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1 History of Modern Acupuncture Research in China 1

1.1 Acupuncture and Traditional Chinese Medicine 1

1.1.1 The Channels and Collaterals 3

1.1.2 Acupoints 4

1.1.3 General Principles of Acupuncture Treatment 4

1.2 Modern Developments in Acupuncture Treatment 5

1.3 Acupuncture Research at Shanghai Medical University 7

1.3.1 Relationship Between the Meridian-Points and Peripheral Nerves 7

1.3.2 Acupuncture Analgesia and Acupuncture Anesthesia 8

1.3.3 Therapeutic Effects and Mechanisms of Acupuncture on Neurological Disorders 19

1.4 Concluding Remarks 23

References 24

2 Neuroanatomic Basis of Acupuncture Points 32

2.1 Introduction 32

2.2 Phenomena of Meridians and Acupoints 33

2.2.1 Theory of Meridians,Collaterals,and Acupoints 33

2.2.2 Relatively Specific Effects of Acupoints 35

2.2.3 Unique Physiological Features of Acupoints 36

2.2.4 Relatively Specific Anatomical Structures of Acupoints 37

2.3 Neuroanatomic Structure of Acupoints 39

2.3.1 Gross Anatomical Observation of Meridians and Acupoints 40

2.3.2 General Histological Features of Acupoints 54

2.3.3 Microanatomic Examination of Acupoints 58

2.3.4 Morphological Basis of Sensation of Acupuncture at Acupoints 60

2.3.5 Other Morphologic Research on Acupoint 62

2.4 Neural Connection Between Meridian-Point and Viscus 63

2.4.1 Segmental Nerve Innervation Between Meridian-Points and Viscera 65

2.4.2 Convergence of Afferent Signals of Meridian-Points and Viscera in the Central Nervous System 69

2.5 Afferent Nerve Fibers and Afferent Pathway of Acupuncture Signal 71

2.5.1 Acupuncture Signal and Afferent Nerve Fibers 71

2.5.2 Acupuncture Signal Transmission Pathway 72

2.6 Concluding Remarks 73

Acknowledgements 74

References 74

3 Neural Transmission of Acupuncture Signal 81

3.1 Introduction 82

3.2 Initiation of Acupuncture Signal 84

3.2.1 Acupoint-Selection Impact on the Pattern of Brain-Area Activity 84

3.2.2 Acupuncture Modality:Manual or Electrical? 85

3.2.3 Wave Forms,Frequency,Intensity,and Timing 86

3.2.4 Transduction of Acupuncture Signal in the Afferent Nerves 87

3.3 Integration of Acupuncture Signalin the Central Nervous System 89

3.3.1 Integration of Nociceptive and Acupuncture Signals in the Spinal Cord and the Gate Control Theory 91

3.3.2 Effects of Brainstem and Descending Control on Acupuncture Analgesia 92

3.3.3 The Limbic System and Acupuncture Analgesia 94

3.4 Neurobiological Mechanism of Acupuncture in Autonomic Nervous System 95

3.4.1 Structure and Function of Autonomic Nervous System 96

3.4.2 Acupuncture Signal Regulating Activation of Autonomic Nervous System 97

3.4.3 Therapeutic Effects of Acupuncture Mediated Through Autonomic Nervous System 98

3.5 Concluding Remarks 100

Acknowledgements 100

References 100

4 Acupuncture-Induced Activation of Endogenous Opioid System 104

4.1 Introduction 104

4.2 Role of Endogenous Opioid System in Acupuncture 105

4.3 Acupuncture-Promoted Release of Endogenous Opioids 105

4.3.1 Central Release 106

4.3.2 Peripheral Circulation 106

4.3.3 Frequency-Dependent Release 107

4.4 Acupuncture-Induced Alteration in the Content of EOP in the Brain 108

4.5 Acupuncture-Enhanced Expression of Endogenous Opioids 110

4.6 Acupuncture and Opioid Receptors 111

4.6.1 Role of Opioid Receptor Subtypes in Acupuncture Effects 112

4.6.2 Acupuncture and Opioid Receptor Density 113

4.7 Concluding Remarks 114

Acknowledgements 115

References 115

5 Effect of Acupuncture on Neurotransmitters/Modulators 120

5.1 Introduction 121

5.2 5-hydroxytryptamine 121

5.2.1 Acupuncture-Induced Increase in Central 5-Hydroxytryptamine Activity 122

5.2.2 Acupuncture Regulation of 5-Hydroxytryptamine Activity in Certain Physiological and Pathophysiologic Conditions 123

