Journal of Acupuncture Research

Korean Acupuncture & Moxibustion Medicine Society (대한침구의학회)
권호 표지
DOI QR코드

DOI QR Code

Acupuncture: How Might the Mechanisms of Treatment Have Contributed to the Diagnosis of "Patterns" and Pattern-based Treatments - Speculations on the Evolution of Acupuncture as a Therapy. Implications for Researchers

  • Birch, Stephen (Kristiania University College, Department of Health Sciences)
  • Received : 2018.04.24
  • Accepted : 2018.04.30
  • Published : 2018.05.30
Download PDF
⟨ Previous Next ⟩

Abstract

Acupuncture is a complex intervention that manifests varied theories, treatment methods, diagnostic methods and diagnostic patterns. Traditionally based systems of acupuncture (TBSAs) often have their own diagnostic approaches and patterns. Despite the wide variety that can be found amongst TBSAs, is it possible that they share a common background in clinical observation and practice? Research has shown that multiple physiological pathways and mechanisms can be triggered by different acupuncture techniques and methods. It is highly likely that clinicians will have observed some of the effects of these responses and used those observations as feedback to help construct the patterns of diagnosis and their associated treatments. This review briefly examines this possibility. Pattern identification will have developed out of a complex interaction of factors that include; theories current at the time of their development, historical theories, personal choices and beliefs, training, practice methods, clinical observations and the natural feedback that comes from observing how things change once the treatment is applied. Researchers investigating TBSAs and pattern identification need to be more explicit about the systems they have investigated in order to understand the biological basis of pattern identification and their treatments.

