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The mechanism, by which acupuncture works is not yet clear, therefore there is no unequivocal consensus about styles and sensations of needling. To enhance the scientific base of acupuncture, needling somehow should be objectified. The term Deqi is understood to represent all or at least the main form of phenomena to acupuncture stimulation. The characteristics of Deqi, however, have always been based on a translation of original Chinese description. Hoping to find a clue to develop sham (placebo) method for subject blinding, we investigated which sensations are frequently expected and experienced, and whether or not these expectations and experiences of sensations are similar in naïve subjects. The acupuncture sensation scale developed by Vincent et al. (1989) was translated into Korean. Thirty-eight healthy acupuncture naïve female volunteers (mean age 29.1, range 25–39) were asked to complete the sensation scale of acupuncture according to what they expected needling to feel like before needling. Needling was done on left Hegu (LI4) point in the hand and consisted of insertion, stimulation for 30 seconds, and removal. Directly after needling, the subjects were asked to complete the same sensation scale according to what they experienced. The subjects expected to feel hurting, penetrating, sharp, tingling, pricking and stinging, and actually experienced aching, spreading, radiating, pricking and stinging more than 60% of the time. Comparison between expectation and experience, the subjects expected more penetrating, tingling, pricking and burning than they experienced, and on the contrary experienced more aching, pulling, heavy, dull, electric and throbbing than they expected. Traditionally described sensations of Deqi are something beyond just a general pain dimension in the Korean population. Further study involving acupuncture experienced subjects or subjects from other cultures need to confirm this finding. Moreover, sham acupuncture should be studied.

The clinical efficacy and safety of acupuncture in the treatment of Seasonal Allergic Rhinitis (SAR) was evaluated by employing a two-phase crossover single-blind clinical trial. Thirty subjects were randomly assigned to two groups with 17 and 13 subjects respectively and treated with real or sham acupuncture (three times per week) for four consecutive weeks and then a crossover for treatments for a further four weeks without a washout period. The administration of real acupuncture treatment was guided by a syndrome differentiation according to Chinese Medicine Theory. Subjects were assessed by various criteria before, during and after the treatments. Outcome measures included subjective symptom scores using a five-point scale (FPS), relief medication scores (RMS) and adverse effect records. Twenty-six (26) subjects completed the study. There was a significant improvement in FPS (nasal and non-nasal symptoms) between the two types of acupuncture treatments. No significant differences were shown in RMS between the real acupuncture treatment group and the sham acupuncture treatment group. No side effects were observed for both groups. The results indicate that acupuncture is an effective and safe alternative treatment for the management of SAR.

The Neiguan acupuncture point (EH-6) of the heart meridian is often used for circulatory disorders. To clarify this effect, we measured coronary diameters in patients with angina pectoris following acupuncture stimulation using cardioangiography. Two kinds of acupuncture stimulation, the leaving needle (LN) and the sparrow pecking method (SPM), were employed for this study. No significant differences were found between LN and SPM. Concerning the pattern of coronary reaction, coronary constriction following acupuncture showed a relationship to patients with vasospastic angina. Coronary dilation following acupuncture showed a relationship to patients with Syndrome X. The mean dilatation with acupuncture was 68.8% of that caused by isosorbide dinitrate. These findings may help to clarify the mechanism of acupuncture treatment.

Our previous study with functional magnetic resonance imaging (MRI) demonstrated that acupuncture stimulation of the vision-related acupoint, Bl-67, activates the visual cortex of the human brain. As a further study on the effect of Bl-67 acupuncture stimulation on the visual cortex, we examined c-Fos expression in binocularly deprived rat pups. Binocular deprivation significantly reduced the number of c-Fos-positive cells in the primary visual cortex, compared with that of normal control rat pups. Interestingly, acupuncture stimulation of Bl-67 resulted in a significant increase in the number of c-Fos-positive cells in the primary visual cortex, while acupuncture stimulation of other acupoints less important for visual function had no significant effect on c-Fos expression in the primary visual cortex. The results suggest the possibility of vision-related acupoint (Bl-67) having an influence over the activity of the primary visual cortex.

Transcutaneous electrical acupoint stimulation (TEAS) provides a convenient and standardized technique for pain treatment. The cold-pressor test is a simple and reliable model in humans for the induction of tonic pain. In this controlled study, the effects of TEAS on cold pressor-induced pain were evaluated in 22 healthy human subjects. Electrical stimulation at 4 Hz and 32 Hz was applied to He-Gu (LI 4) and Nui-Guan (P 6) acupoints for 15 minutes. Pain score ratings were evaluated at four time points from 30–170 seconds during the cold-pressor test. We observed an analgesic effect at both 4 Hz and 32 Hz of stimulation, and pain score rating reductions were statistically significant compared to control (p < 0.01). Our data support the efficacy of TEAS analgesia. However, there was no significant difference between pain scores at 4 Hz and 32 Hz stimulation.

