1 History of Modern Acupuncture Research in China 1
1.1 Acupuncture and Traditional Chinese Medicine 1
1.1.1 The Channels and Collaterals 3
1.1.2 Acupoints 4
1.1.3 General Principles of Acupuncture Treatment 4
1.2 Modern Developments in Acupuncture Treatment 5
1.3 Acupuncture Research at Shanghai Medical University 7
1.3.1 Relationship Between the Meridian-Points and Peripheral Nerves 7
1.3.2 Acupuncture Analgesia and Acupuncture Anesthesia 8
1.3.3 Therapeutic Effects and Mechanisms of Acupuncture on Neurological Disorders 19
1.4 Concluding Remarks 23
References 24
2 Neuroanatomic Basis of Acupuncture Points 32
2.1 Introduction 32
2.2 Phenomena of Meridians and Acupoints 33
2.2.1 Theory of Meridians,Collaterals,and Acupoints 33
2.2.2 Relatively Specific Effects of Acupoints 35
2.2.3 Unique Physiological Features of Acupoints 36
2.2.4 Relatively Specific Anatomical Structures of Acupoints 37
2.3 Neuroanatomic Structure of Acupoints 39
2.3.1 Gross Anatomical Observation of Meridians and Acupoints 40
2.3.2 General Histological Features of Acupoints 54
2.3.3 Microanatomic Examination of Acupoints 58
2.3.4 Morphological Basis of Sensation of Acupuncture at Acupoints 60
2.3.5 Other Morphologic Research on Acupoint 62
2.4 Neural Connection Between Meridian-Point and Viscus 63
2.4.1 Segmental Nerve Innervation Between Meridian-Points and Viscera 65
2.4.2 Convergence of Afferent Signals of Meridian-Points and Viscera in the Central Nervous System 69
2.5 Afferent Nerve Fibers and Afferent Pathway of Acupuncture Signal 71
2.5.1 Acupuncture Signal and Afferent Nerve Fibers 71
2.5.2 Acupuncture Signal Transmission Pathway 72
2.6 Concluding Remarks 73
Acknowledgements 74
References 74
3 Neural Transmission of Acupuncture Signal 81
3.1 Introduction 82
3.2 Initiation of Acupuncture Signal 84
3.2.1 Acupoint-Selection Impact on the Pattern of Brain-Area Activity 84
3.2.2 Acupuncture Modality:Manual or Electrical? 85
3.2.3 Wave Forms,Frequency,Intensity,and Timing 86
3.2.4 Transduction of Acupuncture Signal in the Afferent Nerves 87
3.3 Integration of Acupuncture Signalin the Central Nervous System 89
3.3.1 Integration of Nociceptive and Acupuncture Signals in the Spinal Cord and the Gate Control Theory 91
3.3.2 Effects of Brainstem and Descending Control on Acupuncture Analgesia 92
3.3.3 The Limbic System and Acupuncture Analgesia 94
3.4 Neurobiological Mechanism of Acupuncture in Autonomic Nervous System 95
3.4.1 Structure and Function of Autonomic Nervous System 96
3.4.2 Acupuncture Signal Regulating Activation of Autonomic Nervous System 97
3.4.3 Therapeutic Effects of Acupuncture Mediated Through Autonomic Nervous System 98
3.5 Concluding Remarks 100
Acknowledgements 100
References 100
4 Acupuncture-Induced Activation of Endogenous Opioid System 104
4.1 Introduction 104
4.2 Role of Endogenous Opioid System in Acupuncture 105
4.3 Acupuncture-Promoted Release of Endogenous Opioids 105
4.3.1 Central Release 106
4.3.2 Peripheral Circulation 106
4.3.3 Frequency-Dependent Release 107
4.4 Acupuncture-Induced Alteration in the Content of EOP in the Brain 108
4.5 Acupuncture-Enhanced Expression of Endogenous Opioids 110
4.6 Acupuncture and Opioid Receptors 111
4.6.1 Role of Opioid Receptor Subtypes in Acupuncture Effects 112
4.6.2 Acupuncture and Opioid Receptor Density 113
