Authors: Wan-Chung Hu
Acupuncture and moxibustion are two most important managements of traditional Chinese medicine. However, their precise scientific mechanism is still unknown. Acupuncture is usually practiced on arms with three Ying and three Yang pathways and on legs with three Ying and three Yang pathways. The Ying and Yang pathways are actually co-related with the dermatome distribution on arms and legs. The analgesic effect of acupuncture is to sharply stimulate limbs to inhibit the referred pain area in the inner organs. For examples, the inner arm Ying path: 心包經 is actually the T1 dermatome distribution. Thus, 心包經 acupuncture can control the pain in chest including lung, heart, and esophagus. The other important concept of acupuncture mechanism is it can stimulate POMC production. The neuro-endocrine POMC can generate ACTH and endorphin. ACTH will then up-regulate corticosteroid production. Thus, acupuncture also has anti-inflammatory effects such as curing allergic rhinitis. Endorphin activation can also reduce pain and produce euphoria-like feeling. Acupuncture is mediated by sharp pain via A delta fibers. A delta fiber, stimulating sympathetic acute stress response including epinephrine and norepinephrine, can compete the accompanying slow pain/inflammation transmitting c fiber. Thus, acupuncture can suppress pain and inflammation via gate-control like mechanism. Moxibustion plays the opposite role. Moxibustion produces heat sensation which transmits via c fiber. Thus, it will facilitate the host inflammatory/immune response against pathogen infection. Thus, 黃帝內經云針所不宜灸之所治. Another important mechanism for acupuncture is nerve plasticity. In stroke patients, acupuncture stimulates paralyzed limb nerve re-generation and synapse re-formation. This nerve plasticity is the same as the principle of physical rehabilitation. It is worth nothing ear acupuncture mechanism. Vagus nerve distributes in the ear chlorea. Thus, ear acupuncture can also compete the inner organ pain sensation via vagus nerve inhibition as we view ear as another dermatome of inner organ.
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