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1 History of Modern Acupuncture Research in China1

1.1 Acupuncture and Traditional Chinese Medicine1

1.1.1 The Channels and Collaterals3

1.1.2 Acupoints4

1.1.3 General Principles of Acupuncture Treatment4

1.2 Modern Developments in Acupuncture Treatment5

1.3 Acupuncture Research at Shanghai Medical University7

1.3.1 Relationship Between the Meridian-Points and Peripheral Nerves7

1.3.2 Acupuncture Analgesia and Acupuncture Anesthesia8

1.3.3 Therapeutic Effects and Mechanisms of Acupuncture on Neurological Disorders19

1.4 Concluding Remarks23

References24

2 Neuroanatomic Basis of Acupuncture Points32

2.1 Introduction32

2.2 Phenomena of Meridians and Acupoints33

2.2.1 Theory of Meridians,Collaterals,and Acupoints33

2.2.2 Relatively Specific Effects of Acupoints35

2.2.3 Unique Physiological Features of Acupoints36

2.2.4 Relatively Specific Anatomical Structures of Acupoints37

2.3 Neuroanatomic Structure of Acupoints39

2.3.1 Gross Anatomical Observation of Meridians and Acupoints40

2.3.2 General Histological Features of Acupoints54

2.3.3 Microanatomic Examination of Acupoints58

2.3.4 Morphological Basis of Sensation of Acupuncture at Acupoints60

2.3.5 Other Morphologic Research on Acupoint62

2.4 Neural Connection Between Meridian-Point and Viscus63

2.4.1 Segmental Nerve Innervation Between Meridian-Points and Viscera65

2.4.2 Convergence of Afferent Signals of Meridian-Points and Viscera in the Central Nervous System69

2.5 Afferent Nerve Fibers and Afferent Pathway of Acupuncture Signal71

2.5.1 Acupuncture Signal and Afferent Nerve Fibers71

2.5.2 Acupuncture Signal Transmission Pathway72

2.6 Concluding Remarks73

Acknowledgements74

References74

3 Neural Transmission of Acupuncture Signal81

3.1 Introduction82

3.2 Initiation of Acupuncture Signal84

3.2.1 Acupoint-Selection Impact on the Pattern of Brain-Area Activity84

3.2.2 Acupuncture Modality:Manual or Electrical?85

3.2.3 Wave Forms,Frequency,Intensity,and Timing86

3.2.4 Transduction of Acupuncture Signal in the Afferent Nerves87

3.3 Integration of Acupuncture Signalin the Central Nervous System89

3.3.1 Integration of Nociceptive and Acupuncture Signals in the Spinal Cord and the Gate Control Theory91

3.3.2 Effects of Brainstem and Descending Control on Acupuncture Analgesia92

3.3.3 The Limbic System and Acupuncture Analgesia94

3.4 Neurobiological Mechanism of Acupuncture in Autonomic Nervous System95

3.4.1 Structure and Function of Autonomic Nervous System96

3.4.2 Acupuncture Signal Regulating Activation of Autonomic Nervous System97

3.4.3 Therapeutic Effects of Acupuncture Mediated Through Autonomic Nervous System98

3.5 Concluding Remarks100

Acknowledgements100

References100

4 Acupuncture-Induced Activation of Endogenous Opioid System104

4.1 Introduction104

4.2 Role of Endogenous Opioid System in Acupuncture105

4.3 Acupuncture-Promoted Release of Endogenous Opioids105

4.3.1 Central Release106

4.3.2 Peripheral Circulation106

4.3.3 Frequency-Dependent Release107

4.4 Acupuncture-Induced Alteration in the Content of EOP in the Brain108

4.5 Acupuncture-Enhanced Expression of Endogenous Opioids110

4.6 Acupuncture and Opioid Receptors111

4.6.1 Role of Opioid Receptor Subtypes in Acupuncture Effects112

