Acupuncture Basics
The Estern Asia people discovered acupuncture more than 5,000 years ago. The Estern asia science had a very different paradigm/way of thinking than the Western world. It emphasized holistic patterns, relationships, cycles, and processes. In contrast the western paradigm emphasizes linear thinking, causality and reductionist explanations. Acupuncture was first introduced into Europe by the French Jesuits in the 17th Century. It was not widely accepted in the West because of the clash of paradigms, that is, Western linear thinking couldn't understand how a needle inserted into the hand could cure a toothache. The acupuncture analgesia did not fit into the existing physiological paradigms of the Western scientist and was thus dismissed.
Up until 1976, the evidence of acupuncture anesthesia was mainly anecdotal. There are few scientifically controlled experiments. Since then, the situation has changed dramatically, in the last few years there have been thousands of scientifically controlled experiments in acupuncture. Today, there are at least 17 different lines of scientific evidence verifying acupuncture's effect upon humans and animals.
Biology of Acupuncture
Christine H. Goertz, D.C., Ph.D. (NCCAM, NIH)
BACKGROUND
Though not in common use within the United States until the mid-1970's, acupuncture has been used to improve health and/or treat disease for over 2,500 years. Currently, acupuncture is a very popular form of CAM therapy within this country. It is estimated that over 1 million persons in the US each year receives acupuncture, resulting in approximately 10 million treatment visits. Acupuncture is provided by a broad range of practitioners, ranging from medical physicians to Traditional Chinese Medicine practitioners, for a myriad of conditions, based upon a variety of underlying health care paradigms. There is a growing body of literature delineating various physiological effects resulting from acupuncture. However, given the broad scope of clinical application that potentially exists, much more work in this area is necessary.
Acupuncture
Acupuncture theory is based on the premise that energy, called Qi, travels along prescribed pathways or meridians within the body and is responsible for maintaining good heath. Disturbances in the flow of Qi, either excesses or deficiencies, result in disease. Acupuncture is a group of procedures or techniques used to stimulate specified points on the body for the purpose of regulating this energy flow. While stimulation of acupuncture points is most often achieved by using very thin metal needles to pierce the skin over these areas, other techniques including moxibustion and lasers can also be used.
Acupuncture originated as a broad-based health care system and is still used to treat many conditions, including chronic and acute pain, nausea, headache, heart disease, and asthma. Clinical studies have demonstrated effectiveness in some of these areas. A 1997 NIH consensus statement found "promising" results for the efficacy of acupuncture in treating adult post-operative and chemotherapy nausea and vomiting and in post-operative dental pain (1). It also stated that acupuncture may be useful in treating addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma.
Studies have addressed
potential biological explanations for the treatment effects produced by
acupuncture. It has been established that acupuncture stimulates the release of endogenous opioids in the body and that analgesic effects are blocked in a dose-response manner by naloxone, an opioid antagonist (2).
A developing area of study that shows great promise is the use of functional MRI technology to demonstrate the stimulation of acupuncture points resulting in alteration of signals associated with subcortical structures and the limbic system (3). There is also evidence that electroacupuncture may effect the pressor response, resulting in decreased oxygen demand in the presence of myocardial ischemia (4).
PURPOSE OF PROPOSED INITIATIVE
The NIH invites applications
to elucidate the basic biological mechanisms and processes underlying
acupuncture. The goal of this initiative is to promote innovative research
that will advance our understanding of the underlying mechanisms of this
unique form of therapy, and permit improved clinical trials that may yield
improved clinical applications.
OBJECTIVES
Acquiring the crucial
information needed to develop improved intervention and therapeutic strategies
employing acupuncture requires a broad range of basic studies including,
but not limited to:
- Elucidating the
basic biology and biochemistry of acupuncture;
- Characterizing
the actions of acupuncture at both cellular and system levels;
- Defining actions
of acupuncture on the endocrine, immune, and nervous systems, including
any interactions between these three systems;
- Identifying the
biological and psychological sources of individual differences in response
to acupuncture therapy, including genetic variation;
- Defining and characterizing
of the biological basis for individual acupuncture points;
- Investigating
the scientific basis for key traditional acupuncture concepts such as
Qi and the meridian system;
- Developing objective
methods to overcome the technical challenges faced when studying the
efficacy of acupuncture.
Applications combining
multidisciplinary approaches and applications that include collaborations
between practitioners of acupuncture and scientists with expertise in
the disciplines of anatomy, biochemistry, cellular biology, endocrinology,
imaging technologies, immunology, neurology, pharmacology, physiology,
etc. are strongly encouraged. The use of current paradigms and technical
approaches in these fields to the study of acupuncture is encouraged.
SIGNIFICANCE
Although inroads
in the biology of acupuncture have been made, there are still critical
gaps in the literature. This initiative will support innovative research
intended to increase the knowledge base and expand clinical applications
of acupuncture.
PROPOSED FUNDING
MECHANISMS
The mechanisms of
support will include the investigator-initiated research project grant
(R01), and the exploratory/developmental research grant (R21).
PROPOSED FUNDING
1.5 million dollars
in total costs in FY 2001
________________________________________
LITERATURE CITED
1.
NIH Consensus Statement on Acupuncture. Nov 1997, Vol. 15(5)
2. Cheng
and Pomeranz: Electroacupuncture analgesia is mediated by stereo-specific
opiate receptors and is reversed on antagonists of type I receptors. Life
Sci. 1972;26:631-639.
3.
Hui and Liu et al., Acupuncture modulates the limbic system and subcortical
gray structures of the human brain: evidence from fMRI studies in normal
subjects. Hum Brain Mapp. 2000;9:13-25.
4.
Peng and Koullis et al., Reversal of reflex-induced myocardial ischemia
by median nerve stimulation - A feline model of electroacupuncture. Circulation.
1998;97:1186-1194.
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