AKUPUNKTURUN ETKILERI VE TEMEL PRENSIPLER

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AKUPUNKTURUN ETKILERI VE TEMEL PRENSIPLER

• Uz.Dr. Hasan Ali Nogay
• Sualti ve Hiperbarik Tip Uzmani
• Akupunkturist
• HIPEROX Özel Ayak Sagligi ve Zor Yara
• Hiperbarik Oksijen Tedavi Merkezi
• ANTALYA

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AKUPUNKTUR

• Dogru Noktayi bulmak
  sanatidir
• O kisi için-O zaman-Dogru nokta

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Akupunkturun etki mekanizmasiyla ilgili Teoriler

• Immünite teorisi
• Endorphin teorisi
• Neurotransmitter teorisi
• Dolasim teorisi
• Kapi kontrol teorisi
• Motor Kapi Teorisi
• Homeostasiz teorisi

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Immünmodülasyon(1)

• BALB/c Farelerde anteriyör tibial kaslarinda yer
  alan St-36 noktasina üç gün günde 30 dakika
  olmak üzere uygulanan elektro akupunktur sonunda
  dalak Natural Killer(NK) hücrelerinin
  aktivitelerinin belirgin olarak arttigi tespit
  edilmistir.

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Immünmodülasyon (2)

• Bir çalismada tedavi edilen hastalarin
  45inde 30 dakika, 100ünde ise 24 saat sonra
  monosit fagositozu artmistir

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Immünmodülasyon (3)

• Akupunktur Li4St36 tedavisinden 30 sonra
  hastalarin 80inde CD3,CD4 veCD8 belirgin artis
  göstermis ve artis yüksekligi 24 saat devam
  etmistir,
• Bu vakalarin 80inde beta-endorfin düzeyleri de
  yükselmis ve 24 saat yüksek kalmistir.

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Immünmodülasyon (4)

• X isinlarina tabii tutulan kisilere akupunktur
  uygulandiginda düsen total lökosit, lenfosit ve
  nötrofil sayilarinda artis olmaktadir

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Immünmodülasyon (5)

• St36-Li11ve CV6 noktalari kullanildiginda IL-2
  seviyeleri ve NK hücre aktiviteleri normal gruba
  göre düsük olan malignan tümörlü hastalarda 10
  günlük tedaviden sonra bu parametrelerde anlamli
  derecede artis görülmüstür.

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Effect of acupuncture on interleukin-2 level and
NK cell immunoactivity of peripheral blood of
malignant tumor patients
Wu B, Zhou RX, Zhou MS. First Affiliated
Hospital, Huaxi Medical University,
Chengdu. This paper deals with the observation
of acupuncture therapy affecting
interleukin-2(IL-2) level and natural killer (NK)
cell immunoactivity in the peripheral blood of
patients with malignant tumors. In this
clinical-laboratory test research, randomized
double blind method was used. The patients were
divided into an acupuncture treated group (n
25) and a control group (n 20). The former
group was treated using points, ST36,LI11,RN6
and locations of symptomatic points bilaterally.
They received one treatment of 30 minutes daily
for 10 days. The results showed that the IL-2
level and NK cell activity were lower than
normal in patients with malignant tumor, but
there was an increase in the acupuncture group
after 10 days of treatment. Significance was
found to be remarkable (P lt 0.01). The
difference between the two groups was also
significant (P lt 0.01). This increase might be
related to the mechanism of acupuncture that
adjusting the body's immune function. Thus,
acupuncture therapy could enhance the cellular
immune function of patients with malignant
tumors and providing a beneficial effect in
anti-cancer treatment.

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Effect of acupuncture on immunomodulation in
patients with malignant tumors
Wu B, Zhou RX, Zhou MS. First Affiliated
Hospital, West China University of Medical
Sciences, Chengdu. Forty patients were divided
randomly into two groups, 20 for each. One group
treated with acupuncture and the other one for
control. The acup. group was treated using
points PC6, LI4, ST36, RN4 and location of
symptomatic points bilaterally, one treatment of
30 min daily for 10 days. The results showed
that there were increased levels of CD3, CD4
percentage, CD4/CD8 ratio and radioimmunoassay
of beta-EP in blood plasma, a decreased level of
SIL-2R after acup. The statistical significance
was found to be remarkable (P lt 0.01), so has a
notable difference, the correlation analysis
indicated (1) there was a positive correlation
between beta-EP and T-lymphocytes subgroups (2)
a negative correlation between beta-Bp and
SIL-2R, so did it between T subgroups and SIL-2R.
Results showed that acupuncture has the effect
of enhancing the cellular immunity of patient
with malignant tumor. PMID 8758833 PubMed -
indexed for MEDLINE
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Effects of acupuncture on immunoglobulins in
patients with asthma and rheumatoid arthritis
The effects of acupuncture on immunoglobulins in
patients with asthma and rheumatoid arthritis
were studied. After acupuncture, in 20 patients
with asthma, IgG increased (P lt 0.01), IgM and
IgE decreased (both P lt 0.01), while IgA did not
change markedly (P gt 0.05) in 12 patients with
rheumatoid arthritis, after acupuncture IgG, IgA
and IgM decreased (P lt 0.05, 0.05, and 0.01,
respectively), while IgE did not change
evidently. The results observed in these 32
patients indicate that acupuncture exerts
modulation action on immunoglobulins of the
human body, and that patients with asthma and
rheumatoid arthritis responded effectively to
acupuncture therapy, the latter might be related
to the reinforcement of the immunological
function by acupuncture.