4.6.2 Acupuncture and Opioid Receptor Density113

4.7 Concluding Remarks114

Acknowledgements115

References115

5 Effect of Acupuncture on Neurotransmitters/Modulators120

5.1 Introduction121

5.2 5-hydroxytryptamine121

5.2.1 Acupuncture-Induced Increase in Central 5-Hydroxytryptamine Activity122

5.2.2 Acupuncture Regulation of 5-Hydroxytryptamine Activity in Certain Physiological and Pathophysiologic Conditions123

5.2.3 Acupuncture and 5-Hydroxytryptamine Receptors123

5.3 Noradrenalin124

5.3.1 Acupuncture Reduction of Noradrenalin Release and Content in the Brain125

5.3.2 Effect of Endogenous Opioid Peptides on Noradrenalin During Acupuncture125

5.3.3 Acupuncture and Noradrenergic Receptors126

5.4 Dopamine126

5.4.1 Acupuncture-Induced Alteration in Dopaminergic Activity127

5.4.2 Effect of Other Neurotransmitters on Dopaminergic Activity during Acupuncture127

5.4.3 Acupuncture and Dopaminergic Receptors127

5.5 Acetylcholine128

5.5.1 Acupuncture and Cholinergic Activity128

5.5.2 Role ofAcetylcholine in Acupuncture Effects129

5.5.3 Acupuncture and Cholinergic Receptors130

5.6 Amino Acids130

5.6.1 Excitatory Amino Acids130

5.6.2 Inhibitory Amino Acids131

5.7 Other Neurotransmitters132

5.7.1 Substance P132

5.7.2 Prostaglandin132

5.7.3 Cholecystokinin-Octopeptide-8133

5.7.4 Somatostatin133

5.7.5 Orphanin FQ133

5.7.6 Neurotrophic Factors134

5.7.7 Nitric Oxide134

5.8 Concluding Remarks135

Acknowledgements136

References136

6 Acupuncture-Drug Balanced Anesthesia143

6.1 Introduction:From Acupuncture Analgesia to Acupuncture Anesthesia143

6.2 From Acupuncture Anesthesia to Acupuncture-Drug Balanced Anesthesia145

6.2.1 The Advantages of Acupuncture-Drug Balanced Anesthesia145

6.2.2 The Main Cases of Acupuncture-Drug Balanced Anesthesia146

6.3 Application of Acupuncture Anesthesia in Different Countries or Areas150

6.4 Clinical and Experimental Research on Combination of Acupuncture with Drugs in Pain Treatment153

6.5 Mechanism of the Synergistic Effect of Acupuncture-Drug Combination154

6.6 Concluding Remarks157

Acknowledgements158

References158

7 Acupuncture Analgesia in Clinical Practice162

7.1 Introduction162

7.2 Common Controls for Clinical Acupuncture164

7.3 Types of Acupuncture Approaches165

7.3.1 Manual Acupuncture166

7.3.2 Electroacupuncture166

7.4 Acupuncture Analgesia in Clinical Practice169

7.4.1 Headaches169

7.4.2 Chronic Low Back Pain172

7.4.3 Knee Osteoarthritis175

7.4.4 Chronic Neck Pain177

7.4.5 Neuropathic Pain179

7.4.6 Motor System Injuries181

7.4.7 Fibromyalgia182

7.4.8 Cancer Pain182

7.4.9 Dental Pain184

7.4.10 Phantom Limb Pain185

7.5 Side Effects185

7.6 Concluding Remarks186

Acknowledgements186

References186

8 Neurochemical Basis of Electroacupuncture Analgesia on Acute and Chronic Pain194

8.1 Introduction194

8.2 EA analgesia on Acute and Chronic Pain195

8.2.1 Neuropathic Pain195

8.2.2 Inflammatory Pain197

8.2.3 Cancer Pain198

8.3 Neurochemical Mechanism Underlying EA Analgesia on Acute Pain199

8.3.1 Endogenous Opioid Peptides199

8.3.2 CCK-8203

8.3.3 Glutamate204

8.3.4 GABA205

8.3.5 Serotonin(5-HT)205

8.3.6 Noradrenaline206

8.3.7 Dopamine207

8.4 Neurochemical Basis of EA Analgesia on Chronic Pain207

8.4.1 EOPs208

8.4.2 Other Neuropeptides209

8.4.3 Glutamate210

