Orthogonal design to sift the optimal parameter of Neiguan acupuncture for cerebral infarction

The individual difference and non-repeatability in acupuncture have not only restricted the devel- opment of acupuncture, but have also affected the specificity of acupoints. The present study used instruments to control needle depth, lifting and thrusting frequency, and the duration of acupuncture. Effects of the quantified acupuncture were observed at Neiguan （PC6） with different stimulation parameters. A frequency of 1, 2, or 3 Hz and duration of 5, 60, or 180 seconds were used to observe cerebral blood flow and ratio of infarct volume recovery. Results showed that stimulation at Neiguan with a frequency of 1 Hz and long duration of 180 seconds or 2/3 Hz and long duration of 5/60 seconds significantly increased cerebral blood flow and decreased the ratio of infarct volume. In- teractions between frequency and duration play a critical role in quantified acupuncture therapy.

THE INFLUENCE OF ELECTRO-ACUPUNCTURE AT NEIGUAN AND FIVE SHU POINTS OF TWELVE REGULAR MERIDIANS AT DIFFERENT TIME ON SYSTOLIC TIME INTERVAL OF NORMAL YOUNG ADULTS

The influence of electro-acupuncture at Neiguan (PC 6)and five shu points of twelve regular meridians at different time on systolic time interval (ST I) of normal young adultswere studied with 6×6 Latin square design in this work.In 12 groups according to 12 regular merldlans,the STIs were measured respectively just before and after electro-acupuncture on Neiguan andfive shu points at 00:00,04:00,08:00,12:00,16:00 and 20:00 of a day.It was found thatexcept the PEPI and PEPI/LVETI ratio among Shenmen(HT 7),Shaochong(HT 9)and Neiguan,Guanchong(TE)and Yemen(TE 2)points,the effects of electro-acupuncture at Neiguan pointand five shu points of twelve regular meridians on the indices of STI of normal young adults wereshowing no slgnificant differences.There also was no difference in different sex.But the indices ofSTI were changed when electroacupuncture on the different points of different meridians at differenttime.

Mechanisms on Correlation between the Pericardium Meridian and Heart Effects of Electroacupuncture at Neiguan and Other Acupo

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CLINICAL APPLICATION OF NEIGUAN (内关 PC 6) IN THE TREATMENT OF DISORDERS OF THE DIGESTIVE SYSTEM——THE RELATED RESEARCH PROGRESS

In the present paper, the authors review recent situations of clinical application of Neiguan (PC 6内关), etc. in the treatment of disorders of the digestive system and its related research progresses. In clinical practice, Neiguan (PC 6) is usually selected as one of the main acupoints to treat gastrointestinal reactions induced by ① nausea and vomiting, ② hiccup, ③ gastrointestinal dyskinesia, ④ gastritis, and ⑤ intra-gastric examination, cesarean section, etc. Concerning experimental studies, the effects of Neiguan (PC 6), etc. on ① gastric electrical activities, ② gastrointestinal motion, ③ gastrointestinal hormone secretion, and ④ gastric mucosal structure were observed. Results indicated that Neiguan (PC 6) is an important and effective acupoint for treatment of gastrointestinal disorders in clinic. Stimulation of Neiguan (PC 6) induced favorable regulation of both the peripheral nervous system and central nervous system, and changes of the gastrointestinal hormone secretion may contribute to its effects in treating various disorders.

ACUPUNCTURE AT NEIGUAN POINT FOR TREATMENT OF 106 CASES OF LOW PULSE PRESSURE SYNDROME

In spite of normal mean aterlal pressure,decrease of pulse pressure can induce a seriesof clinical symptoms,which is termed as low pulse pressure syndrorne.Acupuncture at bilateralNeiguan（PC 6）is Capable of raising systolic pressure, lowering diastolic pressure, increasing pulsepressure difference and eliminating corresponding symptoms.The effective rate was more than 92％in this observation.