In the present study, the effect of acupuncture at Zusanli acupoint on nitric oxide synthase (NOS) expression in the hippocampus of streptozotocin (STZ)-induced diabetic rats was investigated via nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) histochemistry. Animals were divided into four groups: the control group, the nondiabetic and acupunctured group, the STZ-induced diabetes group, and the STZ-induced diabetes and acupunctured group. From the results, NADPH-d-positive neurons in the hippocampus were decreased in STZ-induced diabetic rats, while acupuncture increased NOS expression significantly under diabetic conditions. In the present study, it can be suggested that acupuncture treatment may modulate NOS activity in the hippocampus under diabetic conditions.

Thirty-nine women of reproductive age suffering from chronic pelvic inflammatory disease (PID) for at least two years, previously treated pharmacologically with no effect, were enrolled in a four-week therapeutic protocol consisting of 12 acupuncture treatments performed with the frequency of three per week. In each female patient at baseline and after the study, pain score and the following parameters in blood serum were evaluated: concentration of immunoglobulin M (IgM), albumins, α₁-globulins, α₂-globulins and γ-globulins, erythrocyte sedimentation rate (ESR) and white blood cell (WBC) count. During the study, we obtained a significant drop in ESR and IgM levels together with a rise in γ-globulin concentrations. A significant decrease (from 4.89 ± 0.82 to 0.63 ± 1.05) in pain score was obtained. The other parameters remained unchanged. These results suggest that acupuncture treatment of PID exhibits a clear anti-inflammatory and immunocompetent effect.

The effects of acupuncture on the expressions of nitric oxide synthase (NOS) and c-Fos in the hippocampus of gerbils after transient ischemia were investigated via nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d) histochemistry and Fos immunohistochemistry. In animals of the ischemia-induction groups, both common carotid arteries were occluded for 5 minutes. Animals of the acupunctued groups were given acupunctural treatment at Zusanli twice daily for 9 consecutive days. Acupuncture was shown to decrease NADPH-d and c-Fos levels in both the sham-operation group and the ischemia-induction group. These results suggest that acupuncture modulates the expressions of NOS and c-Fos in the hippocampus.

The use of subjective end-points such as VAS pain scales in studies of acupuncture for chronic neck pain have resulted in equivocal results. This study introduces an objective parameter as the primary end-point for the assessment of acupuncture in patients with acute torticollis (stiff neck). Eighteen patients underwent a single 20-minute treatment session, with needling of two acupuncture points Hou Hsi (SI-3) and Luo Zhen (M-UE-24), on the side ipsilateral to the predominantly involved side of the neck. Measuring the angle of lateral head rotation using a simple compass and protractor, a mean improvement of 52.9% was found, more so among those presenting earlier (< 24 hours) as opposed to later (> 72 hours; p = 0.034). The use of objective parameters, as seen in acupuncture research of the gastrointestinal and respiratory tracts, should be incorporated into studies of acute and chronic neck pain. The use of sham needle points and placebo needles is problematic since both may elicit physiological responses.

Acupuncture is based on the theory of channels, which serve as pathways for energy (Qi). On the course of the channels, acupuncture points are described, and by stimulation of these points, therapeutic effects may be achieved. This system is very complex and both channels and acupuncture points are anatomically invisible. Unlike in Western medicine, scientists fail to trace both the origin and the progress of acupuncture theory. Having developed in its full form not later than the 2nd century BC, it never underwent fundamental change. On the other hand, it has become a part of modern Western medicine as an effective therapy and the existence of acupuncture points, specified thousands of years ago, has been demonstrated by modern science. It is hardly probable that acupuncture theory, although dating back to ancient times, could have originated in primitive civilization. The origin of the energy channel theory does not fit into the traditional developmental scheme. The existence of the theory cannot be explained other than by its being a product of a highly developed civilization.

Acupuncture has been widely used as a treatment for various conditions like headache and stroke, especially in Asian countries such as Korea and China. But few scientific investigations have been carried out. The aim of the present study is to investigate the effect of acupuncture on the production of inflammatory cytokines in patients with chronic headache (CH). Patients with CH were treated with acupuncture during the acute stage. Clinical signs of CH disappeared markedly after three months of treatment with acupuncture. Peripheral blood mononuclear cells obtained from a normal group and those from the patients with CH, before and after treatment with acupuncture, were cultured for 24 hours in the presence or absence of lipopolysaccharide (LPS). The amount of interleukin (IL)-1β, IL-6 and tumor necrosis factor-α (TNF-α) in LPS culture supernatant was significantly increased in the patients with CH compared to the healthy control group (p < 0.05). But those cytokines came down toward the levels of the healthy group (p < 0.05) after treatment with acupuncture, although the levels still remained elevated. Plasma cytokine levels were analyzed to evaluate any change due to acupuncture treatment. There was little difference in the levels of IL-1β or IL-6 due to the treatment with acupuncture in the patients with CH, but significantly reduced plasma levels of TNF-α were observed. These data suggest that acupuncture treatment has an inhibitory effect on pro-inflammatory cytokine production in patients with CH.