8.4.4 Serotonin213

8.4.5 EAA and Neuroinflammation214

8.4.6 Neural Growth Factors and Neurotrophins215

8.5 Concluding Remarks217

Acknowledgements218

References218

9 Acupuncture Therapy for Stroke226

9.1 Introduction227

9.2 Clinical Practice of Acupuncture on Stroke229

9.2.1 Clinical Acupuncture and Commonly Used Acupoints in Stroke Treatment230

9.2.2 Efficacy of Acupuncture on Stroke232

9.2.3 Various Factors That Affect the Efficacy of Acupuncture235

9.3 Experimental Study of Acupuncture-Induced Protection from Stroke236

9.3.1 Animal Models236

9.3.2 Anti-Ischemic Effect of Acupuncture in Animals238

9.3.3 Effect of Acupuncture on the Functional Recovery of the Ischemic Brain240

9.3.4 Optimal EA Conditions for Maximal Protection from Cerebral Ischemia241

9.3.5 Mechanisms of Acupuncture-Induced Protection Against Cerebral Ischemia242

9.4 Concluding Remarks254

Acknowledgements254

References255

10 Effects of Acupuncture on Arrhythmia and Other Cardiac Diseases263

10.1 Introduction263

10.2 Clinical Application of Acupuncture for the Treatment of Cardiac Diseases264

10.2.1 Arrhythmia265

10.2.2 Other Cardiac Disorders267

10.3 Mechanisms of Acupuncture Therapy for Cardiac Disorders268

10.3.1 Mechanisms Underlying Acupuncture Correction of Arrhythmia269

10.3.2 Mechanisms of Acupuncture Therapy for Other Cardiac Disorders278

10.4 Concluding Remarks280

Acknowledgements282

References282

11 Acupuncture Therapy for Hypertension and Hypotension289

11.1 Introduction289

11.2 Clinical Application of Acupuncture for Treating Abnormal Blood Pressure290

11.2.1 Hypertension290

11.2.2 Hypotension298

11.3 Mechanisms of Acupuncture Therapy for Abnormal Blood Pressure300

11.3.1 Mechanisms of Acupuncture-induced Decrease in Lowering High Blood Pressure301

11.3.2 Mechanisms of Acupuncture Therapy for Low Blood Pressure312

11.4 Concluding Remarks317

Acknowledgements318

References318

12 Effect of Acupuncture on Epilepsy326

12.1 Introduction326

12.2 Clinical Practice of Acupuncture on Epilepsy328

12.2.1 History328

12.2.2 Current Applications of Acupuncture Therapy331

12.2.3 Acupoints334

12.2.4 Efficacy335

12.2.5 Negative and Opposite Evidences336

12.3 Mechanism of Acupuncture Inhibition of Epilepsy337

12.3.1 Effect of Acupuncture on Electroencephalogram and Power Spectra338

12.3.2 Effect of Acupuncture on Excitatory and Inhibitory Amino Acids340

12.3.3 Effect of Acupuncture on Neuropeptides347

12.3.4 Effect of Acupuncture on Nitric Oxide351

12.3.5 Effect of Acupuncture on Other Neurological Factors352

12.3.6 An Anatomical View355

12.4 Concluding Remarks355

Acknowledgements356

References356

13 Neuroimmuno-effect of Acupuncture on Immune-mediated Disorders365

13.1 Introduction365

13.2 Acupuncture and Immune-mediated Disorders366

13.2.1 Immunostimulant Points367

13.2.2 Acupoint Specificity and Acupuncture Efficacy367

13.2.3 Immune Modulation of Acupuncture368

13.2.4 Common Practice of Acupuncture on Immune-mediated Disorders370

13.3 Mechanism of Acupuncture on Immune-related Diseases376

13.3.1 The General Regulatory Efiects of Acupuncture and the Theory of Neuroendocrine-immune Network376

13.3.2 Role of Hypothalamus-pituitary-adrenal Axis in Acupuncture-mediated Efiects on Immune System378