NEIGUAN(PC 6) BLOCKING FOR PREVENTING NAUSEA AND VOMITING CAUSED BY SUBARACHOID MORPHINE ANALGESIA

To find a simple and an inexpensive by method to reduce postoperative nausea and vom iting abbreviated to (PONV) caused subarachoid morphine analgesia. Methods: ninty-eight gyneeco logic patients who took 0. 5 mg morphine by subarahaid space to control postoperative pain, randomly divided into group Ⅰ (n = 50) whose bilateral Neiguan were blocked by 0. 25% bupivacaine 2 ml, group Ⅱ (n= 48), who were intravenously injected ondansetron 4 mg, preoperatively and postopera tively to prevent nausea and vomiting. The numbers of the patients experienced PONV were observed for 48 hrs after operation. Result: group i had 15 patients, group Ⅱ had 14 ones, who experienced ~ (P >0. 05 ), Conclusion: Neiguan blocking can effectively prevnt PONV caused by subara choid morphine anslgesia without side effects.

Electroacupuncture at the Renzhong (DU 26) and Neiguan (PC 6) acupoints repairs the DNA of nervous tissue supplied by the middle cerebral artery in rats

This study compares the changes of DNA repair in brain tissue dominated by the middle cerebral artery after electroacupuncture at the acupoints of Renzhong （DU 26）, Neiguan （PC 6）, Quchi （LI 11） and Zusanli （ST 36） in rats. In the apurinic/apyrimidinic endonuclease DNA basic group reparative excision experiments, the apurinic/apyrimidinic endonuclease activity of brain tissue increased slightly after electroacupuncture in rats. In the DNA polymerase β （Pol β）experiments, the Pol β ac-tivity of brain tissue increased after electroacupuncture, especially at DU 26 and PC 6. In the DNA ligase experiments, the expression of DNA ligase 1 in brain tissue increased significantly after electroacupuncture. These findings demonstrate increased activity of apurinic/apyrimidinic en-donuclease, Pol β and DNA ligase 1 after electroacupuncture at DU 26 and PC 6. Also, DNA repair in brain tissue supplied by the middle cerebral artery is promoted after electroacupuncture at DU 26 and PC 6, which are more effective than the LI 11 and ST 36 acupoints .

Observation Of Reaction On Different Blood Pressure Treated By Needling Neiguan

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EFFECT OF ELECTRO-ACUPUNCTURE OF “NEIGUAN” ON SPONTANEOUS DISCHARGES OF SINGLE UNIT IN AMYGDALOID NUCLEUS IN RABBITS

In this paper,the regularity on spontaneous dis-charges of the single unit in amygdaloid nucleus(AMYG)in rabbits were analyzed and whether thesignal of Electro-acupuncture(EA)at Neignan (P 6)can reach the AMYG was further observed withthe technique of glass microelectrode.It was foundthat the signals of EA at Neignan can reach AMYGand activate or inhibit the electrical activity of somencurons,manifesting two response patterns:fre-quency-increasing and frequency-decreasing.Addi-tionally,the same neuron had a different response tothe signals of EA at Neiguan and Zusanli(St 36),suggesting that a relative specificity of acupoints ispresent.

EFFECT OF α_1 AND α_2 RECEPTORS IN THE RABBIT THORACIC SPINAL CORD ON ELECTROACUPUNCTURE AT "NEIGUAN" FOR TREATMENT OF ACUTE MYOCARDIAL ISCHEMIA

In the present paper, the effect of α1 and α2 subtypes of the thoracic spinal cord on electroacupuncture (EA)-induced improvement of ischemic cardiac electrical and mechanical activities was observed in 80 anesthetized rabbits by using ECG-ST, MBP, LVP and dp/dt max as indexes. Results showed that:1) EA at "Neiguan" could significantly improve the electrical and mechanical activities of the ischemic heart; 2) the effect of EA could be enhanced to a certain degree when α1 receptors of the thoracic spinal cord were activated by subarachnoid microinjection of phenylephrine, while it was weakened when α1 receptors were inhibited by microinjection of parison; and 3) activation or inhibition of α2 receptors of the thoracic spinal cord by microinjection of clonidine and yohimbine had no marked influence on the effect of EA in improving electrical activity of the ischemic heart, but when activated,they could weaken the effect of EA in raising MBP; while suppressed, they had no any striking influence on the effect of EA in raising MBP. It suggests that among α-receptors, predominantly α1-receptors participate in the process of EA-induced improvement of performance of ischemic heart.