Keywords

References

  1. Paterson C, Dieppe P. Characteristic and incidental (placebo) effects in complex interventions such as acupuncture. BMJ 2005;330:1202-1205. https://doi.org/10.1136/bmj.330.7501.1202
  2. Medical Research Council (Great Britain) [Internet]. Health Services and Public Health Research Board. A framework for development and evaluation of RCTs for complex interventions to improve health. Medical Research Council, 2000. 2000. Available from: http://www.mrc.ac.uk/pru/pdfmrc_cpr.pdf.
  3. Birch S, Felt R. Understanding Acupuncture. Edinburgh (Scotland): Elsevier;1999.
  4. Birch S, Lewith G. Acupuncture research, the story so far. In MacPherson H, Hammerschlag R, Lewith G, Schnyer R (eds). Acupuncture Research: Strategies for Building an Evidence Base. London(UK): Elsevier;2007. p.15-35
  5. Macpherson H, Kaptchuk TJ. Acupuncture in Practice. New York (USA): Churchill Livingstone;1997.
  6. Schnyer R, Birch S, MacPherson H. Acupuncture practice as the foundation for clinical evaluation. In MacPherson H, Hammerschlag R, Lewith G, Schnyer R. (eds). Acupuncture Research: Strategies for Building an Evidence Base. London (UK): Elsevier;2007. p.153-179
  7. Cha WS, Oh JH, Park HJ, Ahn SW, Hong SY, Kim NI. Historical difference between traditional Korean medicine and traditional Chinese medicine. Neurol Res 2007;29:S5-9. https://doi.org/10.1179/016164107X172293
  8. Robinson N, Lorenc A, Ding W, Jia J, Bovey M, Wang XM. Exploring practice characteristics and research priorities of practitioners of traditional acupuncture in China and the EU-A survey. J Ethnopharmacol 2012;140:604-613. https://doi.org/10.1016/j.jep.2012.01.052
  9. Sherman KJ, Cherkin DC, Eisenberg DM, Ezzo J, Hrbek A, Deyo RA. The practice of acupuncture: who are the providers and what do they do? Ann Fam Med 2005;3:151-158. https://doi.org/10.1370/afm.248
  10. MacPherson H, Elliot B, Hopton A, Lansdown H, Birch S, Hewitt C Lifestyle advice and self-care integral to acupuncture treatment for patients with chronic neck pain: secondary analysis of outcomes within a randomized controlled trial. J Alter Complem Med 2017;23:180-187. https://doi.org/10.1089/acm.2016.0303
  11. Birch S. Testing the claims of traditionally based acupuncture. Complem Ther Med 1997;5:147-151. https://doi.org/10.1016/S0965-2299(97)80057-X
  12. Baldry PE. Acupuncture, Trigger Points and Musculoskeletal Pain. Edinburgh (Scotland): Churchill Livingstone;1989.
  13. Birch S, Alraek T. Traditional East Asian medicine: how to understand and approach diagnostic findings and patterns in a modern scientific framework? Chin J Integr Med 2014;20:333-337.
  14. Zhang ZJ, Wang XM, McAlonan GM. Neural Acupuncture Unit: A New Concept for Interpreting Effects and Mechanisms of Acupuncture. Evid Based Complement Alternat Med 2012;2012:429412.
  15. Birch S. The jingmai and qi: acupuncture perspectives. In Birch S, Cabrer Mir MA, Rodriguez Cuadras M. (eds). Restoring order in health and Chinese medicine: Studies of the development and use of qi and the channels. Barcelona (Spain): La Liebre & Jade Stone Group;2014. p.183-266.
  16. Wiseman N, Ellis A. Translation of Zhong Yi Xue Ji Chu, 1975 as: Fundamentals of Chinese Medicine. Brookline (USA): Paradigm Publications;1985.
  17. Wiseman N, Feng Y. A Practical Dictionary of Chinese Medicine. Brookline (USA): Paradigm Publications;1997.
  18. Scheid V. Chinese medicine in contemporary China. Durham (USA): Duke University Press;2002.
  19. Taylor K. Divergent interests and cultivated misunderstandings: the influence of the West on modern Chinese medicine. Soc Hist Med 2004;17:93-111. https://doi.org/10.1093/shm/17.1.93
  20. Chae H, Lee SW, Park SH, Jang ES, Lee SJ. Development and Validation of a Personality Assessment Instrument for Traditional KoreanMedicine: Sasang Personality Questionnaire. Evid Based Complement Alternat Med 2012;2012:657013.
  21. Park MY, Kim SC. A Modern Clinical Approach of the Traditional Korean Saam Acupuncture. Evid Based Complement Alternat Med 2015;2015:703439.
  22. Yasui H. Distinctive features of Kampo medicine. J Kampo, KAIM 2005;1:10-13.
  23. Fukushima K. Meridian Therapy. Tokyo (Japan): Toyo Hari Medical Association;1991.
  24. Shudo D. Introduction to Meridian Therapy. Seattle (USA): Eastland Press;1990.
  25. Connelly D. Traditional Acupuncture: The Law of the Five Elements. Columbia Maryland (USA): The Centre for Traditional Acupuncture;1979.
  26. Worsley JR. Is acupuncture for you? Leamington Spa (England): College of Traditional Chinese Acupuncture;1973.
  27. WHO Western Pacific Region. WHO International Standard Terminologies on Traditional Medicine in the Western Pacific Region. World Health Organization;2007.
