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Evaluation of stress-induced analgesia in acupuncture analgesic effect - An Approach on diameters of acupuncture needles and acupuncture point needlings - (침진통 효과에서 스트레스에 의한 진통 효과 개입 여부 평가 - 침굵기, 침자극 부위를 중심으로 -)

  • Jeong, Byeong-Ju;Choe, Il-Hwan;Shin, Hee-Sup;Lim, Sabina
    • Korean Journal of Acupuncture
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    • v.25 no.3
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    • pp.65-80
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    • 2008
  • Objective : In recent years, many investigators have questioned whether the analgesic effect of acupuncture is simply related to the stress-induced analgesia (SIA). However, there has been lack of studies on this issue. In this study, the stress levels induced by manual acupunctures are compared with the stress in animal experiment models. The experiments have been carried out with Sprague Dawley (SD) rats. Method : For stress level evaluation, Hot plate test has been used. Maximum Possible Effect (MPE) has been measured by checking the pre-test time and post-test time. Cortisol and corticosterone concentrations in serum were measured by enzyme-linked immunosorbent assay (ELISA). Results : In the hot plate test, MPE values of post-test time were significantly decreased after 10 minutes than after 5 minutes. Therefore, optimal time interval was chosen as 10 minutes. There was significant difference of MPE values between Suspension group and all other treatment groups. However, there were no significant differences of MPE values between Sham group and all other treatment groups. However, MPE values showed tendency to decrease when acupuncture needle diameter increased. MPE values of ST040, ST040(lido), NAP040(lido) groups were markedly decreased than that of Suspension group, while that of NAP040 group was substantially increased than that of Sham group increased in acupoint and nonacupoint models. Serum cortisol concentrations of treatment groups were not significantly different from that of Suspension and Sham groups. Serum corticosterone concentration of 0.25 mm group was substantially increased than that of compared with Sham group. Serum cortisol and corticosterone concentrations of treatment groups were not significantly different from those of Suspension and Sham groups in acupoint and nonacupoint models. Conclusion : From hot plate test and serum stress hormones concentrations, it is found that manual acupuncture treatment induces negligible stress or SIA on ST36. And the stress induced by manual acupuncture is more closely related to acupuncture point needlings than diameters of acupuncture needles.

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The Effect of Acupuncture and Electro-acupuncture of Low and High Frequencies at $ST_{41}$ on Experimentally Induced Intestinal Hypermotility in Rats: Comparison between Pre-treatment and Post-treatment (해계 유침 및 전침의 전.후 처치가 실험적으로 항진된 흰쥐의 장운동에 미치는 영향)

  • Choi, Joo-Young;Lee, Hyun
    • Journal of Acupuncture Research
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    • v.27 no.3
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    • pp.117-126
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    • 2010
  • Objectives : The purpose of this study was to compare the effect of needle retention(NR) and electro-acupuncture of low(EA(L)) and high(EA(H)) frequencies at Haegye($ST_{41}$) on intestinal hypermotility induced with carbachol in rats Methods : We made over-activated state of intestinal motility with carbachol in rats and caried out needle retention acupuncture, low frequency electro-acupuncture and high frequency electro-acupuncture at Haegye($ST_{41}$) or sham point in rat devided into pre-treatment group and post-treatment group. And we resulted as followings from measuring charcoal travel rate with observation of intestinal motility. Results : 1. None of acupuncture, low frequency electro-acupuncture and high frequency electro-acupuncture at $ST_{41}$ had significant influences on intestinal motility of rat in normal state. 2. Pre-treated with acupuncture, low frequency electro-acupuncture and high frequency electro-acupuncture and post-treated with acupuncture and low frequency electro-acupuncture at $ST_{41}$ didn't significantly influences intestinal motility in rat which over-activated with carbachol. 3. Post-treated with high frequency electro-acupuncture at $ST_{41}$ suppressed intestinal motility in rat which over-activated with carbachol. Conclusions : These results suggest that treatment high frequency electro-acupuncture at ST41 may be effective on gastric disorders such as intestinal hypermotility and its effect had more cure than prevention.

