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Theories on the Mechanism of Acupuncture
Multiple theories about the mechanism of acupuncture are available, but 3 that stand out for us at Best Health Option connect Traditional Chinese Medicine (TCM) and Western Biomedicine
The connective tissue theory establishes a relationship with acupuncture points to connective tissue planes. The growth control model identifies a relationship between bioelectrical transduction and cell pathogenesis. The neuroimmune response incorporates afferent proprioceptive responses and the vagal nerve.
Connective Tissue Theory
The relationship of acupuncture points and meridians to connective tissue planes researched by Dr. Helene Langevin and Jason Yandow suggest an attraction and coupling between the needle with the elastic and collagen fibers of the subcutaneous connective tissue. Manipulation of the needle facilitates an electro-chemical signal via the connective tissue plane. As manipulation is prolonged or intensified, the needle- tissue torque is intensified thus propagating the response. Tissue samples studied after manipulation suggest prolonged architectural changes in the tissue after withdrawal of the needle (fig).The tissue torque is defined as needlegrasp.This type of response though not defined in this manner traditionally is an established response of de qi, or arrival of qi
In 2002 Lengevin et al. quantified needle grasping by measuring the pullout force of the needle with manipulation. This is a measurable therapeutic response associated with acupuncture. Connective tissue planes were also associated with various acupoint regions as well as Yin and Yang meridians of the arm. Yin meridians and their associated planes were inward and deep, compared to the Yang meridians and their associated planes which were outward and superficial corroborating the external to internal theory of needling. Picture 1-7 shows the connective tissue and needle "whorl"
Growth Control Model
Dr Charles Shang established the Growth Control model in which he determined nodal and vessel systems allocating electro-physiological characteristics with morphogenetic fields initiated cell pathogenesis which occurs with non specific stimuli. In theory a small group of cells (organizers) control a larger region via morphogens.
Morphogens (messenger molecules) form around the organizers. Organizers are either the highest or lowest in concentration of morphogens which is a macroscopic singular point. The bioelectric field affects the morphogen and growth factor producing morphogenesis. When related to acupuncture, evidence connects acupoints and organizers in relationship to distribution at extreme points in surface curvature, response to non specific stimuli and an association with the bioelectric field. The suggestion is made that acupoints originate from organizers and concentration of morphogens and embryogenesis are at the extreme points of curvature in relationship to anatomy.
Traditionally, the high and low concentrations could be conceived as an area of either excess or deficient qi at particular acupoints. The stimulation at a particular curvature where there is a low concentration of morphogen surrounded organizers would experience tonification or bring more qi to that point which may be in fact embryogenesis.Acupoints as stimulating organizers cause transient change in neurotransmitters but will alter growth control signal transduction creating a long term effect.
 The Neuroimmune Response
Dr Donald E Kendell’s peer reviewed publication in 2002 and updated theory and research establishes the neuroimmune response theory inclusive to neural, vascular, immunological and endocrine systems. A local defensive inflammatory response (bradykin release) elicited by the insertion of an acupuncture needle provokes afferent nociceptive neuron distribution to the dorsal horn of the spinal cord. This triggers the gamma loop efferents of the ventral horn to stimulate neurons to cross the spine and send transmissions to the sensory cortex (which are perceived by the person being needled as needle sensation) and the brain stem. Nociceptive and proprioceptive signals stimulate neurons which activate somatic and autonomic motor nerves to the periphery, muscle and internal organ.These signals  inhibit pain, relieve muscle contractions, normalize vascular tone, and restore blood flow. Inhibition of autonomic motor fibers also normalizes organ activity; internal organs also have afferent nociceptive neurons.
Ben Kavoussi and B Evan Ross expanded this theory confirming the brain and immune system form a bidirectional network via the neurohumoral pathways expanding on the idea that when unmyelinated C fibers are stimulated, pro- inflammatory tachykinins which induce vasodilation, and increased vascular permeability ensue. This inflammatory event is transmitted along the afferent vagus nerve and into the brain stem which in turn provoke a transmission pathway of cytokines, causing a direct nerve to immune cell interaction or indirectly via the adrenal neuroendocrine axis. This ultimately leads to a decrease in the pro inflammatory response and an increase in the anti inflammatory cytokines as well as the release of ACTH via the dorsal vagal complex. Both activate the humoral anti inflammatory pathway.
The interesting research that connects this biomedicine theory with traditional teachings is the Vagus nerve and the Spleen. The parasympathetic nervous system (PNS) governs the down regulation of pro inflammatory cytokines and containment of the somatic inflammatory response. Efferent activity in the vagus nerve leads to acetylcholine (ACh) response which inhibits pro inflammatory response only. Studies show that direct electrical stimulation of the efferent vagal nerve blocks TNF synthesis. The Spleen/Stomach Meridians of traditional teaching nearly correlate with the known and hypothetical pathway of the vagal nerve. The vagal nerve is one of the longest cranial nerves and is crucial to the PNS; the Spleen and Stomach are essential to the physiology and pathology in traditional teachings.
*Kavoussi, B. Ross B.E. The Neuroimmune Basis of Anti-inflammatory Acupuncture. Integrated Cancer Therapies 6(3): 251-257. do: 10.1177/1534735407305892
*Carol Mattson Porth, Essentials of Pathophysiology: Concepts of Altered HealthStates Philadelphia, Pennsylvania: Lippincott Williams and Wilkins, 2007
*Helene M. Langevin and Jason Yandow. Relationship of Acupuncture and Meridians to Connective Tissue Planes.The Anatomical Record Review (New Anat) 269:257-265, 2002.
*Kendall, Dr. D.E. The Dao of Chinese medicine: Understanding an Ancient Healing Art.1 ed. USA: Oxford University Press. 2002
*Shang, Dr. C. Basic Acupuncture Research has met the Gold Standard of Science. Department of Medicine, Harvard Medical School. Boston 2009
For more information, articles, other websites that promote science based literature, studies, and educational pieces on Acupuncture visit our Articles and Interest page