5.2.3 Acupuncture and 5-Hydroxytryptamine Receptors 123

5.3 Noradrenalin 124

5.3.1 Acupuncture Reduction of Noradrenalin Release and Content in the Brain 125

5.3.2 Effect of Endogenous Opioid Peptides on Noradrenalin During Acupuncture 125

5.3.3 Acupuncture and Noradrenergic Receptors 126

5.4 Dopamine 126

5.4.1 Acupuncture-Induced Alteration in Dopaminergic Activity 127

5.4.2 Effect of Other Neurotransmitters on Dopaminergic Activity during Acupuncture 127

5.4.3 Acupuncture and Dopaminergic Receptors 127

5.5 Acetylcholine 128

5.5.1 Acupuncture and Cholinergic Activity 128

5.5.2 Role ofAcetylcholine in Acupuncture Effects 129

5.5.3 Acupuncture and Cholinergic Receptors 130

5.6 Amino Acids 130

5.6.1 Excitatory Amino Acids 130

5.6.2 Inhibitory Amino Acids 131

5.7 Other Neurotransmitters 132

5.7.1 Substance P 132

5.7.2 Prostaglandin 132

5.7.3 Cholecystokinin-Octopeptide-8 133

5.7.4 Somatostatin 133

5.7.5 Orphanin FQ 133

5.7.6 Neurotrophic Factors 134

5.7.7 Nitric Oxide 134

5.8 Concluding Remarks 135

Acknowledgements 136

References 136

6 Acupuncture-Drug Balanced Anesthesia 143

6.1 Introduction:From Acupuncture Analgesia to Acupuncture Anesthesia 143

6.2 From Acupuncture Anesthesia to Acupuncture-Drug Balanced Anesthesia 145

6.2.1 The Advantages of Acupuncture-Drug Balanced Anesthesia 145

6.2.2 The Main Cases of Acupuncture-Drug Balanced Anesthesia 146

6.3 Application of Acupuncture Anesthesia in Different Countries or Areas 150

6.4 Clinical and Experimental Research on Combination of Acupuncture with Drugs in Pain Treatment 153

6.5 Mechanism of the Synergistic Effect of Acupuncture-Drug Combination 154

6.6 Concluding Remarks 157

Acknowledgements 158

References 158

7 Acupuncture Analgesia in Clinical Practice 162

7.1 Introduction 162

7.2 Common Controls for Clinical Acupuncture 164

7.3 Types of Acupuncture Approaches 165

7.3.1 Manual Acupuncture 166

7.3.2 Electroacupuncture 166

7.4 Acupuncture Analgesia in Clinical Practice 169

7.4.1 Headaches 169

7.4.2 Chronic Low Back Pain 172

7.4.3 Knee Osteoarthritis 175

7.4.4 Chronic Neck Pain 177

7.4.5 Neuropathic Pain 179

7.4.6 Motor System Injuries 181

7.4.7 Fibromyalgia 182

7.4.8 Cancer Pain 182

7.4.9 Dental Pain 184

7.4.10 Phantom Limb Pain 185

7.5 Side Effects 185

7.6 Concluding Remarks 186

Acknowledgements 186

References 186

8 Neurochemical Basis of Electroacupuncture Analgesia on Acute and Chronic Pain 194

8.1 Introduction 194

8.2 EA analgesia on Acute and Chronic Pain 195

8.2.1 Neuropathic Pain 195

8.2.2 Inflammatory Pain 197

8.2.3 Cancer Pain 198

8.3 Neurochemical Mechanism Underlying EA Analgesia on Acute Pain 199

8.3.1 Endogenous Opioid Peptides 199

8.3.2 CCK-8 203

8.3.3 Glutamate 204

8.3.4 GABA 205

8.3.5 Serotonin(5-HT) 205

8.3.6 Noradrenaline 206

8.3.7 Dopamine 207

8.4 Neurochemical Basis of EA Analgesia on Chronic Pain 207

8.4.1 EOPs 208

8.4.2 Other Neuropeptides 209

8.4.3 Glutamate 210

8.4.4 Serotonin 213

8.4.5 EAA and Neuroinflammation 214

8.4.6 Neural Growth Factors and Neurotrophins 215

8.5 Concluding Remarks 217

Acknowledgements 218

References 218

9 Acupuncture Therapy for Stroke 226

9.1 Introduction 227

9.2 Clinical Practice of Acupuncture on Stroke 229