The Effects of Extracts from Ginseng, Wormwood and Pine needle in Pulmonary Structure and Anti-oxidant Enzyme in Smoking (흡연 시 인삼, 쑥, 솔잎 추출물이 폐 세포의 구조와 항산화 효소에 미치는 영향)

  • Jung, Hyuk;Kim, Sang-Ki;Kim, Sang-Guk;Sung, Mi-Young;Kim, Hyun-Jung;Kim, Bum-Hak;Kim, Yu-Young
    • KSBB Journal
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    • v.19 no.2
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    • pp.138-142
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    • 2004
  • Cigarette smoke causes atypical structure of pulmonary (cell structural) and oxidative damage. Therefore, we carried out to determine if exposure to cigarette smoke alters pulmonary structure and anti-oxidant related enzyme in a ICR mice model, when natural product extracts using by manual sprayer. The mice were divided into five groups, control group, sham-treated group (Sham), natural product extracts-treated group (NPE), natural product extracts-treated with smoke-exposed group (NPE-SM) and smoke-exposed (SM) group. All groups are similar to control group in weight, but SM group is lower than the other groups. Microscopic image of the pulmonary structure in SM group showed deleterious alterations in the morphology, but the other groups are maintained in original structure. In anti-oxidant related enzyme, SOD (superoxide dismutase) and catalase, SM group represents the lowest enzyme activity among all groups. These results indicate that the natural product extracts is an efficient tissue protective agent against smoke-induced lung injury.

The correlations between acupuncture sensation and analgesic effects (침감과 침 진통 효과의 상관성 연구)

  • Chae, Youn-Byoung;Lee, Hwa-Jin;Kim, Hee-Young;Lee, Hye-Jung;Park, Hi-Joon
    • Korean Journal of Acupuncture
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    • v.24 no.1
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    • pp.43-58
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    • 2007
  • Objectives : The elicit of DeQi, a composite of sensation including numbness and fullness that develops at the site of acupuncture stimulation, is considered to be clinically essential to establish treatment efficacy. However, there was little studies investigating the relationship between the subjective feeling of acupuncture sensation and acupuncture analgesia, The current study was therefore performed to determine the correlation between the acupuncture sensation scale (ASS) and the degree of acupuncture analgesia. Methods : Ninety-two female subjects were stimulated at LI4 acupoint on non-dominant hand with real (RA) or sham acupuncture (SA). Finger withdrawal latency (FWL) of each group was also measured to evaluate analgesic effect of acupuncture on the noxious heat stimuli on the dominant hand. All subjects were asked to complete seven point-Likert scale ASS developed by Vincent et al. Results : The increase rate of FWL of the RA group was significantly higher than that of the SA group(36.03 ${\pm}$ 4.45% vs 24.50 ${\pm}$ 3.73%). RA stimulation produced significantly higher rating of all the ASS except for dull sensation, compared to SA stimulation. Significant correlations between analgesic effect of RA, but not of SA, and the degree of the ASS, including burning sensation(r=0.349), Intense sensation(r=0.299), pulsating sensation (r=0.335), and stinging sensation (r=0.306) were found. Conclusions : The results of our study indicate that the DeQi sensation are associated with acupuncture analgesia. Our findings suggest that the evocation of DeQi might be useful clinical indicator of acupuncture treatment.

