Scientific bases of acupuncture analgesia
Keywords:
ACUPUNCTURE ANALGESIA, NOCICEPTION, NEUROMODULATION
Abstract
This review synthesizes the most important papers on acupuncture analgesia written in foreign universities until September 2005.
Acupuncture, a medical therapy, is efficient to relief pain and the concomitant emotional component. It produces reflex responses mediated by super centres of central control and endocrine and immunologic systems.
Neuromodulation of nociception studies as well as other studies related to mechanisms of acupuncture have become more important in the last decades. Using neurophysiologic, neuropharmacologic, neurochemical and neuro-imaging methods, research teams agree that acupuncture stimulation activates afferent fibres of peripheral nerves producing nervous impulse that ascend to the brain via the ventrolateral fascicule of the spinal cord. They conclude that neuromodulation include periphery events, spinal mechanisms, ‘gate control’, supra spinal mechanisms, through descendent inhibitory pathway, diffuse inhibitory nociceptive mechanism, autonomic nervous system, hypothalamus-pituitary-adrenal axis and cortical mechanisms. Some cerebral nucleus take part, such as: caudate nucleus, arcuato, accumbens, periaqueductal gray substance, rafe nucleus, and limbic system areas; peptide modulators; neurotransmitters: serotonine, norepinephrine, acetilcoline and hormones.
Different researchers suggest that it activates the gene expression of endogen opioids peptides precursors: beta endorphins, enkephalins and dynorphins.
Many authors recommend an adequate selection of electro-acupuncture parameters and the combination with drugs if necessary during surgery.
References
1) Pomeranz B, Stux GS. Scientific bases of Acupuncture. Berlin: Springer-Verlag, 1989: 94-9.
2) Wong JY. Manual of neuro-anatomical acupuncture. Musculo-skeletal disorders. Toronto: Toronto Pain and Stress Clinic, 1999.
3) Gonzalo LM. La reflexoterapia en el tratamiento del dolor. Rev Soc Esp Dolor 1998, 5: 461-6.
4) Mayer DJ. Biological mechanisms of acupuncture. Prog Brain Res 2000; 122: 457-77.
5) Ulett GA, Han J, Han S. Traditional and evidence based acupuncture: history, mechanisms and present status. South Med J 1998; 91(12): 1115-20.
6) Carlsson C. Acupuncture mechanisms for clinically relevant long-term effects-reconsideration and a hypothesis. Acupunct Med 2002; 20(2-3): 82-99.
7) Cao X. Scientific bases of acupuncture analgesia. Acupunct Electrother Res 2002; 27(1): 1-14.
8) Manheimer E, White A, Berman B, Forys K, Ernst E. Meta-Analysis: acupuncture for low back pain. Ann Intern Med 2005; 142(11): 651-63.
9) Omura Y. Phato-physiology of acupuncture effects, ACTH, and morphine like substances, phantom sensatiosns (phantom pain, itch, and coldness) brian microcirculation and memory. Acupunct Electrother Res 1976; 2(1-2): 1-31.
10) Culliton PD. Current utilization of acupuncture by United States patients. National Institutes of Health Consensus Development Conference on Acupuncture, Bethesda, November 3-5, 1997.
11) Wu MT, Hsieh JC, Xiong J, Yang CF, Pan HB, Chen YC, et al. Central nervous pathway for acupuncture stimulation: localization of processing with functional MR imaging of brain-preliminary experience. Radiology 1999; 212(1):133-41.
12) Li WM, Wu GC, Arita H, Hanaoka K. Acupuncture stimulation inhibits somato-renal sympathetic A and C reflexes in anhesthetized rats. Acupunct Electrother Res 2002; 27(2): 119-27.
13) Hermida A. Acción de las agujas. In: Acupuntura. Ciencia para occidente. Aplicaciones y explicaciones. Montevideo, 1973: 91-4.
14) Caritat R, Caritat S. Acupuntura. Rev Midu (Montevideo) 1988; 1(2): 37-42.
15) International Association for the Study of Pain. Pain term a current list with definitions and notes on usage. Pain 1986; 24(Suppl. 1): S215-S221.
16) Universidad de La Plata. Facultad de Ciencias Médicas. Departamento de Graduados. Cátedra de Deontología Médica y Medicina Legal. Curso Universitario por Internet: Dolor. La Plata: Universidad de La Plata, 2000. Obtenido de: http://www.curso-dolor.com.ar/dirección.php3. (consultado: 15/11/2004).