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Factors that influence the applicability of sham
needle in acupuncture trials two randomized,
single-blind, crossover trials with
acupuncture-experienced subjects.
METHODS (a LI-4 trial and a BL-23 trial). The
subjects received two sessions of different
stimulations in each trial. A Park Sham Needle
was used in one session, a genuine acupuncture
needle in the other. RESULTS In the LI-4 trial,
all of the 21 subjects (100) felt penetration
with the genuine needle, but only 7 of the 20
subjects (35) felt a similar sensation with the
sham needle (P0.0002). Fifteen of the 21
subjects (71) felt a dull sensation with the
genuine needle, but only 4 of the 20 subjects
(20) felt a similar sensation with the sham
needle (P0.01). In the BL-23 trial, 14 of the
20 subjects (70) felt penetration with the
genuine needle and 10 of the 20 subjects (50)
felt "penetration" with the sham needle (P0.39).
Eight of the 20 subjects (40) felt a dull
sensation with the genuine needle and 2 of the
20 subjects (10) did with the sham needle
(P0.109). CONCLUSIONS Potential factors that
influence the applicability of "placebo"
needling include not only inter-tester
variability but also the patient's knowledge and
experience of acupuncture, acupuncture point
selection, the visual impact of needling, and so
on.
Clin J Pain. 2006 May22(4)346-9.
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Characterization of the "Deqi" Response in
Acupuncture.
Acupuncture stimulation elicits deqi, a
composite of unique sensations that is essential
for clinical efficacy according to traditional
Chinese medicine (TCM). METHODS Manual
acupuncture was performed at LI4, ST36 and LV3
on the extremities in randomized order during
fMRI in 42 acupuncture naive healthy adult
volunteers. RESULTS The deqi response was
elicited in 71 of the acupuncture procedures
compared with 24 for tactile stimulation when
thresholded at a minimum total score of 3 for
all the sensations. The frequency and intensity
of individual sensations were significantly
higher in acupuncture. Among the sensations
typically associated with deqi, aching, soreness
and pressure were most common, followed by
tingling, numbness, dull pain, heaviness, warmth,
fullness and coolness. The study provides
scientific data on the characteristics of the
'deqi' response in acupuncture and its
association with distinct nerve fibers. The
findings are clinically relevant and consistent
with modern concepts
BMC Complement Altern Med. 2007 Oct 317(1)33

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Li- 4 noktasi

• Kalin barsak noktasi analjezik amaçli olarak
  ignelenmisitir.
• Sürekli agrisi olmayan 134 gönüllü üzerinde
  yapilan çalismada deneklerin 11inden de qi hissi
  alinmis, bu 11 kiside fMRIde somatosensoriyel
  kortekste sinyal artisi izlenmistir.
• Nükleus accumbens, amigdala, hippocampus,hipotalam
  us, ventral tegmental saha, insula,ve anteriyör
  cingulatete sinyal azalmasi görülmüstür.(Yani
  limbik sistem agri islevinde görev almaktadir).
• Iki denekte agri hissi uyandirilinca anteriyör
  singulate ve insula aktivitelerinde artma
  olusturmustur.
• Hui et al (2000) Human Brain Mapping, 9, 13-25.
• Replication in Wu et al Radiology 1999
  Jul212(1)133-41 using LI 4 and St 36

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fMRI ve akupunktur

• Ayakta bulunana gözle ilgili akupunktur
  noktalari (UB-60-67) uyarilinca visual kortekste
  gerçek
• (vizüel) görme stimulusu gibi
• aktivasyon olusturmustur,
• Ayakta akupunktur noktasi olmayan yerlerin
  ignelenmesiyle oksipital loplarda aktivasyon
  izlenmemistir.
• Cho et al (1998). Proceedings of the National
  Academy of Science, 95, 2670-2673.

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Ayakta görme ve isitme ile ilgili noktalar
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Li- 4 (HeguThalamus) noktasi

• Analjezik etkisi en baskin olan etkisidir
• St44 ile birlikte siddetli agrilarda çok
  etkindir.
• Sedatif etkisi
• GV20 H7 UB 62 ile birlikte.
• Homeostatik etkisi Li11 St36 Sp6
• Immünmodülatör etkisi GV14 Li11 St36 Sp6 ile
• Vazodilatasyon Tw5 ile

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St36 (Zusanli)

• Li4 ile birlikte Staph. aureusun
  Nötrofiller ile FAGOSITOZU 2 kat artmistir
• Endokrin etkisi
• Li4 ile birlikte ACTH artmis
  eozinofiller azalmistir.
• Homeostatik etkisi Li11 Li4 Sp6 ile
  eritrositler artar ve ESR düser
• Immünmodülatör etkisi GV14 ve Li4 ile
  nötrofiller 20-50 oraninda artmistir.
• Li11 ile beraber NK ve IL2 aktivitesini artirdigi
  gösterilmistir
• T lenfositlerini Li4 ve Sp6 ile beraber artirmis.
• Serum elektroforezinde Gama-Globulin artisi
  (antikor yapimi)
• Solunum sistemine etkisi Solunum kapasitesi 20
  artmistir.