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A Systematic Review of Randomized Controlled Trials on Acupuncture Treatment for Shoulder Pain (견비통에 침치료를 시행한 무작위대조군연구(RCT)들에 대한 계통적 연구)

  • Kim, Hyun-Wook;Kim, Sung-Soo;Park, Se-Woon;Kim, Eon-Kuk;Lee, Geon-Hui;Lee, Geon-Mok
    • Journal of Acupuncture Research
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    • v.27 no.4
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    • pp.67-84
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    • 2010
  • Objectives : To review RCTs on acupuncture treatment for shoulder pain in order to establish a standard acupuncture treatment model in treating shoulder pain. Methods : RCT articles on traditional acupuncture treatment for shoulder pain were searched through online database. Quality of studies were assessed using the FEAS and the modified Jadad score. Results : Eighteen trials of acupuncture for shoulder pain were analyzed. Based on the results of these reviews the following factors might contribute to optimal results from acupuncture treatment. 1) Usage of LI, SI, TE meridians, usage of $LI_{15}$, $TE_{14}$, $GB_{21}$, $LI_{11}$, $LI_4$, $SI_{14}$, $LI_{14}$, $TE_{15}$ acupuncture points. 2) More than four acupuncture points should be used. 3) More than 15 minutes of needle retention time. 4) Needle length-40mm and diameter-0.30mm. 5) More than 9 times treatment 6) More than 5 weeks treatment duration. Conclusions : There was no relation between quality of article and effectiveness of acupuncture. To improve the remedial value, it is necessary to mention De-qi, stimulation of acupuncture and correct variation in diagnosis with the above-mentioned. It is better that clinical trials of acupuncture treatment is designed that type of RCT and double blind. Also when it is set that sham nonpenetrating acupuncture, no treatment group as a control group, and participants don't distinguish wheather acupuncture treatment or not, it will be more meaningful.

Clinical Study on Safety, Clinical Indicators of Polydioxanone Sutures Inserted into Vastus Medialis Muscle in Degenerative Knee Osteoarthritis (무릎 관절염 환자에서 안쪽넓은근에 폴리디옥사논 봉합사 시술 연구)

  • Kim, Ki-Choul;Lee, Hyung-Jun;Lee, Kil-Yong;Park, Hee-Gon
    • Clinical Pain
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    • v.20 no.2
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    • pp.105-121
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    • 2021
  • Objective: Physiologically, the vastus medialis muscle is the first muscle to undergo muscle atrophy, and it was thought that pain in patients with knee osteoarthritis could be reduced if this muscle could be strengthened and stabilized. The purpose of this study was to prove the effectiveness in knee osteoarthritis using polydioxanone sutures that have been tried in other musculoskeletal areas. Method: Forty knee osteoarthritis patients voluntarily participated in the study, and divided into 30 polydioxanone suture needle (MEST-B2375 produced by Ovmedi Co.) and 10 sham needle (without suture). And the needles were inserted into the vastus medialis muscle. In all patients, safety evaluation including blood tests and ultrasonography as well as efficacy evaluation including isometric maximal contractile strength of quadriceps muscle, weight bearing pain, impression of change, quadriceps angle, rescue drug intake were evaluated up to 30 weeks after the procedure. Results: Isometric maximal contractile strength showed a significant improvement at 4 weeks after the procedure in the polydioxanone suture group, and the weight-bearing pain showed a significant improvement at every visit in the polydioxanone suture group compared with baseline values. Patient global impression of change score showed significant improvement at 20 and 30 weeks, and clinical score showed improvement at every visit. Conclusion: Insertion of polydioxanone sutures showed improvement in muscle strength and knee pain by supporting and fixation of the vastus medialis muscle in patients with degenerative knee osteoarthritis. Insertion of polydioxanone sutures is considered to have a therapeutic effect in knee osteoarthritis patients.