13.3.3 Role of Neuropeptides on the Immunoregulatory Effects of Acupuncture379

13.4 Concluding Remarks383

Acknowledgements384

References384

14 Acupuncture Treatment for Female Infertility389

14.1 Introduction389

14.2 Treatment of Infertility391

14.2.1 Principles of Medication and Reproductive Technologies391

14.2.2 Acupuncture Therapeutics392

14.2.3 Acupuncture Combined with Assisted Reproduction Technology394

14.3 Mechanism of Acupuncture Therapy for Infertility394

14.3.1 Clinical Studies395

14.3.2 Experimental Studies397

14.4 Concluding Remarks403

References403

15 Acupuncture Therapy for Menopausal and Perimenopausal Syndrome407

15.1 Introduction407

15.2 Acupuncture Treatment for Menopause and Perimenopausal Syndrome409

15.2.1 Commonly Used Acupoints409

15.2.2 Therapeutic Effects of Acupuncture on Menopausal Syndrome411

15.3 How Does Acupuncture Work?413

15.3.1 Electroacupuncture-induced Regulation of Hypothalamic-pituitary-ovarian Axis413

15.3.2 Role of β-endorphin417

15.3.3 Role of Corticotrophin-releasing Factor and Hypothalamus-pituitary-adrenal Axis418

15.3.4 Role of Extragonadal Aromatization419

15.3.5 Elcctroacupuncture Promotes the Homeostasis in Ovariectomized Rats421

15.3.6 Psychological Impact of Acupuncture422

15.4 Concluding Remarks422

References423

16 Acupuncture for Smoking Cessation426

16.1 Introduction426

16.2 Researches on Smoking Cessation427

16.3 Clinical Application of Acupuncture for Smoking Cessation428

16.3.1 Body Acupuncture429

16.3.2 Auriculo-acupuncture430

16.3.3 Nasal Acupuncture430

16.3.4 Combination Therapy431

16.4 Mechanisms of Acupuncture Therapy for Smoking Cessation432

16.4.1 Gustatory Sensation and Mouth Environment432

16.4.2 Neuroendocrinology433

16.4.3 Cardiorespiratory Function433

16.5 Theory of Traditional Chinese Medicine in Smoking Cessation433

16.6 Concluding Remarks434

References435

17 Beneficial Effect of Acupuncture on Depression437

17.1 Introduction438

17.2 Clinical Trials439

17.2.1 Acupuncture as a Sole Therapy439

17.2.2 Acupuncture Combined with Other Therapies446

17.3 Mechanism Studies448

17.3.1 Effect of Electroacupuncture on the Neurotransmitters449

17.3.2 Effect of Electroacupuncture on the Hypothalamus-pituitary-adrenal Axis450

17.3.3 Effect of Electroacupuncture on the Immune System450

17.3.4 Effect of Electroacupuncture on Signal Transduction System451

17.3.5 Effect of Electroacupuncture on Hippocampus452

17.4 Concluding Remarks453

Acknowledgements456

References456

18 Effect of Acupuncture on Drug Addiction460

18.1 Introduction460

18.2 Clinical Application of Acupuncture for Drug Addiction461

18.2.1 Auriculo-acupuncture461

18.2.2 Body Acupuncture462

18.2.3 Electroacupuncture462

18.2.4 Han'Acupoints Nerve Stimulator463

18.2.5 Combination Therapy464

18.3 Mechanisms of Acupuncture Therapy for Drug Addiction465

18.3.1 The Role of Endorphin in Acupuncture Treatment for Opioid Dependence465

18.3.2 The Roles of Some Neurotransmitters in Acupuncture Treatment for Opioid Dependence467

18.3.3 Regulation of Immunity468

18.3.4 Changes in the Function of Endocrinology468

18.3.5 Alterations in Psychology469

18.4 Concluding Remarks469

References470

Appendix A Milestone of Acupuncture Research:Correlation Between Peripheral Nerves and Meridians-Acupoints473

References474

Index475