Comparison of clinical efficacy of neddle knife at acupoints selected from recent regions along meridians and according to anatomical structures in treating early and middle stage knee osteoarthritis

Objective:To stimulate tenderness points around knee joint in two metholds-corresponding acupoints selected from recent regions along meridians and anatomical structures,to compare the clinical efficacy of neddle knife of to cure early and middle stage knee osteoarthritis.Method:70 patients were randomly(Random Number Tables)divided into test group(acupoints selected from recent regions along meridians,n=35)and control group(anatomical structures,n=35),who were diagnosed as knee osteoarthritis.Observe the VAS(visual analogue scale),Lysholm,WOMAC(the Western Ontario and McMaster Unive rsities Osteoarthritis Index)and ROM(rang of motion)between two groups in first week,first month,third month after treatment.Recording the degree of improvement of knee joint’s pain,dysfunction and symptoms of osteoarthritis and rang of motion.Results:Within groups,the VAS,Lysholm,WOMAC and ROM were obviously different from pre-therapy scores in the third,sixth and twelfth week post-therapy(P<0.05).Between groups no significant difference were observed in the third week post-therapy about VAS,Lysholm,WOMAC scores(P>0.05).However,there were differences in the sixth,twelfth weeks post-therapy(P<0.05);compared with control group,the ROM of test group were difference in the third,sixth,twelfth weeks post-therapy(P<0.05).Conclusion:The clinical efficacy of stimulating corresponding acupoints tenderness points selected from recent regions along meridians to treat early and middle stage knee osteoarthritis was superior to anatomical structures,which can effectively relieve pain,dysfunction,symptoms of osteoarthritis of knee joint and rang of motion.

Understanding Propagated Sensation along Meridians by Volume Transmission in Peripheral Tissue

Propagated sensation along meridians （PSM） is a phenomenon that a sensation moves along meridians during stimulation of an acupoint. PSM has an appearance rate of 1.3% among people and have characteristics of low speed, going toward afflicted sites and being blocked by physical pressure which is difficult to be explained by known neural and blood transmission. Volume transmission （VT） is a widespread mode of intercellular communication in the central nervous system that occurs in the extracellular fluid and in the cerebrospinal fluid. VT signals moves from source to target cells via energy gradients leading to diffusion and convection （flow） which is slow, long distance and much less space filling. VT channel diffuse forming a plexus in the extracellular space with two parameters of volume fraction and tortuosity. Some experiments showed an information transmission between adjacent and distant acupoints along meridians cross spinal segments. This process is a cross-excitation between peripheral nerve terminals which is related to nonsynaptic transmission. Some neurotransmitters or neuropeptides such as glutamate, adenosine triphosphate （ATP） and neuropeptide such as substance P, neurokinin A and calcitonin gene-related peptide relate with the cross-excitation which can be regards as VT signals. Comparing the characteristics of PSM and VT, many similar aspects can be found leading to an assumption that PSM is a process of VT in peripheral tissue along meridians. The reason why VT signals transmit along meridians is that the meridian is rich in interstitial fluid under the condition of low hydraulic resistance which has been proven experimentally. According to Darcy＇s law which descript the flow of interstitial fluid and conservation equation, interstitial fluid will move toward meridians and flow along meridians that restrict the VT signals within the channel and accelerate the flow according to Fick＇s diffusion law. During the process, a degranulation of histamine from mast cells happens on the route which can expand capillary and increase the blood perfusion and interstitial fluid which had already been observed. The mechanism of PSM is featured by alternative axon reflex （wired transmission, WT） and VT in peripheral tissue along meridians, sending simultaneously a continuous sensate signal to control nerve system which can be felt like a PSM.

Electrical Signal Propagated across Acupoints along Foot Taiyang Bladder Meridian in Rats

Objective： To investigate the electrical signals propagated along Foot Taiyang Bladder Meridian （BL） in a rat model. Methods： The experiments were performed on Dark-Agouti （DA）, DA.lU and Sprague Dawley （SD） rats. The antidromic electrical stimulation was applied on the nerve innervating ＂Pishu＂ （BL 20） to mimic the acupoint electro-acupuncture （EA）. The activities recording from adjacent nerve innervating acupoint ＂Danshu＂ （BL 19） or ＂Weishu＂ （BL 21） were recorded as indics for acupoint, including the mechanical threshold and discharge rate. Results： After mimic EA on BL 20, C and A $ units from adjacent BL 19 or BL 21 were sensitized including the decrease in mechanical threshold and increase in discharge rates in DA, DA.1U and SD rats, especially in DA rats. The average discharge rate increased from 2.40± 0.26 to 6.06± 0.55 and from 1.92±0.42 to 6.17± 1.10 impulse/min （P〈0.01）, and the mechanical threshold decreased from 0.52 ± 0.12 to 0.24 ± 0.05 and from 0.27±0.02 to 0.16±0.01 mmol/L （P〈0.01） in C （n=15） and Aδ （n=18） units in DA rats. The net change in discharge rates from C units were 152.5%, 144.7% and 42.4% in DA, DA.1U and SD rats, respectively, among which DA rat＇s was the highest （P〈0.05）. In A δ units, the net change in DA rats were also the highest （221.5%, 139.2% and 49.2% in DA, DA.lU and SD rats）. Conclusions： These results showed that mimic acupoint EA activated adjacent acupoints along BL in three rat strains, which might be related to propagated sensation along meridians （PSM）. In addition, DA rats were more sensitive and might be a good model animal for PSM research.

大鼠循经低流阻通道的发现

Background:Continuous and porous low hydraulic resistance channels(LHRCs)are important structures of meridians in traditional Chinese medicine(TCM).In this study,based on the previous research on LHRCs along meridian paths(LHRCMs)in mini-pig,we aimed to detect the low hydraulic resistance point(LHRP)and display the LHRCMs in rats.Methods:A technique for measuring interstitial hydraulic resistance(Rh)in rats was established to detect and measure the Rh along the conception vessel(CV)in TCM,and Alcian Blue(AB)solution was injected into the LHRP along the CV.The interstitial fluid pressure(IFP)of the LHRP was measured before and after AB injection.Then,the distribution characteristics of the AB solution were investigated to explore the relationship between AB tracks and meridian paths in TCM.Results:The positions of the LHRPs coincided with the low impedance points(LIPs)of the rat skin along the CV.The Rh value along the CV(10.37,1.26,×10^(6)dyne s cm^(-5))was significantly lower than that in the non-meridian area(19.13±1.37,×10^(6)dyne s cm^(-5),P<0.01).After AB injection,the IFP of the LHRP was 2.52 mmHg,which was higher than that before AB injection.The AB tracks(ABT)along the CV,spleen meridian,and kidney meridian appeared in one or two directions,with single or multiple paths and uneven thickness and length.The appearance rate was 73.33%.Conclusions:LHRCMs existed not only in minipigs but also in rats.The LHRCMs could be observed after AB injection into the LHRP in the subcutaneous connective tissues of rats.