4.7 Concluding Remarks 114
Acknowledgements 115
References 115
5 Effect of Acupuncture on Neurotransmitters/Modulators 120
5.1 Introduction 121
5.2 5-hydroxytryptamine 121
5.2.1 Acupuncture-Induced Increase in Central 5-Hydroxytryptamine Activity 122
5.2.2 Acupuncture Regulation of 5-Hydroxytryptamine Activity in Certain Physiological and Pathophysiologic Conditions 123
5.2.3 Acupuncture and 5-Hydroxytryptamine Receptors 123
5.3 Noradrenalin 124
5.3.1 Acupuncture Reduction of Noradrenalin Release and Content in the Brain 125
5.3.2 Effect of Endogenous Opioid Peptides on Noradrenalin During Acupuncture 125
5.3.3 Acupuncture and Noradrenergic Receptors 126
5.4 Dopamine 126
5.4.1 Acupuncture-Induced Alteration in Dopaminergic Activity 127
5.4.2 Effect of Other Neurotransmitters on Dopaminergic Activity during Acupuncture 127
5.4.3 Acupuncture and Dopaminergic Receptors 127
5.5 Acetylcholine 128
5.5.1 Acupuncture and Cholinergic Activity 128
5.5.2 Role ofAcetylcholine in Acupuncture Effects 129
5.5.3 Acupuncture and Cholinergic Receptors 130
5.6 Amino Acids 130
5.6.1 Excitatory Amino Acids 130
5.6.2 Inhibitory Amino Acids 131
5.7 Other Neurotransmitters 132
5.7.1 Substance P 132
5.7.2 Prostaglandin 132
5.7.3 Cholecystokinin-Octopeptide-8 133
5.7.4 Somatostatin 133
5.7.5 Orphanin FQ 133
5.7.6 Neurotrophic Factors 134
5.7.7 Nitric Oxide 134
5.8 Concluding Remarks 135
Acknowledgements 136
References 136
6 Acupuncture-Drug Balanced Anesthesia 143
6.1 Introduction:From Acupuncture Analgesia to Acupuncture Anesthesia 143
6.2 From Acupuncture Anesthesia to Acupuncture-Drug Balanced Anesthesia 145
6.2.1 The Advantages of Acupuncture-Drug Balanced Anesthesia 145
6.2.2 The Main Cases of Acupuncture-Drug Balanced Anesthesia 146
6.3 Application of Acupuncture Anesthesia in Different Countries or Areas 150
6.4 Clinical and Experimental Research on Combination of Acupuncture with Drugs in Pain Treatment 153
6.5 Mechanism of the Synergistic Effect of Acupuncture-Drug Combination 154
6.6 Concluding Remarks 157
Acknowledgements 158
References 158
7 Acupuncture Analgesia in Clinical Practice 162
7.1 Introduction 162
7.2 Common Controls for Clinical Acupuncture 164
7.3 Types of Acupuncture Approaches 165
7.3.1 Manual Acupuncture 166
7.3.2 Electroacupuncture 166
7.4 Acupuncture Analgesia in Clinical Practice 169
7.4.1 Headaches 169
7.4.2 Chronic Low Back Pain 172
7.4.3 Knee Osteoarthritis 175
7.4.4 Chronic Neck Pain 177
7.4.5 Neuropathic Pain 179
7.4.6 Motor System Injuries 181
7.4.7 Fibromyalgia 182
7.4.8 Cancer Pain 182
7.4.9 Dental Pain 184
7.4.10 Phantom Limb Pain 185
7.5 Side Effects 185
7.6 Concluding Remarks 186
Acknowledgements 186
References 186
8 Neurochemical Basis of Electroacupuncture Analgesia on Acute and Chronic Pain 194
8.1 Introduction 194
8.2 EA analgesia on Acute and Chronic Pain 195
8.2.1 Neuropathic Pain 195
8.2.2 Inflammatory Pain 197
8.2.3 Cancer Pain 198
8.3 Neurochemical Mechanism Underlying EA Analgesia on Acute Pain 199
8.3.1 Endogenous Opioid Peptides 199
8.3.2 CCK-8 203
8.3.3 Glutamate 204
8.3.4 GABA 205
8.3.5 Serotonin(5-HT) 205
8.3.6 Noradrenaline 206
8.3.7 Dopamine 207
8.4 Neurochemical Basis of EA Analgesia on Chronic Pain 207
8.4.1 EOPs 208
8.4.2 Other Neuropeptides 209
8.4.3 Glutamate 210
8.4.4 Serotonin 213