Allergic rhinitis is a common health problem usually treated with drug therapy. Some patients experience side effects of drug therapy while others fear the use of drugs. Acupuncture is an interesting alternative to traditional treatment. The few studies evaluating acupuncture indicate a possible clinical effect on allergic rhinitis. This study compared active versus sham acupuncture in 40 consecutive patients with a history of allergic rhinitis and a positive skin test. Patients were randomized and assessed prior to treatment and then reassessed after 12 months. Improvements in symptoms using visual analogue scales, reduction in skin test reactions and levels of specific immunoglobin E (IgE) were used to compare the effect of treatment. For one allergen, mugwort, a greater reduction in levels of specific IgE (p=0.019, 0.039) and skin test reaction (p=0.004) was seen in the group receiving active acupuncture compared to the group receiving sham acupuncture. However, this finding might be an artifact. No differences in clinical symptoms were seen between active versus sham acupuncture, thus the conclusion being that the effect of acupuncture on allergic rhinitis should be further evaluated in larger randomized studies.

The purpose of this study was to investigate the effect of the De-Qi sensations of acupuncture (sourness-distension and distension-numbness) stimulation. Fifty-two healthy medical student volunteers were given acupuncture at the Hoku (LI-4) acupoint as they were resting. During a test that lasted 30 minutes, their skin blood flow was measured at the Quchi (LI-11) acupoint and their palm temperature was measured. Our results indicated that acupuncture increased blood flow when the De-Qi sensation occurred. If the needle was twirled a few minutes thereafter and the De-Qi feeling again occurred, the same blood flow increase was seen again. If the needle was not twirled, but the test person felt soreness, numbness and heat sensation within a few minutes after needle insertion, the same blood flow increase was also seen. After acupuncture, Quchi did not show continuous increase of blood flow as did Hoku. Hoku acupuncture also increased palm temperature suggesting that the blood flow increased from cutaneous vessel vasodilation. In conclusion, when the test person felt the sore and numb De-Qi sensation, there was an increase of blood flow at the acupuncture points. Thus, our results suggest that increased flow may be one of the mechanisms accounting for meridian system responses during acupuncture.

Sexual dysfunction is prevalent in both men and women. Although new pharmaceutical agents have been identified for male erectile problems, sexual desire and orgasm disorders, individuals with sexual dysfunction often seek alternative therapies, including traditional Chinese medicine. This article reviews currently used alternative therapies, such as herbal medications, L-arginine, acupuncture, biofeedback and others. Potential herb-drug interactions are also presented.

This study was designed to (1) test the preventive and therapeutic effects of acupuncture on osteopenia in ovariectomized (OVX) rats, and (2) assess whether treatment of different acupuncture points causes different effects on tibiae, femora or lumbar spines. Thirty-five female Sprague-Dawley rats were divided into four groups: Sham (sham-operated, non-acupuncture); Model (OVX, non-acupuncture); Acp-A [OVX, bilateral needling of points Tsu-San-Li (ST-36) and San-Yin- Chiao (SP-6)]; and Acp-B (OVX, bilateral needling of P'i-Shu (Bl-20) and Shen Shu (Bl-23)). Operations were performed at 8 weeks of age, 1 week later the study was started and continued for 16 weeks. Ovariectomy resulted in decreased bone mineral density (BMD) compared to the sham group over time, and Acp-A tended to have higher BMD than the other OVX groups, especially for tibiae. In addition, the bone ash weight of the Acp groups tended to be heavier than the model group. Deoxypyridinoline, the urinary marker of bone resorption, also appeared to be decreased in both acupuncture groups. Similarly, microarchitecture and bone morphometry of lumbar vertebrae and tibiae, such as bone volume, trabecular thickness, trabecular number, mineralizing surface, bone formation rate, mineral apposition rate, number of nodes and number of node-terminus struts, also showed the same improvement in the acupuncture groups as compared to the model control group. Our findings showed that acupuncture may prevent the development of osteopenia in rats induced by ovariectomy. Needling of Tsu-San-Li (ST-36) and San-Yin- Chiao (SP-6) seems more effective than needling of P'i-Shu (Bl-20) and Shen Shu (Bl-23) in bone anabolic regulation.