17) Carneiro NM. Fundamentos da acupuntura médica. Florianópolis: Sistema, 2001: 393-496.
18) Shen J. Research on the neurophysiological mechanisms of acupuncture: review of selected studies and methodological issues. J Altern Complement Med 2001; 7(Suppl 1): S121-7.
19) Barcia D, Martínez A. Estudio y tratamiento del dolor. Murcia: Roche Internacional, 1985: 23-32.
20) Chen GB, Li SC, Jiang CC. Clinical studies on neurophysiological and biochemical basis of acupuncture analgesia. Am J Chin Med 1986; 14(1-2): 84-95.
21) Abad-Alegria F, Pomaron MA, Barcala-Simo MA. Control de la somestesia por estímulo neurorreflejo: cuantificación de estímulo-respuesta frente a la energía. Rev Neurol 2003; 37(5): 421-5.
22) Chen-yu C, Jen-yi L, Teh-hsing C, Yao-hui P, Shu-chieh C. Studies of spinal ascending pathways for effects of acupuncture analgesia in rabbits. Sci Sin 1975; 18(5): 651-8.
23) Lu GW. Characteristics of afferent fiber innervation on acupucture point zusanli. Am J Physiol 1983; 245(4):R606-12.
24) Chang HT. Integrative action of thalamus in the process of acupuncture for analgesia. Sci Sin 1973; 16(1): 25-60.
25) Melzack R, Wall PD. Pain mechanisms: a new theory. Science 1965; 150(699): 971-9.
26) Carneiro NM. Fundamentos de acupuntura médica. Florianó-polis: Sistema, 2001: 497-609.
27) Hagbarth KE, Kerr DI. Central influences on spinal afferent conduction. J Neurophysiol 1954; 17(3): 295-307.
28) Reynolds DV. Surgery in the rat during electrical analgesia induced by focal brain stimulation. Science 1969; 164(878): 444-5.
29) Shen E. Participation of descending inhibition in acupuncture analgesia. In: Zhang XT, ed. Research on acupuncture, moxibustion and acupuncture anesthesia. Beijing: Science Press, 1986: 31-8.
30) Hui KK, Liu J, Makris N, Gollub RL, Chen AJ, Moore CI, et al. Acupuncture modulates the limbic system and subcortical gray structures of the human brain: evidence from fMRI studies in normal subjets. Hum Brain Mapp 2000; 9(1): 13-25.
31) He LF, Xu SF, Jiang CC. Role of caudate nucleus in acupuncture analgesia. In: Zhang XT, ed. Research on acupuncture, moxibustion and acupuncture anesthesia. Beijing: Science Press, 1986: 146-57.
32) Han JS. The neurochemical basis of pain relief by acupuncture. A collection of papers. Beijing: Medical University Press, 1987.
33) Kaptchuk TJ. Acupuncture: theory, efficacy, and practice. Ann Intern Med 2002; 136(5): 374-83.
34) Mayer DJ, Price DD, Raffii A. Antagonism of acupuncture analgesia in man by the narcotic antagonist naloxone. Brain Res 1977; 121(2): 368-72.
35) Zhang AZ, Pan XP, Cheng JS, Mo WY. Endorphins and acupuncture analgesia. Chin Med J (Engl) 1980; 93(10): 673-80.
36) Li QS, Xi GF, Liu ZY. Changes in serum endogenous opiate-like peptides and plasma leu-enkefallin during acupuncture analgesia in patients with pain and their relationship to the types of traditional patients’ syndrome classified by traditional Chinese medicine. Nucl Technol 1984; 1: 26.
37) He LF. Involvement of endogenous opioid peptides in acupuncture analgesia. Pain 1987; 31(1): 99-121.
38) Han JS, Ding XZ, Fan SG. Frecuency as the cardinal determinant for electroacupuncture analgesia to be reversed by opioid antagonists. Acta Phytophysiol Sinica 1986; 38(5): 475-82.
39) Wan Y, Mogil JS, Huang C, Han JS. Decrease of low frequency (2Hz) electroacupuncture analgesia in mice lacking beta-endorphin. Chin J Pain Med 1999; 5: 161-7.
40) Langone J. Alternative therapies: challenging the mainstream. TIME Special Issue 1996: 40-3.
41) Akca O, Sessler DI. Acupuncture: a useful complement of anesthesia. Minerva Anestesiol 2002; 68(4): 147-51.
42) Xu SF, Cao XD, Mo WY, Xu ZB, Pan YY. Effect of combination of drugs with acupuncture on analgesic efficacy. Acupunct Electrother Res 1989; 14(2): 103-13.
