Acupuncture in the light of modern sciene

Mrigendranath Gantait M.B.B.S (Cal)

P.G. Cert. in Acupuncture (Nanjing, China)

• Consultant Acupuncturist• Ex- Founder Director, Dr. B.K. Basu

Memorial Research & Training Institute of Acupuncture (Govt. of West Bengal)

Just some needles punctureNo drugs given

Relief of symptoms

• How is it possible?

Is Acupuncture a placebo ?

Age old evidences of TCM• Acupuncture (one of TCM) effective in

many ailments of body

• Concepts of body structure and functions (Zang-fu organs,Channels and collaterals, Qi, blood, body fluid)

• Pathogenesis

• Methods of diagnosis

= A complete system of medicine

In modern science

Can we substantiate effects of Acupuncture therapy

in various types of ailments of the whole body ?

While doing acupuncture we do what ?

Puncture needles at some parts of body and stimulate those areas

What effects happen with Acupuncture stimulation ?

Let us examine the effects in parameters of modern science i.e.

• Observation

• Experimentation

• Inference

Effects of Acupuncture Effects of Acupuncture needlingneedling

Following main effects are observed and experimentally reproduced

• ANALGESIA• SEDATION• REGULATORY• IMMUNITY• ANTI-INFLAMMATORY• VASO-DILATION

Analgesic effectAnalgesic effect

Observed clinically in painful conditions e.g.

• Headache , Toothache, LBP, Dysmenorrhoea

Experimentally shown Neuro-Humoral mechanism

• Nerve pathway starts from acupuncture points – sensory nerve – posterior root –in spinal cord through spino-thalamic tract – medulla –mid-brain –thalamus (ventro-medial nucleus) – sensory cerebral cortex.

• Descending inhibitory path and gate control mechanism (Pain modulation path)

Acupuncture point

Acupuncture points are free nerve endings or muscle receptors of sensory nerves

That’s why needling sensation (‘Deqi’) is perceived

If blocked by xylocaine inj – No deqi, No analgesia

Nerve pathway after needling

Ascending pathway of pain and Descending inhibitory pathway

(Pain modulation path)

Only Nerve pathway ?Cross-circulation experiment

Humoral factorsHumoral factors

• Observed in cross-circulation experiment

• Analgesia is produced in the second animal who is connected with 1st animal by cross-circulation, acupuncture was applied to 1st animal only

• Humoral factors detected: 1) 5 HT

• 2) GABA 3) Endorphins

Sedative effectSedative effect

• Observed clinically in insomnia patients

• In animal experiment acupunctured cat becomes quiet, closes eyes, droops head

• EEG after acupuncture shows increase of frequency and intensity of alpha waves, which is observed in natural sleep

• Increased GABA causes sedation

Regulatory (anti-shock) effectRegulatory (anti-shock) effect

• Observed in severe shock patients undergoing surgery with acupuncture anaesthesia, in whom surgery was not possible with conventional general anaesthesia due to severe shock

Shock combat effect (homeostasis) could be reproduced experimentally

Shock combat experiment

Immunity raising effectImmunity raising effect

• Observed clinically in patients who get affected with slight weather variation, exposure to cold etc

• Experment shows• Both cellular and humoral immunity raised• WBC particularly neutrophils increase, T

lymphocytes increase, phagocytic activity of reticulo-endothelial cells increase

• More immunoglobulins, secretory immunoglobulin A (SIGA), complement, bacteriolysin, opsonin

Anti-inflammatory effectAnti-inflammatory effect• Observed clinically in inflammatory and

degenerative joint diseases, trauma

• Experiments show

Anti-inflammatory and fever relieving effects

(Li Jing-yun) 1

Acupuncture reduces activity of super-oxide dismutase (SOD) (an anti-oxidant enzyme) in osteoarthritis patients

• (Gantait M et al)

VasodilationVasodilation

• Observed clinically in ischaemic limbs – Buerger’s and Raynaud’s disease, diabetic gangrene, chronic ulcers

(Gantait M et al) 2

Experimental evidence

• Acupuncture releases Vaso-active Intestinal Peptides (VIP) which relaxes blood vessels

Acupuncture: The W.H.O. view

Acupuncture effective in many ailments

How it acts ?