Clinical Effect of Electroacupuncture Baihui and Neiguan Acupoint on Cognitive Function Recovery in Elderly Patients after General Anesthesia

Objective:To study and analyze the clinical effect of electroacupuncture at Baihui and Neiguan Points on cognitive function recovery of elderly patients after general anesthesia.Methods:The subjects were 80 elderly patients who received general anesthesia from January 2019 to February 2021.According to different anesthesia methods,they were divided into research group(electroacupuncture at Baihui and Neiguan combined with conventional drug anesthesia)and control group(simple drug anesthesia).The postoperative cognitive function recovery of the two groups was observed and compared.Results:Compared with the control group,the MMSE score and POCD incidence of research group were significantly better.There was significant difference between the two groups(P<0.05).Conclusion:Conclusion electroacupuncture at Baihui and Neiguan combined with conventional drug anesthesia can promote the recovery of cognitive function and prevent cognitive dysfunction in elderly patients under general anesthesia.

Effect of electroacupuncture at Neiguan(PC6)at different time points on myocardial ischemia reperfusion arrhythmia in rats

OBJECTIVE:To observe the effects of electroacupuncture at Neiguan(PC6)at different time points on reperfusion arrhythmia(RA)after myocardial ischemia and reperfusion in rats,and to investigate the correlation of this protective effect with nerve growth factor(NGF),tyrosine kinase A(Trk A),tyrosine hydroxylase(TH),and norepinephrine(NE).METHODS:A total of 72 Sprague-Dawley male rats were randomly divided into six groups(n=12 rats/group):normal group(Norm),sham operation group(Sham),ischemia reperfusion group(I/R),pre-ischemic electroacupuncture group(EAI),pre-reperfusion electroacupuncture group(EAII),post-reperfusion electroacupuncture group(EAIII).The myocardial ischemia-reperfusion injury(MIRI)model was induced by occlusion of left anterior descending coronary artery for 20 min followed by reperfusion for 40 min in rats.With no intervention in the Norm group and only threading without ligation in the Sham group.Electroacupuncture pretreatment at 20 min/d for 7 d before ligation in the EAⅠgroup,20 min of electroacupuncture before reperfusion in the EAII group and 20 min of electroacupuncture after reperfusion in the EAIII group.The electrocardiogram(ECG)of each group was recorded throughout the whole process,and the success of the MIRI model was determined based on the changs of J-point and T-wave in the ECG.The arrhythmia score was used to record premature ventricular contractions,ventricular tachycardia and ventricular fibrillation during the reperfusion period to assess the reperfusion induced arrhythmias.The expression levels of NGF,Trk A,TH protein were measured by Western blot.Moreover,the expression levels of plasma and myocardial NE levels were detected by enzyme linked immunosorbent assay.RESULTS:The differences between Norm group and Sham group were not statistically significant in all indexes.Arrhythmia score,myocardial NGF,Trk A,TH,and NE expression were significantly higher in the I/R group compared with the Sham group.Arrhythmia score,myocardial NGF,Trk A,TH,and NE expression were significantly lower in each EA group compared with the I/R group.CONCLUSION:Electroacupuncture at Neiguan(PC6)at different time points can reduce the incidence and severity of reperfusion arrhythmias in rats.This protective effect is related to electroacupuncture regulating NGF,Trk A,TH,NE expression and reducing sympathetic hyperactivation.

