1 / 33

Acupuncture Part 2

Acupuncture Part 2. Physiologic Mechanisms. Physiologic Mechanism. Local inflammation and muscular effects Neural (non-opioid) segmental gate theory Neural (opioid) humeral theory Somatovisceral (autonomic) effects Bioelectrical theory. Local Effects: De Qi Sensation.

zurina
Download Presentation

Acupuncture Part 2

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Acupuncture Part 2 Physiologic Mechanisms

  2. Physiologic Mechanism • Local inflammation and muscular effects • Neural (non-opioid) segmental gate theory • Neural (opioid) humeral theory • Somatovisceral (autonomic) effects • Bioelectrical theory

  3. Local Effects: De Qi Sensation • Caused by sequential activation of • A-delta * • C-fiber * • Group II fiber * • Blocked by local anesthesia • Requires intact nervous system • Not seen at non-AP points

  4. Local Effects: De Qi Sensation

  5. Local Effects: De Qi • PRABM response in horses (pilomotor reaction along bladder meridian)

  6. Local Effects • Muscle Reaction • contraction around the needle • ipsilateral flexion • contralateral extension • Leads to tissue relaxation and relief of muscle spasm • Principle of trigger point therapy

  7. Local Effects • Anatomically, AP points are sensitive to microtrauma • Releases Hageman’s Factor XII • activates clotting cascade, complement cascade, plasminogen and kinins • Produces local PGs • Mast Cell degranulation • histamine, heparin and kinin protease • Releases Bradykinin

  8. Local Effects: Event Sequence • Vasoconstriction 15-30 sec • Quasi-control 10 sec-2 min • Vasodilatation 2 min-2 wk •  local immune status •  local BF •  local muscle and tissue relaxation

  9. Physiologic Mechanism • Local inflammation and muscular effects • Neural (non-opioid) segmental gate theory • Neural (opioid) humeral theory • Somatovisceral (autonomic) effects • Bioelectrical theory

  10. Segmental Analgesia • Evoked by high frequency, low intensity stimulation of AP point • Rapid onset • Diminishes after cessation • Not reversed by naloxone

  11. Types & Speed of Axons

  12. Gate Theory of Melzack & Wall • A-delta fibers conduct information to spinal cord before slow conducting C fiber information arrives • These fibers lead to inhibition (pre-synaptic) of information carried by the C fibers (pain)

  13. Gate Theory of Melzack & Wall • Fast transmitting fibers lead to pre-synaptic inhibition

  14. Physiologic Mechanism • Local inflammation and muscular effects • Neural (non-opioid) segmental gate theory • Neural (opioid) humeral theory • Somatovisceral (autonomic) effects • Bioelectrical theory

  15. Humeral Mechanisms • Interaction of AP point with • Spinal Cord • Brainstem • Higher Centers • Mediated through neurochemical interactions

  16. Opioid Humeral Mechanisms • Take 30-40 minutes • Persists for hours • Generalized effect which is reversed by naloxone • Transferable from one patient to another • Tolerance to and cross tolerance with morphine develops

  17. Opioid Humeral Mechanisms • Dexamethasone  ß-endorphin levels and  AP analgesia • Adrenalectomy  ß- endorphins and  AP analgesia • Hypophysectomy eliminates AP analgesia

  18. 5HT Humeral Mechanisms • [5HT]  in systemic circulation by 30-40% following AP • CNS maintains balance between 5HT and ß-endorphins • endorphins alter 5HT release (regulating pain threshold in spinal cord) •  5HT blocks effects of naloxone

  19. Potentiators of AP effects substance P histamine cGMP Antagonists of AP effects GABA cAMP Other Humeral Mechanisms

  20. Humeral Mechanisms: Systemic Endocrine Effects • Improves BF to pituitary axis and  capillary wall [enzyme] • Releases somatotropin in chronic pain patients • Induces LH release • Stimulates prolactin and oxytocin release • Modulates thyroid function

  21. Physiologic Mechanism • Local inflammation and muscular effects • Neural (non-opioid) segmental gate theory • Neural (opioid) humeral theory • Somatovisceral (autonomic) effects • Bioelectrical theory

  22. Somatovisceral Reflex: Autonomic Effects • AP stimulation converges with visceral efferent resulting in reflexive interactions with internal organs (along internal connecting meridians) • Regionally located • Referred pain regions

  23. Autonomic Effects • Indication of certain AP points correlate with symptoms for viscera at the same spinal segment • Bring descending influence only to the level of stimulation, ipsilaterally • Specificity of AP points related to somatotropic location

  24. Autonomic Effects • Referred pain • Convergence of Somatic and Visceral inputs in CNS • dorsolateral funiculus • spinothalamic tracts • Visceral A-delta fibers reflexively affect muscles • inflammation and cramping

  25. Autonomic Effects • AP of somatic structures can treat internal organs (through meridian connections) • AP modulates both arms of ANS • Segmental sympathetic vasodialation • Highly specific • Stimulate a specific AP point, get a specific physiologic change

  26. Autonomic Effects • AP stimulation of GV26 altered BP, HR and RR in dogs undergoing induced shock • Mortality in controls = 100% • Mortality in AP-treated = 25%

  27. Autonomic Effects • Stimulation of PC6 •  lipid peroxidation of the heart •  coronary blood flow • improved cardiac rhythm

  28. Potentiators of AP effects ß-adrenergic * eserine Antagonists of AP effects -adrenergic * atropine Autonomic Effects

  29. Physiologic Mechanism • Local inflammation and muscular effects • Neural (non-opioid) segmental gate theory • Neural (opioid) humeral theory • Somatovisceral (autonomic) effects • Bioelectrical theory

  30. Bioelectric Theory • DC energy channels correspond to AP meridians • Points of low electrical resistance on the skin correspond to AP points • Acupuncture • AP point • Meridian • Qi • Bioelectric • Amplifier • Conductor • Bioelectricity

  31. OtherAP Effects • Anti-fever • GI regulation • Anti-inflammation effect • Blood pressure regulation • Stress relief • Aging prevention • Performance enhancement • Improving microcirculation • Face lift

  32. Transcutaneous Nerve Stimulation (TENS units) • Well accepted method to produce analgesia • Electrodes hard to apply to haired animals • May just be acupuncture without needles

  33. Conclusions • AP represents part of an ancient system of comprehensive health care • As scientific knowledge expands, modern correlations are being developed which help translate this ancient wisdom into today's terms • May the Qi be with you!!!

More Related