Report of the 3rd Japan-Korea Workshop on Acupuncture and EBM;Protocol development for the acupuncture trial on the osteoarthritis of the knee

  • Jang, Jun-Hyouk;Kenji, Kawakita;Hahn, Seo-Kyung;Park, Hi-Joon;Lee, Seung-Deok;Kim, Yong-Suk;Norihito, Takahashi;Toshiyuki, Shichidou;Kazunori, Itoh;Eiji, Sumiya;Eiji, Furuya;Hitoshi, Yamashita;Hiroshi, Tsukayama
    • Journal of Acupuncture Research
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    • v.23 no.6
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    • pp.239-254
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    • 2006
  • The 3rd Japan-Korea Workshop on Acupuncture and EBM was held at Kanazawa on June $16^{th}$. From Korea team, 4 papers were presented. Dr. Hahn introduced a new approach of data analysis on series of n-of-1 trials using the Bayesian statistics. It offered important information for the future n-of-1 trials. Dr. Park clearly demonstrated the significance of various sham devices proposed and stressed the importance of research questions when we choose the control intervention in RCT. Dr. Lee reported the results of survey in Korean Medical Doctors (KMD) for their point selection and techniques to the distal and local points. Dr. Kim presented the results of face to face survey on the KMD with 28 items for acupuncture treatment on the knee OA. Finally, a draft of protocol was introduced by Dr. Kim. The title was "multi-center, a randomized, single blinded, two arms, parallel-group study to compare the effectiveness and safety of 'individualized acupuncture' and 'standardized minimal acupuncture' in Korean and Japanese patients with knee osteoarthritis (Phase IV)". From Japan team, 7 speakers presented their comments and proposals on the protocol. Dr. Takahashi introduced several issues regarding n-of-1 trials and pointed out the importance of obtaining generalizability from n-of-1 trials. Dr. Shichidou pointed the importance of research design, selection of outcome measures and reduction of biases. Dr. Itoh presented the results of point selection for the knee OA based on the literature survey. Dr. Sumiya introduced several differences between KMD and Japanese acupuncturists based on the questionnaire used in KMD survey. Dr. Furuya demonstrated a result of press tack needle and its sham device on shoulder stiffness. Dr. Yamashita introduced the results of literature survey regarding adverse events occurred by acupuncture on knee OA. Dr.Tsukayama stressed the importance of responsibility of Institutional Review Board (IRB) for the conduction of clinical trials. After several issues were discussed, the need of continued meeting for final protocol development was agreed, then the workshop was closed.

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A Systematic Review of Acupuncture-Moxibustion Treatments for Nonspecific Chronic Neck Pain (비특이적 목 통증에 사용된 침구치료에 대한 체계적 문헌고찰)

  • Yang, Chang-Sop;Kim, Ick-Tae;Kim, Young-Eun;Kim, Bo-Young;Seo, Bok-Nam;Park, Ji-Eun
    • Korean Journal of Acupuncture
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    • v.34 no.4
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    • pp.209-230
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    • 2017
  • Objectives : The aim of this study was to describe the details and to assess the clinical evidence of acupuncture and moxibustion for non-specific chronic neck pain. Methods : We searched seven databases including Korean, English, and Chinese databases through July 2016. Studies using acupuncture, moxibustion, pharmacopuncture, electroacupuncture, auricular-acupuncture, acupressure for non-specific chronic neck pain were included. Only controlled clinical trials or randomized clinical trials were assessed. Study design, number of subject, inclusion criteria, intervention, and results were extracted. In addition, details of intervention including needle type, retention time, acupoints were analyzed. Results : Total 64 studies(39 acupuncture, 9 laser, 6 pharmaco-acupuncture, 3 electro-acupuncture, 3 auricular-acupuncture, 3 moxibustion, 1 acupressure) were included. Among 39 acupuncture studies, 35 used acupuncture as sole intervention. Sham treatment was the most common intervention for control group, followed by no intervention. Various outcome including pain, disability, quality of life, range of motion was used as outcome measurement. The effect of acupuncture and moxibustion was different depending on the type of control and outcome measurement. The most commonly used method in acupuncture for neck pain was GB21, SI3, GB20, LI4, BL11 acupoints, 10~30 mm insertion depth, 20~30 retention time, and 1~2 times per week. Conclusions : Analyzing the details of acupuncture and moxibustion treatment could be helpful for researches and clinics. Further studies should consider the characteristics of study design, intervention, and outcome to assess the effect of TKM.