Effect of acupuncture at Neiguan (PC 6) on cardiac function using echocardiography in myocardial ischemia rats induced by isoproterenol

OBJECTIVE: To investigate the effect of acupuncture at Neiguan(PC 6) on cardiac function using echocardiography in rat models of myocardial ischemia(MI) induced by isoproterenol(ISO).METHODS: Twenty-seven Sprague-Dawley rats were randomly assigned to normal, model, and acupuncture groups. The model and acupuncture groups were given injections of ISO(85 mg/kg) to establish the MI model. After model establishment,the acupuncture group was treated with acupuncture at Neiguan(PC 6) for 30 min. Echocardiography was used to monitor diastolic and systolic function for 30 min starting from the time after the acupuncture needles were removed. Changes in the length of left ventricular internal diameter at end-diastole(LVIDd), length of left ventricular internal diameter at end-systole(LVIDs), the ratio of mitral peak velocity at early diastole and atrial contraction(E/A), ejection fraction(EF), fractional shortening(FS), and stroke volume(SV) were measured.RESULTS: Compared with the model group at 0and 15 min after needles were removed, the means of LVIDd and LVIDs were significantly lower(P <0.01) and E/A, EF, FS, and SV significantly higher(P < 0.01) in the acupuncture group. In the acupuncture group, the means of LVIDd and LVIDs15 min after the needles were removed were significantly higher(P < 0.01) than those at 0 min. The means of E/A, EF, FS, and SV significantly decreased(P < 0.01) from 0 to 15 min in the acupuncture group.CONCLUSION: These findings indicate that acupuncture at Neiguan(PC 6) can affect cardiac function by increasing left ventricular diastolic and systolic function in MI rat models, but the effect only lasts for 15 min.

Effect of electroacupuncture at Neiguan(PC 6) and Baihui(GV 20) on CHOP and caspase-12 gene expressions in rats after ischemia-reperfusion injury

Objective： To investigate the effects of electroacupuncture （EA） at Neiguan （PC 6） and Baihui （GV 20） by observing the changes of CCAAT/enhancer-binding protein（C/EBP） homologous protein （CHOP） and caspase-12 gene expressions in rats after cerebral ischemia-reperfusion injury （IRI）, and explore whether the apoptosis pathway of endoplasmic reticulum stress （ERS） is involved in the protective mechanisms of EA. Methods： Sixty rats were randomly assigned to five groups （12 in each group）： a normal control group （group A）, a sham-operation group （group B）, an operation group （group C）, an Edaravone group （group D） and an EA group （group E）. The cerebral IRI rat model was induced by middle cerebral artery occlusion （MCAO） using intraluminal monofilament. 2,3,5-triphenyl tetrazolium chloride （TTC） staining was adopted in the measurement of cerebral infarction volume. Real-time polymerase chain reaction （RT-PCR） was used to determine the mRNA expressions of CHOP and caspase-12. Results： Compared with group A and group B, the volume of cerebral infarction and mRNA expressions of CHOP and caspase-12 in group C, group D and group E were increased, with statistical significances （P〈0.05 or P〈O.01）; compared with group C, the volume of cerebral infarction and mRNA expressions of CHOP and caspase-12 in group D and group E were decreased significantly （P〈0.05 or P〈0.01）; there were no significant differences between group D and group E in comparing the above items （P〉0.05）. Conclusion： EA at Neiguan （PC 6） and Baihui （GV 20） can effectively suppress the volume of cerebral infarction. Furthermore, the underlying mechanism of EA at Neiguan （PC 6） and Baihui （GV 20） is possibly related to the down-regulation of CHOP and caspase-12 mRNA expressions, so as to decrease cell apoptosis.

Effect of electroacpuncture of Neiguan(PC 6)and Tianquan(PC 2)on skin temperature,blood perfusion,and adrenoceptor response in rats with acute myocardial ischemia

