226
References 227
9 Acupuncture Therapy for Stroke 235
9.1 Introduction 236
9.2 Clinical Practice of Acupuncture on Stroke 238
9.2.1 Clinical Acupuncture and Commonly Used Acupoints in Stroke Treatment 239
9.2.2 Efficacy of Acupuncture on Stroke 241
9.2.3 Various Factors That Affect the Efficacy of Acupuncture 244
9.3 Experimental Study of Acupuncture-Induced Protection from Stroke 245
9.3.1 Animal Models 245
9.3.2 Anti-Ischemic Effect of Acupuncture in Animals 247
9.3.3 Effect of Acupuncture on the Functional Recovery of the Ischemic Brain 249
9.3.4 Optimal EA Conditions for Maximal Protection from Cerebral Ischemia 250
9.3.5 Mechanisms of Acupuncture-Induced Protection Against Cerebral Ischemia 251
9.4 Concluding Remarks 263
References 264
10 Effects of Acupuncture on Arrhythmia and Other Cardiac Diseases 272
10.1 Introduction 272
10.2 Clinical Application of Acupuncture for the Treatment of Cardiac Diseases 273
10.2.1 Arrhythmia 274
10.2.2 Other Cardiac Disorders 276
10.3 Mechanisms of Acupuncture Therapy for Cardiac Disorders 277
10.3.1 Mechanisms Underlying Acupuncture Correction of Arrhythmia 278
10.3.1.1 Regulation of nerve activity 279
10.3.1.2 Role of neurotransmitters 280
10.3.1.3 Humoral and electrolyte mechanisms 283
10.3.1.4 Local cardiac regulation 283
10.3.1.5 Other possible mechanisms 285
10.3.2 Mechanisms of Acupuncture Therapy for Other Cardiac Disorders 287
10.3.2.1 Mechanisms of acupuncture therapy for coronary heart disease 287
10.3.2.2 Mechanisms of acupuncture treatment for other cardiac diseases 289
10.4 Concluding Remarks 289
References 291
11 Acupuncture Therapy for Hypertension and Hypotension 298
11.1 Introduction 298
11.2 Clinical Application of Acupuncture for Treating Abnormal Blood Pressure 299
11.2.1 Hypertension 299
11.2.2 Hypotension 307
11.3 Mechanisms of Acupuncture Therapy for Abnormal Blood Pressure 309
11.3.1 Mechanisms of Acupuncture-induced Decrease in Lowering High Blood Pressure 310
11.3.1.1 Modulation of peripheral resistance of the blood flow 310
11.3.1.2 Neural regulation 311
11.3.1.3 Humoral and other mechanisms 317
11.3.2 Mechanisms of Acupuncture Therapy for Low Blood Pressure 321
11.3.2.1 Peripheral pathway of signal transmission 321
11.3.2.2 Central regulation 322
11.3.2.3 Humoral regulation 323
11.3.2.4 Ionic and other mechanisms 325
11.4 Concluding Remarks 326
References 327
12 Effect of Acupuncture on Epilepsy 335
12.1 Introduction 335
12.2 Clinical Practice of Acupuncture on Epilepsy 337
12.2.1 History 337
12.2.2 Current Applications of Acupuncture Therapy 340
12.2.2.1 Fine acupuncture 340
12.2.2.2 Catgut implantation at acupoints 341
12.2.2.3 Acupuncture plus Chinese herbs 342
12.2.2.4 Other methods 342
12.2.3 Acupoints 343
12.2.4 Efficacy 344
12.2.5 Negative and Opposite Evidences 345
12.3 Mechanism of Acupuncture Inhibition of Epilepsy 346
12.3.1 Effect of Acupuncture on Electroencephalogram and Power Spectra 347
12.3.2 Effect of Acupuncture on Excitatory and Inhibitory Amino Acids 349
12.3.2.1 GABA, Glutamate and their receptors 350
12.3.2.2 Taurine 354
12.3.3 Effect of Acupuncture on Neuropeptides 356
12.3.3.1 Cholecystokinin 356
12.3.3.2 Somatostatin 356
12.3.3.3 Endogenous opioid peptides and opioid receptors 357
12.3.4 Effect of Acupuncture on Nitric Oxide 360
12.3.5 Effect of Acupuncture on Other Neurological Factors 361
12.3.5.1 c-Fos, c-Jun and glutamate decarboxylase 361
12.3.5.2 cAMP and cGMP 362
12.3.5.3 Actylcholine 362
12.3.5.4 Serotonin 363
12.3.5.5 Melatonin 363
12.3.6 An Anatomical View 364
12.4 Concluding Remarks 364
References 365
13 Neuroimmuno-effect of Acupuncture on Immune- mediated Disorders 374
13.1 Introduction 374
13.2 Acupuncture and Immune-mediated Disorders 375
13.2.1 Immunostimulant Points 376
13.2.2 Acupoint Specificity and Acupuncture Efficacy 376
13.2.3 Immune Modulation of Acupuncture 377
13.2.3.1 The modulatory effects of acupuncture on circulating white blood cells 377
13.2.3.2 The modulatory effects of acupuncture on T-lymphocytes 378
13.2.3.3 The modulatory effects of acupuncture on natural killer cells 378
13.2.3.4 The modulatory effects of acupuncture on antibody levels 378
13.2.4 Common Practice of Acupuncture on Immune-mediated Disorders 379
13.2.4.1 Rheumatoid arthritis 379
13.2.4.2 Acupuncture and cancer-related immunosuppression 382
13.2.4.3 Acupuncture and surgery-induced immunosuppression 383
13.3 Mechanism of Acupuncture on Immune-related Diseases 385
13.3.1 The General Regulatory Effects of Acupuncture and the Theory of Neuroendocrine-immune Network 385
13.3.2 Role of Hypothalamus-pituitary-adrenal Axis in Acupuncture-mediated Effects on Immune System 387