Acupuncture has anxiolytic effects. We investigated the effect of acupuncture on the Bispectral Index (BIS) values and anxiety. Fifty patients were randomly assigned to group A to receive acupuncture for 15 minutes on the extra 1 point (yintang) or to group C, where they received the same treatment on a control point located 2 cm lateral to the end of the right eyebrow. BIS values were recorded before acupuncture; during acupuncture every 30 seconds for 15 minutes and every 30 seconds for 90 seconds when the acupuncture treatment was accomplished. Anxiety level was assessed before and after acupuncture by a verbal score scale (VSS) (0=no anxiety, 10=worst anxiety). BIS values were significantly decreased during acupuncture when applied on the extra 1 point (p=0.0001) but not on the control point.

Acupuncture application significantly decreased the VSS values within the A group (p=0.027) and in the C group (p=0.0001), when compared to the baseline (pre-acupuncture) VSS values. However, no differences were found between the two groups regarding BIS or VSS values. In conclusion, needling the extra 1 point preoperatively significantly decreases the BIS values and the VSS for anxiety but needling of a control point decrease only VSS values.

In acupunctural reflexotherapy, it is usually stated that no appreciable therapeutic effect is obtained under a certain stimulation level, which is determined by the appearance of a particular sensation known as De-Qi. Given that afference control actions of the central nervous system do not work in this way, but rather adapt, with some peculiarities, to a classical schedule of proportionality between stimulus and response, our aim is to evaluate the extent to which acupunctural stimuli of increasing intensity can also increasingly modify neurophysiological parameters, by focusing on quantification of metameric levels, by an F-wave study and by means of somatosensorial evoked potential in the telencephalus. Twenty-one healthy volunteers were studied; values corresponding to the parameters indicated in a basal situation were taken and both a non-acupunctural point and the classical 4IG point were punctured simply, until the De-Qi sensation was obtained, following which, electrical stimulation was applied. Clear progressiveness was observed in the modifications of both the F-value and somesthesic potential values with increasing stimuli. It is true that the main inflexion occurs where obtaining De-Qi, but when overstimulation is applied from that time, greater variations take place, which is particularly patent in the case of somesthesic potential latency. Furthermore, the puncture of an extrachannel point shows that the mere puncturing of the skin does not produce any of the aforementioned effects. Despite the classical postulates, it is observed that, the greater the intensity of the acupunctural stimulus, the greater the modifications in the neurophysiological parameters studied. Control of somesthesic afference by acupuncture has already been demonstrated and quantified; now, however, the direct relation between the intensity of this effect and that of the stimulus used to produce it, which is quite far removed from the classical energetic conceptions, is also observed. The effect of acupunctural stimulation is closely related to the intensity of the stimulus applied and the De-Qi sensation is not required to obtain neurofunctional modifications and stimulations that go beyond it producing greater effects.

Energy medicine is becoming more frequently used in supporting patients to attain optimal health. The concept of energy medicine as a holistic practice is introduced and its relationship to physical medicine is discussed. In addition, descriptions of energy systems and modalities that are commonly used are also offered.

Meridian theory is an important part of traditional Chinese medicine (TCM). Although acupuncture has been accepted in many countries, the nature of the meridian theory and the principles of acupuncture are still unclear in the modern scientific view. The purpose of this study was to determine the differences in wave propagation of mechanical vibrations (optimal stimulator frequency of 40 Hz) through the pericardium meridian [EH-4 (Chieh-Men) and EH-5 (Chien-Shih)] and adjacent control regions in 20 subjects using hydrodynamic analysis. The mean transfer speed was significantly lower in the meridian (4 m/s) than in the adjacent control region (8.5 m/s, P<0.001). There were also significant differences between the meridian and control points in the attenuation rate (P<0.001) and peak amplitude (P<0.001). In conclusion, these results imply that the substance of the meridian differs from that of the adjacent control regions.

Acupuncture and acupressure points correlate well with sites on the body that have low transcutaneous electrical resistance (TER). Using lightly sedated, adult Sprague-Dawley rats, we identified an acupoint (i.e. site with low TER) located on the hind limb of the rat and compared the effects of acupressure at this site on the nociceptive threshold to an adjacent, non-acupoint site (i.e. site with high TER). Focal pressure (55.42±2.2 g) was applied to the site for 10 minutes and the tail flick response (TFR) was determined by draping the distal portion of the tail over a heated wire (75±5°C). Three trials were performed during each of three randomized conditions (i.e. acupoint, placebo and control) and the trials were averaged. All rats tested (5/5) showed a statistically significant increase in TFR following 10 minutes of acupressure at the acupoint compared to placebo or control trials (p=0.007). Acupressure at the placebo point resulted in a TFR that was not statistically different from the control. Systemic administration of naloxone completely abolished the tail-flick inhibition induced by acupressure at the acupoint. These data suggest that acupressure elicits an antinociceptive effect in rats that is mediated by the endogenous release of opioids.