  28. Birch S, Bovey M. Qi, Jingmai: Scientific investigation of concepts based in traditional East Asian medicine: challenges to cross-paradigm research. In Birch S, Cabrer Mir MA, Rodriguez M. (eds). Restoring order in health and Chinese medicine: Studies of the development and use of qi and the channels. Barcelona (Spain): La Liebre & Jade Stone Group;2014. p.367-399.
  29. Birch S. Traditionally based systems of acupuncture - their "explanatory" nature, models, needs and requirements for testing them. Proceedings of the International Symposium on Theory and Evidence for Acupuncture. Nanyang Technological University (Singapore):Institute for advanced studies;2013. p.19-45.
  30. Zhang CS, Tan HY, Zhang GS, Zhang AL, Xue CC, Xie YM. Placebo Devices as Effective Control Methods in Acupuncture Clinical Trials: A Systematic Review. PLoS ONE 2015;10:e0140825. https://doi.org/10.1371/journal.pone.0140825
  31. MacPherson H, Vertosick E, Lewith G, Linde K, Sherman KJ, Witt CM et al. Influence of Control Group on Effect Size in Trials of Acupuncture for Chronic Pain: A Secondary Analysis of an Individual Patient Data Meta-Analysis. PLoS ONE 2014;9:e93739. https://doi.org/10.1371/journal.pone.0093739
  32. Appleyard I, Lundeberg T, Robinson N. Should systematic reviews assess the risk of bias from sham-placebo acupuncture control procedures? Eur J Integr Med 2014;6:234-243. https://doi.org/10.1016/j.eujim.2014.03.004
  33. Oschman JL. Energy Medicine. Edinburgh (Scotland): Churchill Livingstone;2000.
  34. Bai L, Lao L. Neurobiological foundations of acupuncture: the relevance and future prospect based on neuroimaging evidence. Evid Based Complement Alternat Med 2013;2013:812568.
  35. Bowsher D. Mechanisms of acupuncture. In Filshie J, White A. (eds). Medical Acupuncture. Edinburgh (Scotland): Churchill Livingstone;1998. p.69-83.
  36. Chae Y, Chang DS, Lee SH, Jung WM, Lee IS, Jackson S et al. Inserting needles into the body: a meta-analysis of brain activity associated with acupuncture needle stimulation. J Pain 2013;14:215-222. https://doi.org/10.1016/j.jpain.2012.11.011
  37. Chen SJ, Meng L, Yan H, Bai LJ, Wang F, Huang Y et al. Functional organization of complex brain networks modulated by acupuncture at different acupoints belonging to the same anatomic segment. Chin Med J 2012;125:2694-2700.
  38. Dhond RP, Kettner N, Napadow V. Neuroimaging acupuncture effects in the human brain. J Altern Complement Med 2007;13:603-616. https://doi.org/10.1089/acm.2007.7040
  39. Dhond RP, Yeh C, Park K, Kettner N, Napadow V. Acupuncture modulates resting state connectivity in default and sensorimotor brain networks. Pain 2008;136:407-418. https://doi.org/10.1016/j.pain.2008.01.011
  40. Han JS. Physiology of acupuncture: A review of thirty years of research. J Alt Complem Med 1997;3:101-108. https://doi.org/10.1089/acm.1997.3.101
  41. Huang W, Pach D, Napadow V, Park K, Long X, Neumann J et al. Characterizing acupuncture stimuli using brain imaging with FMRI--a systematic review and meta-analysis of the literature. PLoS One 2012;7:e32960. https://doi.org/10.1371/journal.pone.0032960
  42. Pomeranz B, Berman B. Scientific basis of acupuncture. In: Stux G, Berman B, Pomeranz B. Basics of Acupuncture. 5th ed. Berlin (Germany): Springer- Verlag;2003. p.1-86.
  43. Fields T. Touch Therapy. London (UK): Churchill Livingstone;2000.
  44. Kawakita K, Shinbara H, Imai K, Fukuda F, Yano T, Kuriyama K. How Do Acupuncture and Moxibustion Act? - Focusing on the Progress in Japanese Acupuncture Research. J Pharmacol Sci 2006;100:443-459. https://doi.org/10.1254/jphs.CRJ06004X
  45. Leder D, Krucoff MW. The touch that heals: the uses and meanings of touch in the clinical encounter. J Alt Complem Med 2008;14:321-327. https://doi.org/10.1089/acm.2007.0717
  46. McCraty R, Atkinson M, Tomasino D, Tiller WA. The electricity of touch: Detection and measurement of cardiac energy exchange between people. In Pribram K. (Ed). Brain and Values: Is a Biological Science of Values Possible? Mahwah (USA): Lawrence Erlbaum Associates Publishers;1998. p.359-379.
  47. Asghar AUR, Green G, Lythgoe MF, Lewith G, MacPherson H. Acupuncture needling sensation: The neural correlates of deqi using fMRI. Brain Research 2010;1315:111-118. https://doi.org/10.1016/j.brainres.2009.12.019
  48. Itaya K, Manaka Y, Ohkubo C, Asano M. Effects of acupuncture needle application upon cutaneous microcirculation of rabbit ear lobe. Acupunct Electrother Res 1987;12:45-51. https://doi.org/10.3727/036012987816951121
  49. Jung WS, Park SU, Park JM, Kim DY, Hong IK, An YS et al. Changes in SPECT cerebral blood flow following Japanese style, superficial acupuncture at LI-4 and LI-11 in healthy volunteers. J Altern Complement Med 2011;17:357-362. https://doi.org/10.1089/acm.2010.0331
