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Journal of Chinese Integrative Medicine ›› 2012, Vol. 10 ›› Issue (5): 532-537.doi: 10.3736/jcim20120508

• Original Clinical Research • Previous Articles     Next Articles

Can heat and cold be parameterized? Clinical data of a preliminary study

Christoph A. Doenitz1,2,3, Ana Anjos1,3, Thomas Efferth4, Tobias Greten2,3, Henry J. Greten1,2,3   

  1. 1. Institute of Biomedical Sciences (ICBAS), University of Porto, Largo Professor Abel Salzar 2, 4099-030 Porto, Portugal;
    2. German Society of Traditional Chinese Medicine, 69126 Heidelberg, Germany;
    3. Heidelberg School of Chinese Medicine, 69126 Heidelberg, Germany;
    4. Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, University of Mainz, Mainz, Germany;
  • Received:2012-01-18 Accepted:2012-03-16 Online:2012-05-20 Published:2018-06-15

Objective: The aim of this study was to demonstrate whether it is possible to objectively assess the effects of acupuncture by microcirculation-related parameters in the given clinical scenario, to evaluate the significance of the status of capillary perfusion prior to acupuncture for the treatment of a clinical cold pattern, and to evaluate the possible role of microcirculation-related parameters for the future parameterization of the traditional Chinese medicine (TCM) diagnosis.

Methods: This prospective, uncontrolled, unblinded preliminary clinical trial included 32 elderly patients after surgical treatment for femoral fractures. For acupuncture treatment the patients received acupuncture with the “leopard spot technique” on the stomach meridian (Liangqiu, S34/ST34). Measurements of microcirculation-related parameters (velocity, blood flow, haemoglobin, oxygen saturation) by white light spectroscopy and laser Doppler were performed prior to and after acupuncture treatment.

Results: Two subgroups of patients after femur fracture could be identified: a low- and a high-perfusion group. Capillary flow velocity and blood flow were significantly augmented by acupuncture in the low-perfusion group only. In the high-perfusion group, there was no significant change of perfusion after acupuncture. The statistical analysis of all patients regardless of their pre-acupuncture perfusion status revealed no statistically significant alteration after acupuncture. The acupuncture effect may have been masked by the inhomogeneity of the overall group.

Conclusion: Microcirculation-related parameters may be valuable to measure acupuncture effects objectively and to characterize the vegetative functions prior to acupuncture so as to homogenize the comparison groups in clinical trials. In our example, a local cold pattern (low capillary perfusion of the leg) could be treated successfully by a point which enhances qi and blood flow, whereas in heat pattern (high capillary perfusion) this intervention had no such effect. Future studies may be directed to correlate the vegetative status as measurable by TCM vegetative parameters with the key symptoms of TCM diagnosis.

Key words: acupuncture therapy, microcirculation, femoral fracture, traditional Chinese medicine theories, blood flow velocity, hemoglobins, clinical trials

Figure 1

Flow chart of this study"

Figure 2

Blood flow before and after acupuncture"

Figure 3

Blood flow before and after acupuncture in the low-perfusion group"

Figure 4

Blood velocity before and after acupuncture in the low-perfusion group"

