2013 Akupunktur

NEURO ACUPUNCTURE:BASIC CONCEPTS: BRAIN-ORGAN

ACUPUNCTURE AND SAFTY IN ACCUPUNKTUR

Dr. Titiek Hidayati M. Kes.

Dept. Epidemiologi, kedokteran keluarga dan kedokteran masyarakat

Does acupuncture work ? Adolf Huxley “It can‟t be believed”

That a needle stuck into one‟s foot should improve the

functioning of one‟s liver is obviously incredible.

It can‟t be believed, because, in terms of currently

accepted physiological theory „it makes no sense‟.

Within our system of explanation there is no reason why

a needle-prick should be followed by an improvement of

liver function.

Therefore we say, it can‟t happen. The only trouble with

this argument is that, as matter of empirical fact, it does

happen.

It is important to appreciate that we do not know how acupuncture works and because of this, the results obtained seem illogical

Consequently : 1. The doctor must appreciate the empirical

evidence concerning the effectiveness of acupuncture

2. He should understand that the majority of disorders are self limiting, that the individual has immense resources available to heal himself improves the quality of his life

3. Through his knowledge and experience, he must develop confidence in the usefulness of acupuncture

How does acupuncture work ?

British Medical Journal, vol. 283, 195-196

September 19, 1981

Mechanism of acupuncture stimulation

• Via vascular/autonomic nerve system

• Via sistem saraf (Neuroacupuncture)

L. Sherwood, Human Physiology, 2004

pendekatan ilmiah mekanisme efek terapi akupunktur

melalui pembuktian dengan metode kedokteran barat

yang menghasilkan efek yang terukur, objektif,

bisa diulang, model penelitian dpt dengan hewan coba

akupunktur medik

Pendekatan dengan metode barat (pemakaian peralatan canggih

terjamin objektivitasnya)

• Termografi (kamera sinar inframerah)

• Bioassay

• Brain CT Scan

• fMRI

• Mikroskop elektron

Penelitian Litscher, Wang Termografi PC-6 + LI-11

Anonymous, The miracle of acupuncture, 1993

• When a nerve is blocked by local anesthetic, acupuncture is ineffective in the territory supplied by that nerve

• Acupuncture effect is conducted along the nerve (Cheng, 1973)


• 309 acupoints : on or very closed to nerves

• 286 acupoints : on or very closed to major blood vessels

• Sympathetic nerve also be involved (Goulden 1921)

many acupoints correlate closely with trigger points (Travell & Simon1983), correspond with motor points of muscles (Liu, Varela & Oswald 1977)

Cho, Neuroacupuncture, 2001

Evidence implicating the sympathetic nervous system in acupuncture effects

• A fall in blood pressure and intestinal vasodilatation following electroacupuncture in rabbits (Matsumoto & Mayers 1973)

• Skin vasoconstriction followed by longer lasting warming effect in human volunteers following manual and electrical acupuncture stimulation (Ernst & Lee 1985)


The peripheral nervous system is neurologically linked to internal organs through the autonomic system.

Stimulation of the musculoskeletal system can reach and modify autonomic activity (Lee & Ernst 1989).

Filshie, J. Medical Acupuncture 1998


Deqi :

A subjective feeling of warmth in the patient

A red flare in the skin (revealed by therapist) (axon reflex brought about by stimulation of C and A fibers)

• Segmental

• Heterosegmental


Segmental acupuncture : the most effective form of pain relief

Cornu posterior medulla spinalis

Tractus Spinotalamicus

Nociceptive Pathway 1. Tranduksi (transduction) : stimuli kuat

mekanik, termik atau kimiawi diubah menjadi suatu aktivitas listrik

2. Transmisi (transmission) : penjalaran impuls melalui syaraf sensoris menyusul proses transduksi

3. Modulasi (modulation) : interaksi antara sistem analgesik endogen dengan input nyeri yang masuk ke cornu posterior medulla spinalis

4. Persepsi (perception) : hasil akhir dari proses interaksi yang komplek dan unik

• Cheng – Pomeranz

(1979)

• Han Ji Sheng

(1998)

• Cho, ZH (2001)

• Mekanisme

endorphinergic

• Dinetralkan

dengan naloxon

2013 Akupunktur

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