Patho-Physiology of Acupuncture Treatment: Effects of Acupuncture on Cardiovascular and Nervous Systems

The effects of Acupuncture (Ac.) on the Cardio-Vascular and Nervous Systems have been studied since 1972. Using the improved accurate non-invasive ultra-miniature measuring technique of peripheral and brain micro-circulation developed by the author, the following three consecutive vascular changes were observed in the majority of more than 400 human subjects (160 females and 255 males between 5 and 85 years old), with or without various medical problems, as the effects of Acupuncture: 1st phase–Vaso-constriction; 2nd phase–Quasi-control; 3rd phase–Vaso-dilation (V-d).

The Vaso-constriction phase is usually accompanied by pain and slight increase in blood pressure (B.P.) The V-d phase is accompanied by relief from pain or relaxation of the spastic muscles, mental relaxation, etc., and euphoric sensation. This study indicates that whenever significant generalized V-d is developed in the capillaries and arteriolar systems in the distal parts of the body (often including brain micro-circulation), significant lowering of the B.P. was also observed in about 60 per cent of the patients who had essential hypertension. The effects of Ac. on the blood chemistries often began to appear within 24 hr after Ac. (particularly significant between 4 to 24 hr after Ac.), whenever significant generalized V-d of the arterioles and the capillaries were observed in micro-circulatory networks of the various parts of the body. Among them the most significant changes were decreases in triglycerides and phospholipids, often between 30 and 60%; decrease in the cholesterol concentration (conc.) was less than 30%. Often delayed γ-globulin increases were observed 4-10 days after Ac. In these patients serum pre-β-lipo-protein often diminished after effectively given Ac. Serum glucose conc. also often increased up to +30% (in rare cases, up to +100% increase), while some patients had a decrease of serum glucose of up to -30%. These Ac-induced serum lipid changes usually lasted from a few days to one to two weeks. Uric acid also decreased in various degrees. The changes in the serum electrolyte concentrations were usually insignificant.

Effects of Ac. on the serum conc. of CPK, SGOT, LDH, Lipase, Amylase, Electrophoretic pattern of serum protein, serum lipo-protein, serum cortisol, urinary 17-OH-CS, serum serotonin, etc. are also described. Ac. often increases white blood cell (WBC) count particularly if control count is below normal. When the WBC count before Ac. is increased, Ac. often reduces the count. Most significant changes in CBC were an increase in percentage of the segmented neutrophile cells and a decrease in the % of lymphocyte with or without eosinopenia of basopenia. Therefore, these changes in the WBC differentials and increase in the serum glucose conc., as well as some of the blood chemistry changes, resemble ACTH-administration-like effects in the individual who has normal adrenal cortical functions.

The effects of Ac. on EEGs were often seen as enhanced appearance of a series of clustering alpha-waves (most significantly at occipital and parietal regions), accompanied by the patient's feeling of euphoria and relaxation. The time required before the appearance of the significant alpha waves following the insertion and the twirling of the needle depends upon the distance from the Acupunctured point to the brain. Ac. often decreased slightly the nerve conduction velocities (NCV) of motor and sensory nerves, only at the limited area located near the Acupunctured area, but the NCVs at the remaining part of the same nerve fibers did not produce any detectable changes. Threshold stimulation for pain sensation at the Acupunctured area increased significantly (sometimes exceeding more than 250% of pre-Ac. threshold stimulation). Such increase in the threshold stimulation was also observed in the distal part from the Acupunctured area depending upon the point where Ac. was given.

To evaluate the effectiveness of the Ac., the above described V-d of micro circulatory networks, particularly generalized V-d, as well as characteristic changes in CBC and blood chemistries were used as objective criteria. To determine the therapeutic schedule, CBC and blood chemistries were examined within 24 hr before, 10 to 24 hr after and one week after Ac. To evaluate the hypnotic factors, an “Eye Roll Test” was given to every patient before and after Ac. The results indicated that, even including those who had very low susceptibility for hypnosis, an average of at least 60% of the patients developed various degrees of beneficial effects of Ac. as well as the above described Ac.-induced changes. Therefore, the hypnotic factor does not play a significant role in obtaining beneficial effects of Ac. However, relatively frequently after Ac., the hypnotizability score slightly increased. The above described circulatory changes were observed regardless of whether Ac. was given on “Heart Meridian” or “Peri-cardium Meridian” or any other meridian or even on non-Ac. point. Unless continuous twirling was given, effects of Ac. given at non-Ac. points were often insignificant. And, if sufficient twirling was given on non-Ac. points, then often similar vascular responses, but with less significant changes and beneficial effects, were observed. Therefore, the author concluded that Ac. given on non-Ac. points often cannot be considered as the control or placebo, in a strict sense, particularly when prolonged manipulation of needle was given.

Even when the Ac. was given at the same point or area of the body, the results of the Ac. could be quite different depending upon how the manipulation was carried out, how long it was given and what technique was used. If Electro-Acupuncture is used, the beneficial as well as the adverse effects depend on the duration of the application and the type of stimulation, whether d.c. or pulse form or other type of wave patterns, their frequencies, time duration, voltage measured before and after connecting biological load, output impedance of the electrical stimulator, etc.

Factors involved in effective and safe Electro-Acupuncture, and simple methods and criteria of eliminating side effects of breakage of positive electrodes and necrosis of body tissue around electrodes are discussed.

Abnormal responses of blood chemistry and CBC to Ac. can provide us with clues to the underlying mechanism of the disease or symptoms of the patient.

To explain the mechanism of the relief of pain and relaxation of the spastic muscle following the improvement of circulation by Ac., a realistic broad concept of the “Vaso-neuromuscular (functional) unit” is proposed. In addition to the beneficial effects of Ac-induced ACTH release through its secondary increase in Gluco-Corticoids (particularly serum cortisol) and their beneficial effects (including the analgesic or hypoalgesic and anti-inflammatory effects), which are considered to be one of the important factors in obtaining Ac.'s beneficial effects, the author also suggests that some of the known beneficial effects of Ac. are due to the release of certain chemical substances, such as some of the prostaglandines from the interior of the cells. Depending upon the location of the stimulation, different prostaglandins may be released. This is probably because the cell membranes become leaky by mechanical irritation through twisting, squeezing, or pressure given by either manual twirling of Ac. needle or contraction of muscles by electrical stimulation, or Shiatsu by strong manual pressure without using needles. Thus it is concluded that if the circulatory and nervous systems in the area are not severed, Ac. can be used for the treatment of many diseases and symptoms (including pain or spastic muscles) that are produced directly or indirectly due to a circulatory disturbance.