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J Tradit Med Clin Natur Copyright: © Szilard H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Acupuncture: is one of the most accepted CAM therapies, most well: known branch of the Traditional Chinese Medicine, which flows intensive research a few decades in the US, Europe, even in China.
Is backed by proving research results of Evidence Based Medicine for properly as well. Results: Acupuncture and TCM, are one of the most researched area of non—conventional, complementary therapies.
We have already demonstrated convincingly established by the management of the majority of acupuncture point physiological responses.
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The mediator neurohormonal transmitters are already known about now. The performance of in: service training is a university competence. Evidence Based Medicine has an efficient and effective use based on the quality of training in: service training, which is conducted in some Universities for more decades.
Further development of this training, quality education can only be realistic to achieve the goals which effectively give rise to a dedicated TCM Confucius Institute Pecs University.
What is the essence of mechanical peripheral stimulus, the nervous and neurohumoral mechanism mediating acupuncture e.
Is there an acceptable and relevant professional literature proving the efficiency of clinical acupuncture? The application of this principle can be carried out by mechanical stimulus: needle puncture, massage, temperature stimulus, vacuum based suction, as well as by ultrasound, laser, etc. In China it has been known for blood pressure is lower when lying down about different herbs on which meridian they are effective and whether they belong to the type of yin or yang.
So the knowledge of channels and points was also taken into consideration in Chinese phytotherapy. We can say, that we are talking about a diagnostic and therapeutic whole body complex system 3 based on a unitary theoretic foundation which is consistent in itself.
A newer recognition is the study and application of the Yamamato4 scalp system. Is it more efficient to treat an acupuncture point already known than to place the needle into a sham acupuncture point? By examining the efficiency of acupunctural pain-killing [ 1 ] 6 came to the conclusion that pains induced in acute, laboratory conditions both in humans and animals could only be efficiently alleviated by stimulating acupuncture points, while in the case of treating non-acupuncture points there was no really measurable pain-killing effect observed.
At the same time, in the cases of chronic pain this difference is not so obvious. A great number of cases are needed to achieve the statistical significance a minimum of experimental persons per examination ; furthermore this issue has not been closed up to now. Do acupuncture points have a specific anatomic structure? According to the finding of a number of microscopic and electromicroscopic examinations there is no separate structure apart from our skin sense organ representative of special acupuncture points, but a bigger number of sensory nerve endings can be recognized at the indicated points, e.
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Physiological and biophysical description of acupuncture points In Europe it was the French Niboyet who first described that the areas of the skin surface with low electrical resistance can be identified with acupuncture points.
Simultaneous factors influencing skin resistance must also be taken into consideration since a measurement can be hindered by several influential factors temperature, surface humidity, calibration of the measuring device.
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During the measurement we apply a very weak measuring current. The surface of the skin shows mV potential difference in its areas, where it is the surface to be considered more negative compared to the deeper layers [ 5 - 7 ]. When measuring skin potential values acupuncture points are also measurable and bigger differences can be measured in these areas.
This partially gives an explanation on the chemical and physical processes induced by the needle applied.
During acupuncture it is not only the damage potential that induces current, but also the needle itself functions as a thermo element, since when applying the needle there is a temperature difference of more than 10°C. According to our latest knowledge it is a virtual network system which refers to the succesive sequences of the recognized bioactive acupuncture points, so it is not a separately and touchable anatomic structure.
The very first clear answer to the nervous mediation of low— frequency Electroacupuncture EA applied via inserted needles was given by Chiang [ 11 ], whose research is still going on.
This explains why an electric stimulation with low frequency and higher current stability is important. This is in accord with the following nervous mechanism in case of applying a low frequency and high intensity electro-acupuncture EA. The fibres responsible for the impulse transmission are myelinated type 2 and 3 afferents with a small diameter.
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They are responsible for the numbness and the feeling of fullness induced by the spreading needle sensation but the pain is mediated by the bare type 4 fibres. In case of an activation of skin nerves the A-delta fibres play a role.
This pre-sinaptically inhibits either through encephalin or dynorphin mediation but not through ß-endorfin one, which means it blocks the transmission of the pain stimuli. Consequently, the encephalins and the dynorphin may block the pain already at the level of the spinal cord.
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Next the needle stimuli advance through the ascending tracts to the thalamus in the spinal cord. In the peri-aquaeductal grey matter PAG of the midbrain it activates the raphe nucleus in the caudal part of the medulla oblongata through encephalin mediation. It sends back descending impulses in the dorsolateral part of the spinal cord DLT through monoamine serotonin and norepinephrine mediation to the cells of the spinal cord. Both monoamine mechanisms might take part in pain-killing. The originally activated ascending tract in spinal cord also activates the nucleus arcuatus in the hypothalamus-hypophysis complex, while other parts of the hypothalamus receive ß-endorphin from blood pressure is lower when lying down hypothalamus itself.
It effects through the blood current only to a small extent, it rather gets to the cell on a direct retrograde way without getting through the blood-brain barrier Figures 1 and 2. Anyhow, the destruction of hypophysis in experimental animals inhibits the creation of an acupunctural effect. The hypophysis also releases ACTH in an equimolar amount with ß-endorphin since their precursor is common.
Figure 1: Regulation of acupuncture in EU. Adrenocorticotropic Hormone ACTH stimulates the adrenal gland to release cortisol, which explains the anti-inflammatory effect of acupuncture in conditions such as asthma, arthritis, etc. At the same time this little amount of cortisol does not have harmful side effects neither does it cause a positive feed-back.
The recent excellent radiological diagnostic techniques PET, fMRI prove that acupuncture can activate further parts of central nervous system parts such as nucleus accumbens, amygdala, habenula, thalamic nuclei, etc. In a study of volunteer participants with artificially induced toothache were treated by manual stimulation of Large Intestine 4 LI4 on hand acupuncture point 14 to relieve pain. One group received intravenous saline; the other group received intravenous naloxone.
None of the participants knew which group they were in.