9.2.1 Clinical Acupuncture and Commonly Used Acupoints in Stroke Treatment 230

9.2.2 Efficacy of Acupuncture on Stroke 232

9.2.3 Various Factors That Affect the Efficacy of Acupuncture 235

9.3 Experimental Study of Acupuncture-Induced Protection from Stroke 236

9.3.1 Animal Models 236

9.3.2 Anti-Ischemic Effect of Acupuncture in Animals 238

9.3.3 Effect of Acupuncture on the Functional Recovery of the Ischemic Brain 240

9.3.4 Optimal EA Conditions for Maximal Protection from Cerebral Ischemia 241

9.3.5 Mechanisms of Acupuncture-Induced Protection Against Cerebral Ischemia 242

9.4 Concluding Remarks 254

Acknowledgements 254

References 255

10 Effects of Acupuncture on Arrhythmia and Other Cardiac Diseases 263

10.1 Introduction 263

10.2 Clinical Application of Acupuncture for the Treatment of Cardiac Diseases 264

10.2.1 Arrhythmia 265

10.2.2 Other Cardiac Disorders 267

10.3 Mechanisms of Acupuncture Therapy for Cardiac Disorders 268

10.3.1 Mechanisms Underlying Acupuncture Correction of Arrhythmia 269

10.3.2 Mechanisms of Acupuncture Therapy for Other Cardiac Disorders 278

10.4 Concluding Remarks 280

Acknowledgements 282

References 282

11 Acupuncture Therapy for Hypertension and Hypotension 289

11.1 Introduction 289

11.2 Clinical Application of Acupuncture for Treating Abnormal Blood Pressure 290

11.2.1 Hypertension 290

11.2.2 Hypotension 298

11.3 Mechanisms of Acupuncture Therapy for Abnormal Blood Pressure 300

11.3.1 Mechanisms of Acupuncture-induced Decrease in Lowering High Blood Pressure 301

11.3.2 Mechanisms of Acupuncture Therapy for Low Blood Pressure 312

11.4 Concluding Remarks 317

Acknowledgements 318

References 318

12 Effect of Acupuncture on Epilepsy 326

12.1 Introduction 326

12.2 Clinical Practice of Acupuncture on Epilepsy 328

12.2.1 History 328

12.2.2 Current Applications of Acupuncture Therapy 331

12.2.3 Acupoints 334

12.2.4 Efficacy 335

12.2.5 Negative and Opposite Evidences 336

12.3 Mechanism of Acupuncture Inhibition of Epilepsy 337

12.3.1 Effect of Acupuncture on Electroencephalogram and Power Spectra 338

12.3.2 Effect of Acupuncture on Excitatory and Inhibitory Amino Acids 340

12.3.3 Effect of Acupuncture on Neuropeptides 347

12.3.4 Effect of Acupuncture on Nitric Oxide 351

12.3.5 Effect of Acupuncture on Other Neurological Factors 352

12.3.6 An Anatomical View 355

12.4 Concluding Remarks 355

Acknowledgements 356

References 356

13 Neuroimmuno-effect of Acupuncture on Immune-mediated Disorders 365

13.1 Introduction 365

13.2 Acupuncture and Immune-mediated Disorders 366

13.2.1 Immunostimulant Points 367

13.2.2 Acupoint Specificity and Acupuncture Efficacy 367

13.2.3 Immune Modulation of Acupuncture 368

13.2.4 Common Practice of Acupuncture on Immune-mediated Disorders 370

13.3 Mechanism of Acupuncture on Immune-related Diseases 376

13.3.1 The General Regulatory Efiects of Acupuncture and the Theory of Neuroendocrine-immune Network 376

13.3.2 Role of Hypothalamus-pituitary-adrenal Axis in Acupuncture-mediated Efiects on Immune System 378

13.3.3 Role of Neuropeptides on the Immunoregulatory Effects of Acupuncture 379

13.4 Concluding Remarks 383

Acknowledgements 384

References 384

14 Acupuncture Treatment for Female Infertility 389