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Confluent Points (Ba Mai Jiao Hui Xue)Synonyms
Tuning points, Cardinal PointsAyar noktalari
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KARDINAL NOKTALARPsikonöroimmünregülasyon
Si 3 (Du Mai) 0 Retro-Coeliac
BI 62 (Yang Qiao Mai) Pineal-Epifiz bezi
Lu 7 (Ren Mai) Akciger alani
Ki 6 (Yin Qiau Mai) Diazepam
P 6 (Yin Wei Mai) Stellat ganglion
GB 41 (Dai Mai) PGE1 noktasi
Sp 4 (Chong Mai) Interferon
SJ 5 (Yang Wei Mai) Timus
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Tw5SJ5TIMUS Romatizmal hastaliklarda Master
Kulaktaki yerleri
Timus SJ5 T3-4 düzeyinde Insülin SJ4
T10-12 düzeyinde Kortizon SJ3 T12-L1
düzeyinde Tiroid SJ6 C6-7
düzeyinde Paratiroid SJ7C5-6 düzeyinde
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Romatoid Artritte GB41
PGE1
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SI3-Genel Mukoza UyariciDumaiGV için Kardinal
Si3-Li3 immünstimülan etkiyi uyarir Si3-Bl62
Psikonöroimmün uyari
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Interferon (SP4) veHistamin (BL40)
Histamin-Alerji Shen men Ayak alerji Timus Interfe
ron Valium(K6) Epifiz ? ?
Alerji B40
Ayak Alerji
Shen men
Dalak
Timus TW5
Interferon Sp4
Valium K6
Epifiz B62
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Özel Dokularin Hastaliklari

• CV 12 Fu-Içi bos organlar
• CV 17 solunum sistemi
• Bl 11 kemik ve kartilaj
• Bl 17 Kan

• LR 13 Zang-Içi dolu organlar
• Lu 9 vasküler sistem
• GB 34 kas ve tendonlar
• GB 39 Kemik iligi

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? KUZEY ? DOGU ? GÜNEY ? MERKEZ ? BATI
organ Böbrekler Karaciger Kalp, perikard Dalak, pankreas Akciger
doku Kemikler tendonlar Kan Damarlari Kas ve bag dokusu Deri,saçlar
Duyu organi Kulaklar Gözler Dil Agiz Burun
Duygusal durum Korku Öfke Sevinç,nese Derin düsünce Merhamet Acima
Kontrol ettigi doku veya organ Kulaklar gözler Dil dudaklar Burun
Tat tuzlu eksi aci tatli Hos bir aciligi olan
Renk siyah yesil kirmizi sari Beyaz
sekresyon Müköz tükrük gözyasi ter Seröz tükrük Nazal akinti
Iklim kis ilkbahar yaz geç yaz sonbahar
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Enerji Qi Sirkülasyonu

• Meridyenler enerjinin devamli sirküle edebilecegi
  sekilde konuslanmislardir.
• Lung
• Stomach Large Int.
• Spleen Heart
• Bladder Small Int.
• Kidney
  Pericard
  
• Gall Bl. Triple W
• Liver

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BIORITM

• 0700-0900 Mide
• 0900-1100 Pankreas-Dalak
• 1100-1300 Kalp
• 1300-1500 Incebarsak
• 1500-1700 Mesane
• 1700-1900 Böbrek
• 1900-2100 Perikard-Sex
• 2100-2300 Üçlü isitici
• 2300-0100 Safra kesesi
• 0100-0300 Karaciger
• 0300-0500 Akciger
• 0500-0700 Kalinbarsak

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YIN NABIZLARI DERINDE
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Yin Meridian Jing-wellAgaç Ying-springAtes Shu-streamToprak Jing-riverMetal He-SeaSu
Lu Tai yin 11 10 9 8 5
Pc Jue yin 9 8 7 5 3
He Shao yin 9 8 7 4 3
Sp Tai yin 1 2 3 5 9
Lv Jue yin 1 2 3 4 8
Ki Shao yin 1 2 3 7 10
Yang Meridian Jing-wellMetal Ying-springSu Shu streamAgaç JingriverAtes He-SeaToprak
Li Yang ming 1 2 3 5 11
Tw Shao yang 1 2 3 6 10
Si Tai yang 1 2 3 5 8
St Yang ming 45 44 43 41 36
Gb Shao yang 44 43 41 38 34
Bl Tai yang 67 66 65 60 40
B E S S H U N O K T A S I