43) Yu Y, Gao M, He LF. Time course of alteration of pro-opiomelanocortin m-RNA level in rat hypotalamic arcuato nucleus following electroacupuncture. Acta Acad Med Shangai 1994: 59-62.
44) Nepp J, Jandrasits K, Schauersberger J, Schild G, Wedrich A, Sabine GL, et al. Is acupuncture an useful tool for pain-treatment in ophthalmology? Acupunct Electrother Res 2002; 27(3-4): 171-82.
45) Han JS, Wang Q. Mobilization of specific neuropeptides by peripheral stimulation of identified frecuencies. News Physiol Sci 1992; 7: 176-90.
2) Wong JY. Manual of neuro-anatomical acupuncture. Musculo-skeletal disorders. Toronto: Toronto Pain and Stress Clinic, 1999.
3) Gonzalo LM. La reflexoterapia en el tratamiento del dolor. Rev Soc Esp Dolor 1998, 5: 461-6.
4) Mayer DJ. Biological mechanisms of acupuncture. Prog Brain Res 2000; 122: 457-77.
5) Ulett GA, Han J, Han S. Traditional and evidence based acupuncture: history, mechanisms and present status. South Med J 1998; 91(12): 1115-20.
6) Carlsson C. Acupuncture mechanisms for clinically relevant long-term effects-reconsideration and a hypothesis. Acupunct Med 2002; 20(2-3): 82-99.
7) Cao X. Scientific bases of acupuncture analgesia. Acupunct Electrother Res 2002; 27(1): 1-14.
8) Manheimer E, White A, Berman B, Forys K, Ernst E. Meta-Analysis: acupuncture for low back pain. Ann Intern Med 2005; 142(11): 651-63.
9) Omura Y. Phato-physiology of acupuncture effects, ACTH, and morphine like substances, phantom sensatiosns (phantom pain, itch, and coldness) brian microcirculation and memory. Acupunct Electrother Res 1976; 2(1-2): 1-31.
10) Culliton PD. Current utilization of acupuncture by United States patients. National Institutes of Health Consensus Development Conference on Acupuncture, Bethesda, November 3-5, 1997.
11) Wu MT, Hsieh JC, Xiong J, Yang CF, Pan HB, Chen YC, et al. Central nervous pathway for acupuncture stimulation: localization of processing with functional MR imaging of brain-preliminary experience. Radiology 1999; 212(1):133-41.
12) Li WM, Wu GC, Arita H, Hanaoka K. Acupuncture stimulation inhibits somato-renal sympathetic A and C reflexes in anhesthetized rats. Acupunct Electrother Res 2002; 27(2): 119-27.
13) Hermida A. Acción de las agujas. In: Acupuntura. Ciencia para occidente. Aplicaciones y explicaciones. Montevideo, 1973: 91-4.
14) Caritat R, Caritat S. Acupuntura. Rev Midu (Montevideo) 1988; 1(2): 37-42.
15) International Association for the Study of Pain. Pain term a current list with definitions and notes on usage. Pain 1986; 24(Suppl. 1): S215-S221.
16) Universidad de La Plata. Facultad de Ciencias Médicas. Departamento de Graduados. Cátedra de Deontología Médica y Medicina Legal. Curso Universitario por Internet: Dolor. La Plata: Universidad de La Plata, 2000. Obtenido de: http://www.curso-dolor.com.ar/dirección.php3. (consultado: 15/11/2004).
17) Carneiro NM. Fundamentos da acupuntura médica. Florianópolis: Sistema, 2001: 393-496.
18) Shen J. Research on the neurophysiological mechanisms of acupuncture: review of selected studies and methodological issues. J Altern Complement Med 2001; 7(Suppl 1): S121-7.
19) Barcia D, Martínez A. Estudio y tratamiento del dolor. Murcia: Roche Internacional, 1985: 23-32.
20) Chen GB, Li SC, Jiang CC. Clinical studies on neurophysiological and biochemical basis of acupuncture analgesia. Am J Chin Med 1986; 14(1-2): 84-95.
21) Abad-Alegria F, Pomaron MA, Barcala-Simo MA. Control de la somestesia por estímulo neurorreflejo: cuantificación de estímulo-respuesta frente a la energía. Rev Neurol 2003; 37(5): 421-5.
22) Chen-yu C, Jen-yi L, Teh-hsing C, Yao-hui P, Shu-chieh C. Studies of spinal ascending pathways for effects of acupuncture analgesia in rabbits. Sci Sin 1975; 18(5): 651-8.