  50. MacPherson H, Green G, Nevado A, Lythgoe MF, Lewith G, Devlin R et al. Brain imaging of acupuncture: comparing superficial with deep needling. Neurosci Lett 2008;434:144-149. https://doi.org/10.1016/j.neulet.2008.01.058
  51. Tanaka TH, Leisman G, Nishijo K. The physiological responses induced by superficial acupuncture: a comparative study of acupuncture stimulation during exhalation phase and continuous stimulation. Int J Neurosci 1997;90:45-58. https://doi.org/10.3109/00207459709000625
  52. O'Brien KA, Birch S, Abbas E, Movsessian P, Hook M, Komesaroff PA. Traditional East Asian Medical pulse diagnosis - a preliminary physiological investigation. J Altern Comp Med 2013;19:793-798. https://doi.org/10.1089/acm.2012.0141
  53. Han JS. Acupuncture analgesia: Areas of consensus and controversy. Pain 2011;152:S41-S48. https://doi.org/10.1016/j.pain.2010.10.012
  54. Witzel T, Napadow V, Kettner NW, Vangel MG, Hamalainen MS, Dhond RP. Differences in cortical response to acupressure and electroacupuncture stimuli. BMC Neurosci 2011;12:73. https://doi.org/10.1186/1471-2202-12-73
  55. Napadow V, Dhond RP, Kim J, LaCount L, Vangel M, Harris RE et al. Brain encoding of acupuncture sensation--coupling on-line rating with fMRI. Neuroimage 2009;47:1055-1065. https://doi.org/10.1016/j.neuroimage.2009.05.079
  56. Lee MHM, Ernst M. Clinical research observations on acupuncture analgesia and thermography. In Stux G, Pomeranz B. Scientific Bases of Acupuncture. Berlin (Germany): Springer Verlag;1988. p.157-175.
  57. Li QQ, Shi GX, Xu Q, Wang J, Liu CZ, Wang LP. Acupuncture Effect and Central Autonomic Regulation. Evid Based Complement Alternat Med 2013;2013:267959.
  58. Nishijo K, Mori H, Yosikawa K, Yazawa K. Decreased heart rate by acupuncture stimulation in humans via facilitation of cardiac vagal activity and suppression of cardiac sympathetic nerve. Neurosci Lett 1997;227:165-168. https://doi.org/10.1016/S0304-3940(97)00337-6
  59. Huang T, Wang RH, Zhang WB, Han B, Wang GJ, Tian YY et al. The influence of different methods of acupuncture on skin surface perfusion. J Tradit Chin Med 2012;32:40-44. https://doi.org/10.1016/S0254-6272(12)60029-6
  60. McDonald JL, Cripps AW, Smith PK, Smith CA, Xue CC, Golianu B. The anti-inflammatory effects of acupuncture and their relevance to allergic rhinitis: a narrative review and proposed model. Evid Based Complement Alternat Med 2013;2013:591796.
  61. Zijlstra FJ, van den Berg-de Lange I, Huygen FJ, Klein J. Anti-inflammatory actions of acupuncture. Mediators Inflamm 2003;12:59-69. https://doi.org/10.1080/0962935031000114943
  62. Aguiar DN, Silva MM, Parreira WV, Tome FD, Batista LF, Gomes CM et al. Electroacupuncture at the ST36 acupoint increases interleukin-4 responsiveness in macrophages, generation of alternatively activated macrophages and susceptibility to Leishmania major infection. Chin Med 2012;7:17. https://doi.org/10.1186/1749-8546-7-17
  63. Mori H, Nishijo K, Kawamura H, Abo T. Unique immunomodulation by electro-acupuncture in humans possibly via stimulation of the autonomic nervous system. Neurosci Lett 2002;320:21-24. https://doi.org/10.1016/S0304-3940(02)00012-5
  64. Yamaguchi N, Takahashi T, Sakuma M, Sugita T, Uchikawa K, Sakaihara S et al. Acupuncture regulates leukocyte subpopulations in human peripheral blood. Evid Based Complement Alternat Med 2007;4:447-453. https://doi.org/10.1093/ecam/nel107
  65. Rodriguez M. Qi, jingmai, yaoyi. In Birch S, Cabrer Mir MA, Rodriguez M (eds). Restoring order in health and Chinese medicine: Studies of the development and use of qi and the channels. Barcelona (Spain): La Liebre & Jade Stone Group;2014. p.293-332.
  66. Cheng XN. Chinese Acupuncture and Moxibustion. Beijing (China): Foreign Languages Press;1987.
  67. Wang Y, Tian CH, Li ZM. Preliminary observation on the treatment of fever due to the invasion of exogenous pathogenic wind cold with warm moxibustion. In Selection from Article Abstracts on Acupuncture and Moxibustion. Beijing (China): China Association of Acupuncture and Moxibustion;1987. p.344-345.
  68. Sivin N. Traditional Medicine in Contemporary China. Ann Arbor (USA): Centre for Chinese Studies, University of Michigan;1987.
  69. Unschuld PU. Medicine in China: A History of Ideas. Berkeley (USA): University of California Press;1985.

Cited by

  1. Inter-Rater Agreement in Traditional Chinese Medicine: On the Potential Contribution of Popplewell's Work vol.25, pp.11, 2018, https://doi.org/10.1089/acm.2019.0314
  2. Understanding blood stasis in traditional East Asian medicine: a comparison of Asian and Western sources vol.44, pp.None, 2021, https://doi.org/10.1016/j.eujim.2021.101341