There was few human study evaluated the analgesic effect of acupuncture on central nervous system (CNS). The electrical temporal summation (TS) pain model has been validated and provides the opportunity to study the central inhibition effect of acupuncture in healthy humans. The present study aimed to: 1. systematically review available randomised, controlled trials (RCTs) of acupuncture on experimentally induced pain in healthy humans; 2. conduct a RCT to assess the effect of manual acupuncture (MA) and electro-acupuncture (EA) on TS of pain and the spatial (i.e. the local and remote sites to acupuncture stimulation) and the temporal (i.e. immediately after and 24-hours after the intervention) characteristics of this effect. The systematic review was carried out in accordance with the requirements of a Cochrane Systematic Review. The methodological quality and credibility of the acupuncture intervention of the included RCTs were assessed. The Review Management software (RevMan version 4.2, The Cochrane Library) was used for data extraction and data analysis. 605 papers were identified from four databases (Pubmed, Cochrane Library, CINAHL and EMBASE). Only nine papers met the inclusion criteria. The methodological quality and credibility of the acupuncture invention were satisfactory. The pain models and interventions applied varied substantially from study to study. Consequently, meta-analyses were not conducted. Comparing acupuncture with non-invasive control, significant acupuncture analgesia was reported. These studies also demonstrated that invasive controls produced analgesia. For the RCT of acupuncture on TS, 27 healthy volunteers were recruited and randomly assigned to either EA, MA or sham-acupuncture (SA) group, with nine volunteers in each group. To test pain thresholds, transcutaneous electrical stimulation was delivered to two sites on the anterior aspects of both legs and one site on the dorsum of the non-dominant forearm. Pain thresholds to single electrical stimulation (SPT) and to TS stimulation (TST) were assessed before, 30-minutes after and 24-hours after the intervention. Acupuncture was given to Zusanli (ST36) and Fenglong (ST 40) on the dominant leg. The level of anxiety was assessed before and after acupuncture with Spielberg State and Anxiety Inventory. The three groups were comparable at baseline. The level of anxiety did not change significantly after acupuncture. EA significantly increased SPT and TST on the treatment leg 24-hour after the treatment when compared with SA (p less than 0.05), but did not increase those measured on the non-treatment leg or the forearm. The fact that such an effect increased within 24 hours after acupuncture might indicate the potential role of neurohumoral mechanisms in acupuncture analgesia. The analgesia effect of EA on TS tended to be localised at the needling site. This observation is different from the understanding of the wide-spread effect of acupuncture. The discrepancy could be due to the small sample size of the current study. In conclusion, this is the first study that demonstrates EA elicits a strong inhibition on the CNS in health humans. Such a central effect lasts more than 24 hours, and limits to the site where acupuncture is applied. These findings need to be confirmed in other TS models.
| Identifer | oai:union.ndltd.org:ADTP/210382 |
| Date | January 2008 |
| Creators | Feng, Jian Qiang / Sam, S3069785@student.rmit.edu.au |
| Publisher | RMIT University. Health Sciences |
| Source Sets | Australiasian Digital Theses Program |
| Language | English |
| Detected Language | English |
| Rights | http://www.rmit.edu.au/help/disclaimer, Copyright Jian Qiang / Sam Feng |
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