NEI (Nerve-Endocrine-NEI (Nerve-Endocrine-Immune network)Immune network)

Nervous system, Endocrine system and Immune system have common

messengers and receptors

Nerve

Endocrine

Immune

In NEI - Mutual effectIn NEI - Mutual effectOne system may affect other system

e.g. immune system disorder may have effects :

on endocrine (Diabetes);

on musculo-skeletal system (Rheumatoid arthritis)

on nervous system (Multiple sclerosis)

Mutual effectMutual effectImmune disorder affects other systemsImmune disorder affects other systems

Mutual cross-talkMutual cross-talk

• Cells release Interleukins (Cytokines) to send information to other cells.

• In disease these systems have mutual cross-talk about various information for necessary processing

One system’s messenger may open other systems

Acupuncture works through Acupuncture works through NEINEI

• Acupuncture needling is a stimulation ( to nerves)

• It causes series of events

• It can be compared with a stone drop in a pond, when wave spreads all around

A stone drop creates waves in whole pond

Local effects :Mild pain with biochemical

events

Effects at other placesEffects at other places• Various neuro-transmitters and

hormones are releasedA) Opioid peptides : i) Enkephalins

at brain and gut, ii) Beta endorphin released at hypophysis

B) Other polypeptides: i) somatostatin ii) Calcitonin-gene-related-peptide (CGRP), iii) Neuropeptide Y (NPY), iv) Vaso-active Intestinal Peptide (VIP)

• Neuro-transmitters: 5HT, GABA, Acetyl choline, Nor-epinehrine, Epinephrine, Histamine

• Cytokines

Neuro-hormones / Neuro-steroids

Effects of EA on NEIEffects of EA on NEIEA of St 36 releases:

1)multiple brain-gut peptides (hormone-like effect)

2) Increase of cellular immunity 3) erythrocyte immuno-adhesive ability in normal and immuno-suppressed rats

4) Synthesis and release of SP, VIP, Beta-endorphin

5) Increase of contents of multiple kinds of brain-gut peptides in peripheral blood

(Liang Feng-xia) 3

Immunity raisedImmunity raised

24 hours following EA of St 36

• Increase of plasma Beta-endorphin

• Increase of CD8,CD4, CD3 T lymphocytes

• Increase of phagocytosis of mono-nuclear lymphocytes

• (Petit F Bangraji et al) 4

Traditional evidences are similar in countries

• Yogic aasan Bajrasana may be compared to

St. 36 point Acupuncture

Bajrasana gives pressure on leg muscles

Effects of acupuncture needling

Acupuncture acts through Acupuncture acts through body’s own mechanismbody’s own mechanism

1) No adverse side-effects

2) Correction of deviation from normal

3) Holistic action(Endo-pharmacology)

Bi-directional effects:Correction of deviation from

normal

St 36 acupoint is effective for two opposite conditions- Diarrhoea and Constipation

• Acupuncture reduces plasma glucose in hyperglycaemia and increases plasma glucose in low plasma glucose

• (Gantait M et al) 6

Difference with DrugsDifference with Drugs

• Drug has also holistic action

i.e. effects in various sites of body

• But they may produce unwanted side-effects too

Acupuncture hasAcupuncture has

Holistic

and

Body-friendly effects only

In the light of modern science

Acupuncture is not a placebo

• Acupuncture has definite effects in living being

• Which can be applied for treatment and prevention of diseases

References• 1. Li Jing-yun, Acupuncture has effects of anti-inflammatory and fever relieving,

World J of Acup, Vol 14, No. 3, September, 2004, p 43-44

• 2. Gantait M et al, World J of Acup, Vol 5, No. 3, Sept, 1995, Beijing p 12-15, Acupuncture in relief of pain and healing gangrene of limbs

• 3. Liang Feng-xia, World J of Acup, Vol. 14, No. 1, March, 2004, Beijing Comments on the holistic action of Acupuncture in view of its influence on nerve-endocrine-immune network, p 43-48

• 4.Petit F, Bangrali A, Liguori et al, Effects of Acupuncture on immune response related to opioid like peptides, J Trad Chin Med, 1998, 18(1), 55

• 5 . Gantait M et al, World J of Acup, Vol 16, No. 4, December, 2006, Beijing p 24-27, Effects of acupuncture in plasma glucose level in human volunteers

• 6. R H Bannerman, Acupuncture: The W.H.O. View, World Health, December, 1979, Geneva

• 7. Ganong’s Physiology

THANK YOU