23) Lu GW. Characteristics of afferent fiber innervation on acupucture point zusanli. Am J Physiol 1983; 245(4):R606-12.
24) Chang HT. Integrative action of thalamus in the process of acupuncture for analgesia. Sci Sin 1973; 16(1): 25-60.
25) Melzack R, Wall PD. Pain mechanisms: a new theory. Science 1965; 150(699): 971-9.
26) Carneiro NM. Fundamentos de acupuntura médica. Florianó-polis: Sistema, 2001: 497-609.
27) Hagbarth KE, Kerr DI. Central influences on spinal afferent conduction. J Neurophysiol 1954; 17(3): 295-307.
28) Reynolds DV. Surgery in the rat during electrical analgesia induced by focal brain stimulation. Science 1969; 164(878): 444-5.
29) Shen E. Participation of descending inhibition in acupuncture analgesia. In: Zhang XT, ed. Research on acupuncture, moxibustion and acupuncture anesthesia. Beijing: Science Press, 1986: 31-8.
30) Hui KK, Liu J, Makris N, Gollub RL, Chen AJ, Moore CI, et al. Acupuncture modulates the limbic system and subcortical gray structures of the human brain: evidence from fMRI studies in normal subjets. Hum Brain Mapp 2000; 9(1): 13-25.
31) He LF, Xu SF, Jiang CC. Role of caudate nucleus in acupuncture analgesia. In: Zhang XT, ed. Research on acupuncture, moxibustion and acupuncture anesthesia. Beijing: Science Press, 1986: 146-57.
32) Han JS. The neurochemical basis of pain relief by acupuncture. A collection of papers. Beijing: Medical University Press, 1987.
33) Kaptchuk TJ. Acupuncture: theory, efficacy, and practice. Ann Intern Med 2002; 136(5): 374-83.
34) Mayer DJ, Price DD, Raffii A. Antagonism of acupuncture analgesia in man by the narcotic antagonist naloxone. Brain Res 1977; 121(2): 368-72.
35) Zhang AZ, Pan XP, Cheng JS, Mo WY. Endorphins and acupuncture analgesia. Chin Med J (Engl) 1980; 93(10): 673-80.
36) Li QS, Xi GF, Liu ZY. Changes in serum endogenous opiate-like peptides and plasma leu-enkefallin during acupuncture analgesia in patients with pain and their relationship to the types of traditional patients’ syndrome classified by traditional Chinese medicine. Nucl Technol 1984; 1: 26.
37) He LF. Involvement of endogenous opioid peptides in acupuncture analgesia. Pain 1987; 31(1): 99-121.
38) Han JS, Ding XZ, Fan SG. Frecuency as the cardinal determinant for electroacupuncture analgesia to be reversed by opioid antagonists. Acta Phytophysiol Sinica 1986; 38(5): 475-82.
39) Wan Y, Mogil JS, Huang C, Han JS. Decrease of low frequency (2Hz) electroacupuncture analgesia in mice lacking beta-endorphin. Chin J Pain Med 1999; 5: 161-7.
40) Langone J. Alternative therapies: challenging the mainstream. TIME Special Issue 1996: 40-3.
41) Akca O, Sessler DI. Acupuncture: a useful complement of anesthesia. Minerva Anestesiol 2002; 68(4): 147-51.
42) Xu SF, Cao XD, Mo WY, Xu ZB, Pan YY. Effect of combination of drugs with acupuncture on analgesic efficacy. Acupunct Electrother Res 1989; 14(2): 103-13.
43) Yu Y, Gao M, He LF. Time course of alteration of pro-opiomelanocortin m-RNA level in rat hypotalamic arcuato nucleus following electroacupuncture. Acta Acad Med Shangai 1994: 59-62.
44) Nepp J, Jandrasits K, Schauersberger J, Schild G, Wedrich A, Sabine GL, et al. Is acupuncture an useful tool for pain-treatment in ophthalmology? Acupunct Electrother Res 2002; 27(3-4): 171-82.
45) Han JS, Wang Q. Mobilization of specific neuropeptides by peripheral stimulation of identified frecuencies. News Physiol Sci 1992; 7: 176-90.
Published
2005-12-30
How to Cite
1.
Gubitosi Moya E. Scientific bases of acupuncture analgesia. Rev. Méd. Urug. [Internet]. 2005Dec.30 [cited 2024May17];21(4):282-90. Available from: http://www2.rmu.org.uy/ojsrmu311/index.php/rmu/article/view/791
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