[1] Linde K, Allais G, Brinkhaus B, Manheimer E, Vickers A, White AR . Acupuncture for tension-type headache[J].Cochrane Database Syst Rev, 2009,(1):CD007587
doi: 10.1002/14651858.CD007587 pmid: 19160338
[2] Linde K, Allais G, Brinkhaus B, Manheimer E, Vickers A, White AR . Acupuncture for migraine prophylaxis[J].Cochrane Database Syst Rev, 2009,(1):CD001218
[3] Greten HJ . Kursbuch traditionelle Chinesische Medizin: TCM Verstehen und richtig Anwenden. Stuttgart: Thieme. 2007. German.
[4] Greten HJ. Understanding TCM . Heidelberg: Heidelberg School Editions. 2007.
[5] Porkert M .Chinese medicine: A science in its own right[J].Eastern Horizon, 1977,2: 12-18
[6] Porkert M . The difficult task of blending Chinese and Western science: The case of modern interpretations of traditional Chinese medicine. In: Li GH, Zhang MW, Cao TQ. Explorations in the history of science and technology in China: Special number of the “Collections of Essays on Chinese Literature and History” in honor of the eightieth birthday of Dr.Joseph Needham[M]. Shanghai: Chinese Classics Publishing House,1982: 553-572
[7] Greten HJ, Greten T, Brazkiewicz F , Donitz C, Correia N, Goncalves M, Karrer O . Quality control by parametrizing TCM diagnosis: Objectifying calor/“heat” as a guiding criterion (ba gang). Shanghai: The 10th Meeting of the Consortium for Globalization of Chinese Medicine. 2011.
[8] Greten HJ . Chinese medicine as a model of system biology: Diagnosis as the foundation of acupoint selection. In: Xia Y, Ding GH, Wu GC. Current research in acupuncture (research monograph). New York: Springer. 2012; in press.
[9] Grimes JP, Gregory PM, Noveck H, Butler MS, Carson JL . The effects of time-to-surgery on mortality and morbidity in patients following hip fracture[J]. Am J Med, 2002,112(9):702-709
doi: 10.1016/S0002-9343(02)01119-1
[10] Hannan EL, Magaziner J, Wang JJ, Eastwood EA, Silberzweig SB, Gilbert M, Morrison RS, McLaughlin MA, Orosz GM, Siu AL . Mortality and locomotion 6 months after hospitalization for hip fracture: risk factors and risk-adjusted hospital outcomes[J]. JAMA, 2001,285(21):2736-2742
doi: 10.1001/jama.285.21.2736
[11] Willig R, Keinanen-Kiukaaniemi S, Jalovaara P . Mortality and quality of life after trochanteric hip fracture[J]. Public Health, 2001,115(5):323-327
doi: 10.1038/sj.ph.1900773 pmid: 11593441
[12] Hauer K, Wendt I, Schwenk M, Rohr C, Oster P, Greten J . Stimulation of acupoint ST-34 acutely improves gait performance in geriatric patients during rehabilitation: A randomized controlled trial[J]. Arch Phys Med Rehabil, 2011,92(1):7-14
doi: 10.1016/j.apmr.2010.09.023
[13] Wen TS . Acupunctura clássica Chinesa. São Paulo: Editora Cultrix. 1985. Portuguese.
[14] Wiseman N, Ellis A . Fundamentals of Chinese medicine. Brookline: Paradigm Publications. 1985.
[15] Porkert M, Hempen CH . Classical acupuncture: the standard textbook. Dinkelscherben: Phainon Editions & Media. 1995.
[16] Donitz C, Anjos A, Maimer A, Greten HJ . Objective measurement of TCM diagnostic features and acupuncture effects by O2C. Shanghai: The 10th Meeting of the Consortium for Globalization of Chinese Medicine. 2011.
[17] Litscher G, Schwarz G, Sandner-Kiesling A, Hadolt I, Eger E . Effects of acupuncture on the oxygenation of cerebral tissue[J]. Neurol Res, 1998,20(Suppl 1):S28-S32
doi: 10.1080/01616412.1998.11740605 pmid: 9584920
[18] Litscher G . Computer-based quantification of traditional Chinese-, ear- and Korean hand acupuncture: needle-induced changes of regional cerebral blood flow velocity[J]. Neurol Res, 2002,24(4):377-380
doi: 10.1179/016164102101200177
[19] Litscher G . Bioengineering assessment of acupuncture, part 2: monitoring of microcirculation[J]. Crit Rev Biomed Eng, 2006,34(4):273-293
doi: 10.1615/CritRevBiomedEng.v34.i4.10 pmid: 17206916
[20] Zhang W, Wang L, Huang T, Tian Y, Xu Y, Wang L, Litscher G . Laser Doppler perfusion imaging for assessment of skin blood perfusion after acupuncture[J]. Med Acupunct, 2008,20(2):109-118
doi: 10.1089/acu.2007.0618
[21] Folstein MF, Folstein SE, McHugh PR . “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician[J]. J Psychiatr Res, 1975,12(3):189-198
doi: 10.1016/0022-3956(75)90026-6
[22] Marshall WJ, Bangert SK , Clinical biochemistry: metabolic and clinical aspects. 2nd ed. Philadelphia: Churchill Livingstone/Elsevier. 2008.
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