OBJECTIVE: To investigate the effect of electroacupuncture(EA) of acupoints Neiguan(PC 6) and Tianquan(PC 2) on the skin temperature, blood perfusion, and alpha1-and beta2-adrenoreceptor(α1-AR and β2-AR) protein and m RNA level in rats with acute myocardial ischemia.METHODS: Thirty male adult Wistar rats [(230 ±20) g] were randomly assigned into five groups(n = 6 each): a control group, sham operation group, model group, model group treated with EA at low frequency(L-EA, 2 Hz, 1 m A) and model group treated with EA at high frequency(H-EA, 100 Hz, 1 m A). The rat model was prepared by ligating the left anterior descending coronary artery. Electroacupuncture was performed at the left Neiguan(PC 6) for 20 min daily for 3 d. After the 3 rd time of the treatment, measurements of skin blood perfusion and temperature in Neiguan(PC 6) and Tianquan(PC 2) in all groups were made by laser speckle contrast imaging and infrared thermal image instrument. Real-time PCR and ELISA were used to measure m RNA level and protein level of α1-AR andβ2-AR in the skin tissues of Neiguan(PC 6) and Tianquan(PC 2), respectively. Serum levels of c Tn T and electrocardiogram were used to identify the state of myocardium.RESULTS: In the group receiving electroacupunture at Neiguan(PC 6), compared with control group,the skin temperature, blood perfusion, and β2-AR m RNA and protein level of model group significantly decreased(P < 0.05), α1-AR m RNA and protein level of model group significantly increased(P < 0.05);compared with model group, the skin temperature,blood perfusion, and β2-AR m RNA and protein level of L-EA significantly increased(P < 0.05), α1-AR m RNA and protein level of L-EA and H-EA significantly decreased(P < 0.05). The same trend has taken place in the former four groups of the Tianquan(PC 2).CONCLUSION: Low-or high-frequency electroacupuncture can improve the skin temperature and blood perfusion which may be induced by decreasingthelevelofα1-ARandincreasingthelevelofβ2-AR of the Neiguan(PC 6) and Tianquan(PC 2) in the rat with acute myocaidial ischemia.

Effect of transcutaneous electroacupuncture at Neiguan(PC 6) on refractory vomiting in patients in intensive care unit

OBJECTIVE: To observe the effect of transcutaneous electroacupuncture(TEA) at Neiguan(PC 6) on refractory vomiting in critically ill patients in intensive care(ICU) setting.METHODS: Ten patients admitted in ICU and presenting vomiting refractory to one or more antiemetic drugs were prospectively included in the study. TEA was applied at acupoint of Neiguan(PC6) during 30 min with a neuromuscular transmission monitor(single-twitch stimulation with 1 Hz at a constant current of 10 m A). Nausea and Vomiting were evaluated at the following intervals: immediately after 30 min of TEA at Neiguan(PC 6),30 min-6h and 6-24 h. The presence of nausea and/or vomiting throughout the observational period was defined as the primary end point.RESULTS: The presence of nausea or vomiting throughout the observational period was 10% at the end of TEA, 40% between 30 min and 6 h, and50% between 30 min and 24 h(P < 0.001, P = 0.01 and P = 0.03 vs pre-TEA, respectively). There were no complications or side effects related to TEA.CONCLUSION: TEA at Neiguan(PC 6) seems effective in reducing refractory vomiting in the patients in ICU setting, even if larger trials are needed to define optimal modalities.

Efficacy on rabbits with arrhythmia: needling acupoint of Neiguan(PC6) at shallow or deep depth, and retaining needles for 10, 20, or 30 min

OBJECTIVE:To compare the effects of Neiguan(PC6)acupuncture at different depths and retention time on arrhythmia duration,myocardial tissue morphology,mRNA expression level of L-type calcium channelα1C subunit and Ca^(2+)-Mg^(2+)-At Pase activity in tachirrhythmia model of rabbits.METHODS:The tachyarrhythmia model was made by intravenous injection of barium chloride into the ears of rabbits.A total of 56 healthy adult male New Zealand big-eared white rabbits,apply the random number table method,divided into normal control group(group A),model group(group B),shallow needling Neiguan(PC6)10 min group(group C),shallow needling Neiguan(PC6)20 min group(group D),shallow needling Neiguan(PC6)30 min group(group E),deep needling Neiguan(PC6)10 min group(group F),deep needling Neiguan(PC6)20 min group(group G),deep needling Neiguan(PC6)30 min group(group H),7 animals in each group.Electrocardiograms were used to collect the duration of arrhythmia;hematoxylin-eosin staining method was performed on myocardial tissue,RT-PCR tested the expression ofα1C subunit mRNA,and the activity of Ca^(2+)-Mg^(2+)-ATPase were quantified by phosphorus determination method.RESULTS:The duration of arrhythmia in each acupuncture treatment group was shortened to varying degrees.Compare to the model group,the tissue damage from barium chloride inducing was improved in the acupuncture group.Compared to the model group,except for group E,most treatment groups had varying degrees of improvement with significantly down-regulated L-type calcium channelα1C subunit mRNA expressions level and increased Ca^(2+)-Mg^(2+)-ATPase activity.CONCLUSIONS:The effect of acupuncture at Neiguan(PC6)with different depths and retention time can reduce the duration of arrhythmia induced by barium chloride relatively,improve the induced pathological changes,down regulate L-type calcium channelα1C subunit mRNA expressions level and increase Ca^(2+)-Mg^(2+)-ATPase activity.Both the shallow and deep tissues of Neiguan(PC6)may be involved in transmitting acupuncture information.There is an optimal induction period for shallow needling at Neiguan(PC6)to reach the best therapeutic effect.