8.4.5 EAA and Neuroinflammation 214
8.4.6 Neural Growth Factors and Neurotrophins 215
8.5 Concluding Remarks 217
Acknowledgements 218
References 218
9 Acupuncture Therapy for Stroke 226
9.1 Introduction 227
9.2 Clinical Practice of Acupuncture on Stroke 229
9.2.1 Clinical Acupuncture and Commonly Used Acupoints in Stroke Treatment 230
9.2.2 Efficacy of Acupuncture on Stroke 232
9.2.3 Various Factors That Affect the Efficacy of Acupuncture 235
9.3 Experimental Study of Acupuncture-Induced Protection from Stroke 236
9.3.1 Animal Models 236
9.3.2 Anti-Ischemic Effect of Acupuncture in Animals 238
9.3.3 Effect of Acupuncture on the Functional Recovery of the Ischemic Brain 240
9.3.4 Optimal EA Conditions for Maximal Protection from Cerebral Ischemia 241
9.3.5 Mechanisms of Acupuncture-Induced Protection Against Cerebral Ischemia 242
9.4 Concluding Remarks 254
Acknowledgements 254
References 255
10 Effects of Acupuncture on Arrhythmia and Other Cardiac Diseases 263
10.1 Introduction 263
10.2 Clinical Application of Acupuncture for the Treatment of Cardiac Diseases 264
10.2.1 Arrhythmia 265
10.2.2 Other Cardiac Disorders 267
10.3 Mechanisms of Acupuncture Therapy for Cardiac Disorders 268
10.3.1 Mechanisms Underlying Acupuncture Correction of Arrhythmia 269
10.3.2 Mechanisms of Acupuncture Therapy for Other Cardiac Disorders 278
10.4 Concluding Remarks 280
Acknowledgements 282
References 282
11 Acupuncture Therapy for Hypertension and Hypotension 289
11.1 Introduction 289
11.2 Clinical Application of Acupuncture for Treating Abnormal Blood Pressure 290
11.2.1 Hypertension 290
11.2.2 Hypotension 298
11.3 Mechanisms of Acupuncture Therapy for Abnormal Blood Pressure 300
11.3.1 Mechanisms of Acupuncture-induced Decrease in Lowering High Blood Pressure 301
11.3.2 Mechanisms of Acupuncture Therapy for Low Blood Pressure 312
11.4 Concluding Remarks 317
Acknowledgements 318
References 318
12 Effect of Acupuncture on Epilepsy 326
12.1 Introduction 326
12.2 Clinical Practice of Acupuncture on Epilepsy 328
12.2.1 History 328
12.2.2 Current Applications of Acupuncture Therapy 331
12.2.3 Acupoints 334
12.2.4 Efficacy 335
12.2.5 Negative and Opposite Evidences 336
12.3 Mechanism of Acupuncture Inhibition of Epilepsy 337
12.3.1 Effect of Acupuncture on Electroencephalogram and Power Spectra 338
12.3.2 Effect of Acupuncture on Excitatory and Inhibitory Amino Acids 340
12.3.3 Effect of Acupuncture on Neuropeptides 347
12.3.4 Effect of Acupuncture on Nitric Oxide 351
12.3.5 Effect of Acupuncture on Other Neurological Factors 352
12.3.6 An Anatomical View 355
12.4 Concluding Remarks 355
Acknowledgements 356
References 356
13 Neuroimmuno-effect of Acupuncture on Immune-mediated Disorders 365
13.1 Introduction 365
13.2 Acupuncture and Immune-mediated Disorders 366
13.2.1 Immunostimulant Points 367
13.2.2 Acupoint Specificity and Acupuncture Efficacy 367
13.2.3 Immune Modulation of Acupuncture 368
13.2.4 Common Practice of Acupuncture on Immune-mediated Disorders 370
13.3 Mechanism of Acupuncture on Immune-related Diseases 376
13.3.1 The General Regulatory Efiects of Acupuncture and the Theory of Neuroendocrine-immune Network 376
13.3.2 Role of Hypothalamus-pituitary-adrenal Axis in Acupuncture-mediated Efiects on Immune System 378
13.3.3 Role of Neuropeptides on the Immunoregulatory Effects of Acupuncture 379
