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Journal of Acupuncture and Meridian Studies

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J Acupunct Meridian Stud 2013;6(2):124e125

- CONFERENCE ABSTRACTS -

International Scientific Acupuncture and MeridianSymposium (iSAMS) 2012

A Decade and a Half of Acupuncture Research, Mechanistic Insights from Bench toBedside

Over the last several decades there has been an explosion of articles on acupuncture, including studies that have begun toexplore mechanisms underlying its analgesic and cardiovascular actions. Modulation of cardiovascular function is mosteffective during manual and low frequency, low intensity electroacupuncture (EA) at a select set of acupoints situated alongmeridian maps located over deep somatic nerves on the upper and lower extremities. Stimulation at these acupointsactivates underlying Group III and IV somatic afferent pathways that project to a number of spinal and supraspinal regionsthat ultimately regulate autonomic outflow and hence cardiovascular function. A long-loop pathway involving the arcuatenucleus of the hypothalamus, ventrolateral periaqueductal gray in the midbrain, nucleus raph pallidus and rostral ventrallateral medulla underlies modulation by EA of sympathoexcitatory reflex increases in blood pressure. Excitatory and in-hibitor neurotransmitter systems including glutamate, acetylcholine, endocannabinoids, g-aminobutyric acid (GABA),nociceptin, b-endorphin, enkephalins and serotonin in these central neural regions underlie central neural processing inacupuncture’s action on elevated blood pressure. Nociceptin and possibly dynorphin in the dorsal horn and intermedio-lateral column of the thoracic spinal cord also participate in acupuncture’s hypotensive action. Low blood pressure andbradycardia evoked by phenylbiguanide stimulation of cardiopulmonary afferents likewise is limited by acupuncture, anaction mediated by opioid and GABA inhibition of preganglionic parasympathetic outflow from the nucleus ambiguus to theheart.Clinical studies guided by principles learned in experimental investigation demonstrate in patients with mild to moderatehypertension that the autonomic influence of acupuncture is slow in onset but prolonged in duration, typically lasting wellbeyond the period of stimulation. Thus, acupuncture may have a role in treatment of cardiac disease, such as hypertensionand myocardial ischemia, when these conditions are associated with overactivity of the sympathetic nervous system.Acupuncture’s role in reversing hypotension remains to be better defined.

Longhurst J. A Decade and a Half of Acupuncture Research, Mechanistic Insights from Bench to Bedside. In proceedings fromthe International Scientific Acupuncture and Meridian Symposium, Oct 5-Oct 7, 2012; Sydney, Australia

Effects of Trigger Point Acupuncture Treatment on Temporomandibular Disorders:A Preliminary Randomized Clinical Trial

We compared the effects of trigger point acupuncture with that of sham acupuncture treatments on pain and oral functionin patients with temporomandibular disorders (TMDs). This 10-week study included 16 volunteers from an acupuncture

Copyright ª 2013, International Pharmacopuncture InstitutepISSN 2005-2901 eISSN 2093-8152http://dx.doi.org/10.1016/j.jams.2013.01.018

Conference abstracts 125

school with complaints of chronic temporomandibular joint myofascial pain for at least 6 months. The participants wererandomized to one of two groups, each receiving five acupuncture treatment sessions. The trigger point acupuncture groupreceived treatment at trigger points for the same muscle, while the other acupuncture group received sham treatment onthe trigger points. Outcome measures were pain intensity (visual analogue scale) and oral function (maximal mouthopening). After treatment, pain intensity was less in the trigger point acupuncture group than in the sham treatment group,but oral function remained unchanged in both groups. Pain intensity decreased significantly between pretreatment and 5weeks after trigger point (p<0.001) and sham acupunctures (p<0.050). Group comparison using the area under the curvedemonstrated a significant difference between groups (pZ0.0152). Compared with sham acupuncture therapy, trigger pointacupuncture therapy may be more effective for chronic temporomandibular joint myofascial pain.

Itoh K, Asai S, Ohyabu H, et al. Effects of Trigger Point Acupuncture Treatment on Temporomandibular Disorders: A Pre-liminary Randomized Clinical Trial, In proceedings from the International Scientific Acupuncture and Meridian Symposium,Oct 5-Oct 7, 2012; J Acupunct Meridian Stud 2012;5(2):57-62

From bed-side to bench-top: which mechanism is responsible for acupuncture inpain treatment?

One of the most common applications of acupuncture today is for the treatment of pain conditions. In clinical practices,different methods of acupoint selection have been adopted: some use local points, some use distant points, while othersuse auricular points; yet some use a combination of these points. Similarly, different method of stimulation, includingmanual acupuncture, electroacupuncture and moxibustion, may be used. These practice regimes have been regarded asempirically chosen without much scientific basis. Despite over 40 years of research in this area, the mechanism of acu-puncture treatment for pain is still far from clear. Consequently, many clinical trials have been conducted to evaluate theeffectiveness of acupuncture treatment without always embracing the full treatment regime in their protocols. As a result,these clinical trials have yielded inconsistent and even contradictory findings. To bridge the gap between clinical and basicresearch, this presentation will discuss the possible mechanisms underlying the complex acupuncture treatment regimes forpain conditions. It will demonstrate that different acupoints with different stimulation methods may each activate distinctphysiological mechanisms conducive to pain relief. It is argued that the design of clinical trial for acupuncture in paintreatment should take into account the various mechanisms involved and should maintain the clinical treatment regime asfar as possible in its protocol.

Zhang SP. From bed-side to bench-top: which mechanism is responsible for acupuncture in pain treatment? In proceedingsfrom the International Scientific Acupuncture and Meridian Symposium, Oct 5-Oct 7, 2012; Sydney, Australia

Acupuncture and hot flashes

After menopause, 10e20% of all women have nearly intolerable hot flushes. Long term use of hormone replacement therapyinvolves a health risk, and many women seek alternative strategies to relieve climacteric complaints. Is acupuncture analternative?I will give an overview over the current evidence for acupuncture for hot flashes. I will also share with the audience myexperiences from being one of the researchers in the ACUFLASH study, a multicenter, pragmatic, randomised controlledstudy, were TCM acupuncture was used as the intervention for hot flashes in postmenopausal women. I will go through thediagnostic process according to TCM in women with hot flashes. This procedure guides the practitioners to establish forthemselves a correct treatment according to their theoretical knowledge and clinical experience within Chinese medicine.With examples from a qualitative study I will describe changes in health experienced by postmenopausal women afterhaving acupuncture treatment for hot flashesThese results describe a variety of health changes that may not be revealed by limited outcome measures in acupuncturestudies. Further analysis of the relationship between such bodily experiences could lead to the development of hypothesesor models for how the acupuncture effect is mediated in complex bodily systems, and also contribute to development ofoutcome measures relevant for acupuncture studies.

Alraek T. Acupuncture and hot flashes. In proceedings from the International Scientific Acupuncture and Meridian Sympo-sium, Oct 5-Oct 7, 2012; Sydney, Australia