The Effect of Acupunture and Electroacupunture of Low and High Frequencies at $SP_6$ on Experimentally Induced Intestinal Hypomotility in Rats;Comparison between Pre-treatment and Post-treatment (삼음교 유침, 저주파 및 고주파 전침의 전.후 처치가 실험적으로 억제된 흰쥐의 장운동에 미치는 영향)

  • Lee, Sung-Hwan;Yim, Yun-Kyoung;Lee, Hyun
    • Journal of Acupuncture Research
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    • v.25 no.4
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    • pp.105-116
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    • 2008
  • Objectives : The aim of this study was to compare the effect of acpuncture and electroacupuncture of low(EA(L)) and high(EA(H)) frequencies at San Yin Jiu($SP_6$) and sham point in rats. We made suppressed state of intestinal motility with loperamide in rat and carried out needle retention acupuncture, low frequency electro-acupuncture and high frequency electro-acupuncture at ($SP_6$) in rat devided into pre-treatment group and post-treatment group. We fed charcoal to them after the treatment and measured the travel rate of charcoal in the gastrointestine track to analyze which treatment affected more in intestinal hypermotility Results : 1. Examining intestinal motility of normal rat treated with electro-acupuncture at $SP_6$, high frequency electro-acupuncture significantly increased intestinal motility. 2. Pre-treated with acupuncture at $SP_6$ significantly suppressed intestinal motility. 3. Post treatment with acupunture and low frequency electro-acupuncture at $SP_6$ showed significant increase of intestinal motility. Conclusions : As folowing study there were 21 groups to find out which treatment showed significant increase of intestinal motility and pre-treated acupuncture, post-treated with acupunture and low frequency electro-acupuncture at $SP_6$ was highly significant with control at the figure than any other groups.

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The Effects of Sa-am Acupuncture Simpo-jeongkyeok Treatment on the Blood Pressure, Pulse Rate, and Body Temperature

  • Choi, Woo-Jin;Cho, Yoon-Young;Sun, Seung-Ho
    • Journal of Pharmacopuncture
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    • v.18 no.2
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    • pp.33-41
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    • 2015
  • Objectives: The present study evaluated the effects of sa-am acupuncture (SAA) simpo-jeongkyeok (SPJK) treatment on the blood pressure (BP), pulse rate (PR), and body temperature (BT) of patients with hwa byung (HB). Methods: This patient assessor blind, randomized, placebo controlled trial included 50 volunteers, divided randomly into two groups. The treatment group underwent SPJK (PC9, LR1, PC3, KI10) while the control (sham) group received minimal needle insertion at non acupoints. The BP in both arms, PR, and BT at several acupoints were measured before and after treatment at the $1^{st}$, $2^{nd}$, $3^{rd}$, and $4^{th}$ visits and before treatment at the follow-up visit. We analyzed data by using the repeated measured analysis of variance (RM ANOVA), Mann-Whitney U, and wilcoxon signed rank tests; differences at P < 0.05 were considered significant. Results: No significant differences in the systolic blood pressure (SBP), diastolic blood pressure (DBP) and PR between the treatment and control group were observed at each visit. However, the decrease in the SBP for the treatment group before and after each visit was significantly higher than it was in the control group. The SBP in both arms in the treatment group was decreased between visits 1 and 2, 1 and 3, 1 and 4, and 1 and follow-up. The DBP in both arms and in the right arm between visits 1 and 3 in the treatment group showed decreases. A minimal BT increase for treatment at CV06 and CV12 and a minimal BT decrease for treatment at CV17 and (Ex) Yintang were found. Patients in the treatment group who visited more frequently experienced a greater decrease in the PR, but that effect was not maintained. Conclusion: The results suggest that SAA SPJK treatment has instant positive effects on the BP, PR, and BT in patients with HB, but the effects on the BP and PR are not maintained.