Enhances Generation of Nitric Oxide and Increases Local Circulation
Tsuchiya M, et al. Departments of Biochemistry, Osaka City University Medical
School, Abeno-Ku, Japan.
Although it is widely used, the mechanisms and effects of acupuncture
on pain are not completely understood. Recently, increased nitric
oxide (NO) synthase activity has been found in meridians and
acupoints. Because NO is a key regulator of local circulation, and
because change in circulation can affect the development and
persistence of pain, we propose that acupuncture might regulate NO
levels. We studied the effects of acupuncture on local NO levels and
circulation in a randomized, double-blind, crossover study with 20
volunteers, each of whom underwent one session each of real and
noninvasive sham acupuncture in a single hand and forearm with a 1-wk
interval between treatments. NO concentration in the plasma from the
acupunctured arm was significantly increased by 2.8 +/- 1.5 micromol/L
at 5 min and 2.5 +/- 1.4 micromol/L at 60 min after acupuncture. Blood
flow in palmar subcutaneous tissue of the acupunctured arm also
increased, and this correlated with the NO increase. These changes
were not observed in noninvasive sham-acupunctured hands and forearms. In
conclusion, acupuncture increases the NO level in treated regions and thereby
increases local circulation. These regulatory effects
might contribute to pain relief provided by acupuncture.
Anesth Analg. 2007 Feb;104(2):301-7
and Amygdala Response to Acupuncture Stimuli in Carpal Tunnel Syndrome
Napadow V, et al. Martinos Center for Biomedical Imaging,
Department of Radiology, Massachusetts General Hospital, Charlestown, MA, United
States; Department of Radiology, Logan College of Chiropractic, Chesterfield,
MO, United States.
Brain processing of acupuncture stimuli in chronic neuropathic pain
patients may underlie its beneficial effects. We used fMRI to evaluate
verum and sham acupuncture stimulation at acupoint LI-4 in Carpal
Tunnel Syndrome (CTS) patients and healthy controls (HC). CTS patients
were retested after 5 weeks of acupuncture therapy. Thus, we
investigated both the short-term brain response to acupuncture
stimulation, as well as the influence of longer-term acupuncture
therapy effects on this short-term response. CTS patients responded to
verum acupuncture with greater activation in the hypothalamus and
deactivation in the amygdala as compared to HC, controlling for the
non-specific effects of sham acupuncture. A similar difference was
found between CTS patients at baseline and after acupuncture therapy.
For baseline CTS patients responding to verum acupuncture, functional
connectivity was found between the hypothalamus and amygdala - the
less deactivation in the amygdala, the greater the activation in the
hypothalamus, and vice versa. Furthermore, hypothalamic response
correlated positively with the degree of maladaptive cortical
plasticity in CTS patients (inter-digit separation distance). This is
the first evidence suggesting that chronic pain patients respond to
acupuncture differently than HC, through a coordinated limbic network
including the hypothalamus and amygdala.
Pain. 2007 Jan 18;
Medicine as Complementary Therapy for Reduction of Chemotherapy-Induced Toxicity
Mok T, et al. Department of Clinical Oncology, Prince of Wales
Hospital, Institute of Chinese Medicine, Hong Kong Cancer Institute, Chinese
University of Hong Kong, Hong Kong Special Administrative Region (HKSAR), China.
BACKGROUND: Chinese herbal medicine (CHM) is a common complementary therapy used
by patients with cancer for reduction of
chemotherapy-induced toxic effects. This study applied the highest
standard of clinical trial methodology to examine the role of CHM in
reducing chemotherapy-induced toxicity, while maintaining a tailored
approach to therapy. PATIENTS AND METHODS: Patients with early-stage
breast or colon cancer who required postoperative adjuvant
chemotherapy were eligible for the study. Enrolled patients were
randomly assigned to one of three Chinese herbalists who evaluated and
prescribed a combination of single-item packaged herbal extract
granules. Patients received either CHM or placebo packages with a
corresponding serial number. The placebo package contained
nontherapeutic herbs with an artificial smell and taste similar to a
typical herbal tea. The primary end points were hematologic and
non-hematologic toxicity according to the National Cancer Institute
Common Toxicity Criteria Version 2. RESULTS: One hundred and twenty
patients were accrued at the time of premature study termination.
Patient characteristics of the two groups were similar. The incidence
of grade 3/4 anemia, leukopenia, neutropenia, and thrombocytopenia for
the CHM and placebo groups were 5.4%, 47.3%, 52.7%, and 1.8% and 1.8%, 32.2%,
44.7%, and 3.6%, respectively (P = 0.27, 0.37, 0.63, and 0.13, respectively).
Incidence of grade 2 nausea was the only
non-hematologic toxicity that was significantly reduced in the CHM
group (14.6% versus 35.7%, P = 0.04). CONCLUSIONS: Traditional CHM
does not reduce the hematologic toxicity associated with chemotherapy.
CHM, however, does have a significant impact on control of nausea.
Ann Oncol. 2007 Jan 17;