14.1 Introduction 389

14.2 Treatment of Infertility 391

14.2.1 Principles of Medication and Reproductive Technologies 391

14.2.2 Acupuncture Therapeutics 392

14.2.3 Acupuncture Combined with Assisted Reproduction Technology 394

14.3 Mechanism of Acupuncture Therapy for Infertility 394

14.3.1 Clinical Studies 395

14.3.2 Experimental Studies 397

14.4 Concluding Remarks 403

References 403

15 Acupuncture Therapy for Menopausal and Perimenopausal Syndrome 407

15.1 Introduction 407

15.2 Acupuncture Treatment for Menopause and Perimenopausal Syndrome 409

15.2.1 Commonly Used Acupoints 409

15.2.2 Therapeutic Effects of Acupuncture on Menopausal Syndrome 411

15.3 How Does Acupuncture Work? 413

15.3.1 Electroacupuncture-induced Regulation of Hypothalamic-pituitary-ovarian Axis 413

15.3.2 Role of β-endorphin 417

15.3.3 Role of Corticotrophin-releasing Factor and Hypothalamus-pituitary-adrenal Axis 418

15.3.4 Role of Extragonadal Aromatization 419

15.3.5 Elcctroacupuncture Promotes the Homeostasis in Ovariectomized Rats 421

15.3.6 Psychological Impact of Acupuncture 422

15.4 Concluding Remarks 422

References 423

16 Acupuncture for Smoking Cessation 426

16.1 Introduction 426

16.2 Researches on Smoking Cessation 427

16.3 Clinical Application of Acupuncture for Smoking Cessation 428

16.3.1 Body Acupuncture 429

16.3.2 Auriculo-acupuncture 430

16.3.3 Nasal Acupuncture 430

16.3.4 Combination Therapy 431

16.4 Mechanisms of Acupuncture Therapy for Smoking Cessation 432

16.4.1 Gustatory Sensation and Mouth Environment 432

16.4.2 Neuroendocrinology 433

16.4.3 Cardiorespiratory Function 433

16.5 Theory of Traditional Chinese Medicine in Smoking Cessation 433

16.6 Concluding Remarks 434

References 435

17 Beneficial Effect of Acupuncture on Depression 437

17.1 Introduction 438

17.2 Clinical Trials 439

17.2.1 Acupuncture as a Sole Therapy 439

17.2.2 Acupuncture Combined with Other Therapies 446

17.3 Mechanism Studies 448

17.3.1 Effect of Electroacupuncture on the Neurotransmitters 449

17.3.2 Effect of Electroacupuncture on the Hypothalamus-pituitary-adrenal Axis 450

17.3.3 Effect of Electroacupuncture on the Immune System 450

17.3.4 Effect of Electroacupuncture on Signal Transduction System 451

17.3.5 Effect of Electroacupuncture on Hippocampus 452

17.4 Concluding Remarks 453

Acknowledgements 456

References 456

18 Effect of Acupuncture on Drug Addiction 460

18.1 Introduction 460

18.2 Clinical Application of Acupuncture for Drug Addiction 461

18.2.1 Auriculo-acupuncture 461

18.2.2 Body Acupuncture 462

18.2.3 Electroacupuncture 462

18.2.4 Han'Acupoints Nerve Stimulator 463

18.2.5 Combination Therapy 464

18.3 Mechanisms of Acupuncture Therapy for Drug Addiction 465

18.3.1 The Role of Endorphin in Acupuncture Treatment for Opioid Dependence 465

18.3.2 The Roles of Some Neurotransmitters in Acupuncture Treatment for Opioid Dependence 467

18.3.3 Regulation of Immunity 468

18.3.4 Changes in the Function of Endocrinology 468

18.3.5 Alterations in Psychology 469

18.4 Concluding Remarks 469

References 470

Appendix A Milestone of Acupuncture Research:Correlation Between Peripheral Nerves and Meridians-Acupoints 473

References 474

Index 475