Effect of electronic stimulation at Neiguan(PC 6) acupoint on gene expression of adenosine triphosphate-sensitive potassium channel and protein kinases in rats with myocardial ischemia

OBJECTIVE:To investigate the effects of electronic stimulation at acupoints Neiguan(PC 6) and Lieque(LU 7) on the gene expression of the adenosine triphosphate(ATP)-Sensitive potassium channel(KATP:Kir6.1,Kir6.2,SUR2 A,and SUR2B) and protein kinases(PKA,PKG,and PKCβ2) in myocardial cells of rats with myocardial ischemia(Ml) induced by isoproterenol(ISO).METHODS:Rats were randomly divided into a control,model,Neiguan(PC 6),Lieque(LU 7),and non-acupoint groups.The Ml model was established by injecting rats with ISO.Electro-acupuncture treatment was given to the acupuncture groups,once a day for 7 days.Gene expression was analyzed with real-time PCR.RESULTS:The gene expression of KATP and protein kinases in the model group was higher than those in the control group(P < 0.05).After acupuncture treatment,the KATP and protein kinase expression levels were significantly lower in the Neiguan(PC 6)and Lieque(LU 7) groups compared with the model group[P < 0.05).The Neiguan(PC 6) group lowered these levels significantly more than that of the Lieque(LU 7) group(P < 0.05).No significant differences were observed between the model and non-acupoint groups(P > 0.05).CONCLUSION:Our findings suggest that electronic needling of Neiguan(PC 6) can both reduce the gene expression of KATP and protein kinases in rats with ISO-induced Ml.

Clinical Application of Acupoint Neiguan (PC 6)

Acupoint Neiguan (PC 6) is first recorded in LingShu (Spritual Pivot). It is the Luo-Connecting pointof the Pericardium Meridian and communicateswith acupoint Waiguan (TE 15); it is also one ofeight confluent points, and associates with the YinLink Vessel. We often use Neiguan (PC 6) alone oras the cardinal acupoint to treat many disorders inclinical practice. It is now reported as follows.

穴位电刺激对人体24 h头低位卧床脑电功率谱密度的影响

目的观察24 h头低位卧床模拟失重期间脑电图(EEG)变化特点及穴位电刺激干预效果。方法将22名志愿者随机分为电针组和对照组,每组11人。对照组头低位卧床24 h,电针组头低位卧床24 h后刺激双侧内关穴30 min。分析比较卧床前后两组受试者静息态EEG信号功率谱密度(PSD)变化及心境状态变化。结果与卧床前相比,头低位卧床24 h后各脑区θ、α频带PSD普遍降低,右颞叶θ频带PSD及右中央区、右顶叶和左枕叶α频带PSD显著降低(P<0.05),卧床后心境状态量表(POMS)的疲劳、抑郁和愤怒评分及消极情绪纷乱总分显著升高(P<0.05),精力评分显著降低(P<0.05)。与对照组相比,电针组右额叶θ频带PSD显著降低(P<0.05),卧床后POMS抑郁评分有降低趋势。结论24 h头低位卧床模拟失重效应改变了静息时部分脑区的θ和α频带活动,同时更容易引起负面情绪的产生。电针刺激调节了右额叶θ频带的活动,对各脑区α频带活动可能存在正性调节作用,并在一定程度上减轻了头低位卧床引起的不良情绪的产生。