RELATIONSHIP BETWEEN INTERNAL ORGAN(VISCERA) AND ACUPOINTS:TOWARD MERIDIAN THEORY

The theory of interrelation between acupoints and viscera （IBAV） is one of the most important parts in Traditional Chinese Medicine and the key concept in the theory of Zangfu and Jingluo （meridians）. IBAV expresses the rule between body surface and inner organs which guides the diagnosis and treatment in acupuncture practice. Yellow Emperor said. ＂The twelve-channel is the passage of the flowing of the blood and energy in human body, it has close relation with the existence of the flowing of the blood and energy in human body, it has close relation with the existence of man, the forming of disease, the human health and the recovery of disease... ＂ （Chapter 11 Jing Bie Yellow Emperors Canon Internal Medicine） Early studies noted that IBAV is bi-direetional by reflex reaction to the aeupoints on body surface. Stimulation on the acupoints can simultaneously regulate visceral functions. Recent research showed that acupuncture stimulations induced neuronal nitric oxide expression in the brainstem. Nitric Oxide in the medulla medicates various physiological reflexes. In this Review, the evidence of the relationship between viscera and acupoints will be summarized and emphases on the study of interrelation between acupoints and viscera is not only for improving clinical effects, but also for clarifying the mechanisms of acupuncture-moxibustion. A main way to treat visceral illnesses is choosing acupoints based on differentiation of symptoms and signs.

Acupuncture inhibition on neuronal activity of spinal dorsal horn induced by noxious colorectal distention in rat

AIM: To observe how acupuncture stimulation influences the visceral nociception in rat and to clarify the interactions between acupuncture or somatic input and visceral nociceptive inputs in the spinal dorsal horn. These will provide scientific base for illustrating the mechanism of acupuncture on visceral pain.METHODS: Experiments were performed on SpragueDawley rats and the visceral nociceptive stimulus was generated by colorectal distention (CRD). Unit discharges from individual single neuron were recorded extracellularly with glass-microelectrode in L1-3 spinal dorsal horn.Acupuncture stimulation was applied at contralateral heterotopic acupoint and ipsilateral homotopic acupoint,both of which were innervated by the same segments that innervate also the colorectal-gut.RESULTS: The visceral nociception could be inhibited at the spinal level by the heterotopic somatic mechanical stimulation and acupuncture. The maximal inhibition was induced by acupuncture or the somatic noxious stimulation at spinal dorsal horn level with inhibiting rate of 68.61%and 60.79%, respectively (P＜0.01 and ＜0.001). In reversible spinalized rats (cervical-thoracic cold block)both spontaneous activity and responses to CRD increased significantly in 16/20 units examined, indicating the existence of tonic descending inhibition. The inhibition of acupuncture on the noxious CRD disappeared totally in the reversible spinalized rats (P＜0.001).CONCLUSION: The inputs of noxious CRD and acupuncture may interact at the spinal level. The nociceptive visceral inputs could be inhibited by acupuncture applied to hetero-topic acupoint. The effect indicates that the spinal dorsal horn plays a significant role in mediating the inhibition of acupuncture and somatic stimulation on the neuronal response to the noxious visceral stimulation and the inhibition is modulated by upper cervical cord and/or supra-spinal center.

THEORETICAL ANALYSIS ON THE AUTOPLOIDY BETWEEN THE TWELVE YUAN (SOURCE) POINTS AND THEIR CORRESPONDING ZANGFU-ORGANS

In the present paper, the authors make a theoretical analysis on the autoploidy between the twelve Yuan （source） points and their corresponding Zangfu-organs from 1 ） historical development, 2） correlation, 3） clinical application, 4） experimental research results about the relationship between Yuan points and the Zangfu-organs, and between meridians and Zangfu-organs, and 5） literature description. The twelve Yuan points have an important role in clinical diagnosis and treatment of diseases, and a close association with the Zangfu-organs.

Mechanism of acupuncture regulating visceral sensation and mobility

Chinese ancient medical scientists have long focused on the internal and external contacts between acupoints on the surface of the body and the viscera.The Miraculous Pivot(it is one of the earliest medical classics in China)stated,“Twelve regular channels belong to the zang-fu organs internally,and connect to the extremities and joints externally.”Traditional Chinese medicine considers acupoints as defined areas where the Qi of viscera and meridians are transfused.These include the reaction points of visceral diseases on the body surface as well as the acupuncture trigger points that promote the flow of Qi and blood,and regulate visceral function.Chinese ancient medical scientists classified the specificity of the main acupoints in the body based on the meridian doctrine,which has been instructing clinical application for about 2000 years.Laws on the domino effect of acupoints have mainly focused on conclusions to clinical experiences.Indications of some acupoints exceed the practical paradigm since the excessive extension occurred during theory derivation.The current research direction on acupuncture focuses on three aspects:the effectiveness of acupuncture and moxibustion;the relevances and associations between meridians and viscera;and the physical and chemical properties and relevant physical basis of acupoints.The relevance between meridians and viscera is the central theory in the meridian doctrine,and acupoints are regarded as an important link in the relationship between meridians and viscera.Specific relationships between acupoints and target organs exist.Stimulating different acupoints on the body surface can help deal with different diseases,especially visceral diseases.In addition,acupoints have a dual function of reflecting and treating visceral diseases.There is no systemic research available on acupoint specificity,despite current knowledge and clinical experiences,which results in a weak foundation for acupuncture theory.This study focuses on the relevance and associations between meridians and viscera.A summary of the mechanisms of acupuncture regulating visceral sensation and mobility and the specific relationships between acupoints and their target organs are presented in this review.

Mechanism of relation among heart meridian,referred cardiac pain and heart

It has been demonstrated that an important clinical phenomenon often associated with visceral diseases is the referred pain to somatic structures, especially to the body areaof homo-segmental innervation. It is interesting that the somatic foci of cardiac referred pain wereoften and mainly distributed along the heart meridian (HM), whereas the acupoints of HM havebeen applied to treat cardiac disease since ancient times. The purpose of this study was to inves-tigate the neural relationship between the cardiac referred pain and the heart meridian.Fluorescent triple-labeling was injected into the pericardium, some acupoints of HM and lung me-ridian (LM, for control). The responses of the left cardiac sympathetic nerve and of the EMG in left HM and LM were electrophysiologically studied, when the electrical stimuli were applied to the acupoints of left HM and to the left cardiac sympathetic nerve. More double-labeled neurons in HM-heart, not in LM-heart, were observed in the ipsilateral dorsal root ganglia of the spinal segments C8-T3. Electric stimulation of the acupoints of left HM was able to elicit more responses of left cardiac sympathetic nerve than that of the LM-acupoints. Electric stimulation of the left cardiac sympathetic nerve resulted in stronger activities of EMG-response in the acupoints of left HM than in LM-acupoints. We conclude that double-labeling study has provided direct evidence for the existence of dichotomizing afferent fibers that supply both the pericardium and HM. Electrophysiological results show that HM is more closely related functionally to heart. These findings provide a possible morphological and physiological explanation for the referred cardiac pain and HM-heart interrelation.