13.3.3 Role of Neuropeptides on the Immunoregulatory Effects of Acupuncture 388
13.3.3.1 Endogenous opioid-like peptides 390
13.3.3.2 Substance P 391
13.3.3.3 Role of central IL-1.. on the immunoregulatory effects of acupuncture 392
13.4 Concluding Remarks 392
References 393
14 Acupuncture Treatment for Female Infertility 398
14.1 Introduction 398
14.2 Treatment of Infertility 400
14.2.1 Principles of Medication and Reproductive Technologies 400
14.2.2 Acupuncture Therapeutics 401
14.2.2.1 Involved acupoints 401
14.2.2.2 Acupuncture induction of ovulation 402
14.2.3 Acupuncture Combined with Assisted Reproduction Technology 403
14.3 Mechanism of Acupuncture Therapy for Infertility 403
14.3.1 Clinical Studies 404
14.3.1.1 Effects of acupuncture on the levels of blood reproductive hormones 404
14.3.1.2 Acupuncture may modulate the activity of sympathetic nervous system 405
14.3.2 Experimental Studies 406
14.3.2.1 Induced maturation and exfoliation of vaginal epithelium and raise in the blood estradiol 406
14.3.2.2 Inhibition of over-compensative release of hypothalamic gonadotropin- releasing hormone and promotion of the release of hypothalamic ..-endorphin 407
14.3.2.3 Effect of acupuncture on the expression of brain prolactin-releasing peptide and orphanin FQ 408
14.3.2.4 Acupuncture accelerates the extragonadal aromatization 409
1. Acupuncture enhances the activity of adrenal argyrophil nucleolar organizer regions and the blood level of corticosterone and androgen 409
2. Acupuncture promotes adrenal expressions of P450CYP mRNA 409
3. Acupuncture increases the activity and expression of tissue aromatase in subcutaneous abdominal adipose and liver tissues 410
14.3.2.5 Acupuncture may improve uterine artery blood flow impedance 411
14.3.2.6 Acupuncture and stress reduction 411
14.4 Concluding Remarks 412
References 412
15 Acupuncture Therapy for Menopausal and Perimenopausal Syndrome 416
15.1 Introduction 416
15.2 Acupuncture Treatment for Menopause and Perimenopausal Syndrome 418
15.2.1 Commonly Used Acupoints 418
15.2.2 Therapeutic Effects of Acupuncture on Menopausal Syndrome 420
15.3 How Does Acupuncture Work? 422
15.3.1 Electroacupuncture-induced Regulation of Hypothalamic- pituitary-ovarian Axis 422
15.3.2 Role of ..-endorphin 426
15.3.3 Role of Corticotrophin-releasing Factor and Hypothalamus- pituitary-adrenal Axis 427
15.3.4 Role of Extragonadal Aromatization 428
15.3.5 Electroacupuncture Promotes the Homeostasis in Ovariectomized Rats 430
15.3.6 Psychological Impact of Acupuncture 431
15.4 Concluding Remarks 431
References 432
16 Acupuncture for Smoking Cessation 435
16.1 Introduction 435
16.2 Researches on Smoking Cessation 436
16.3 Clinical Application of Acupuncture for Smoking Cessation 437
16.3.1 Body Acupuncture 438
16.3.2 Auriculo-acupuncture 439
16.3.3 Nasal Acupuncture 439
16.3.4 Combination Therapy 440
16.4 Mechanisms of Acupuncture Therapy for Smoking Cessation 441
16.4.1 Gustatory Sensation and Mouth Environment 441
16.4.2 Neuroendocrinology 442
16.4.3 Cardiorespiratory Function 442
16.5 Theory of Traditional Chinese Medicine in Smoking Cessation 442
16.6 Concluding Remarks 443
References 444
17 Beneficial Effect of Acupuncture on Depression 446
17.1 Introduction 447
17.2 Clinical Trials 448
17.2.1 Acupuncture as a Sole Therapy 448
17.2.2 Acupuncture Combined with Other Therapies 455
17.3 Mechanism Studies 457
17.3.1 Effect of Electroacupuncture on the Neurotransmitters 458
17.3.2 Effect of Electroacupuncture on the Hypothalamus-pituitary-adrenal Axis 459
17.3.3 Effect of Electroacupuncture on the Immune System 459
17.3.4 Effect of Electroacupuncture on Signal Transduction System 460
17.3.5 Effect of Electroacupuncture on Hippocampus 461
17.4 Concluding Remarks 462
References 465
18 Effect of Acupuncture on Drug Addiction 469
18.1 Introduction 469
18.2 Clinical Application of Acupuncture for Drug Addiction 470
18.2.1 Auriculo-acupuncture 470
18.2.2 Body Acupuncture 471
18.2.3 Electroacupuncture 471
18.2.4 Han’s Acupoints Nerve Stimulator 472
18.2.5 Combination Therapy 473
18.3 Mechanisms of Acupuncture Therapy for Drug Addiction 474
18.3.1 The Role of Endorphin in Acupuncture Treatment for Opioid Dependence 474
18.3.2 The Roles of Some Neurotransmitters in Acupuncture Treatment for Opioid Dependence 476
18.3.3 Regulation of Immunity 477
18.3.4 Changes in the Function of Endocrinology 477
18.3.5 Alterations in Psychology 478
18.4 Concluding Remarks 478
References 479
Appendix A Milestone of Acupuncture Research: Correlation Between Peripheral Nerves and Meridians-Acupoints 482
References 483
Index 484