13.4 Concluding Remarks 383
Acknowledgements 384
References 384
14 Acupuncture Treatment for Female Infertility 389
14.1 Introduction 389
14.2 Treatment of Infertility 391
14.2.1 Principles of Medication and Reproductive Technologies 391
14.2.2 Acupuncture Therapeutics 392
14.2.3 Acupuncture Combined with Assisted Reproduction Technology 394
14.3 Mechanism of Acupuncture Therapy for Infertility 394
14.3.1 Clinical Studies 395
14.3.2 Experimental Studies 397
14.4 Concluding Remarks 403
References 403
15 Acupuncture Therapy for Menopausal and Perimenopausal Syndrome 407
15.1 Introduction 407
15.2 Acupuncture Treatment for Menopause and Perimenopausal Syndrome 409
15.2.1 Commonly Used Acupoints 409
15.2.2 Therapeutic Effects of Acupuncture on Menopausal Syndrome 411
15.3 How Does Acupuncture Work? 413
15.3.1 Electroacupuncture-induced Regulation of Hypothalamic-pituitary-ovarian Axis 413
15.3.2 Role of β-endorphin 417
15.3.3 Role of Corticotrophin-releasing Factor and Hypothalamus-pituitary-adrenal Axis 418
15.3.4 Role of Extragonadal Aromatization 419
15.3.5 Elcctroacupuncture Promotes the Homeostasis in Ovariectomized Rats 421
15.3.6 Psychological Impact of Acupuncture 422
15.4 Concluding Remarks 422
References 423
16 Acupuncture for Smoking Cessation 426
16.1 Introduction 426
16.2 Researches on Smoking Cessation 427
16.3 Clinical Application of Acupuncture for Smoking Cessation 428
16.3.1 Body Acupuncture 429
16.3.2 Auriculo-acupuncture 430
16.3.3 Nasal Acupuncture 430
16.3.4 Combination Therapy 431
16.4 Mechanisms of Acupuncture Therapy for Smoking Cessation 432
16.4.1 Gustatory Sensation and Mouth Environment 432
16.4.2 Neuroendocrinology 433
16.4.3 Cardiorespiratory Function 433
16.5 Theory of Traditional Chinese Medicine in Smoking Cessation 433
16.6 Concluding Remarks 434
References 435
17 Beneficial Effect of Acupuncture on Depression 437
17.1 Introduction 438
17.2 Clinical Trials 439
17.2.1 Acupuncture as a Sole Therapy 439
17.2.2 Acupuncture Combined with Other Therapies 446
17.3 Mechanism Studies 448
17.3.1 Effect of Electroacupuncture on the Neurotransmitters 449
17.3.2 Effect of Electroacupuncture on the Hypothalamus-pituitary-adrenal Axis 450
17.3.3 Effect of Electroacupuncture on the Immune System 450
17.3.4 Effect of Electroacupuncture on Signal Transduction System 451
17.3.5 Effect of Electroacupuncture on Hippocampus 452
17.4 Concluding Remarks 453
Acknowledgements 456
References 456
18 Effect of Acupuncture on Drug Addiction 460
18.1 Introduction 460
18.2 Clinical Application of Acupuncture for Drug Addiction 461
18.2.1 Auriculo-acupuncture 461
18.2.2 Body Acupuncture 462
18.2.3 Electroacupuncture 462
18.2.4 Han'Acupoints Nerve Stimulator 463
18.2.5 Combination Therapy 464
18.3 Mechanisms of Acupuncture Therapy for Drug Addiction 465
18.3.1 The Role of Endorphin in Acupuncture Treatment for Opioid Dependence 465
18.3.2 The Roles of Some Neurotransmitters in Acupuncture Treatment for Opioid Dependence 467
18.3.3 Regulation of Immunity 468
18.3.4 Changes in the Function of Endocrinology 468
18.3.5 Alterations in Psychology 469
18.4 Concluding Remarks 469
References 470
Appendix A Milestone of Acupuncture Research:Correlation Between Peripheral Nerves and Meridians-Acupoints 473
References 474
Index 475