Search JIM Advanced Search

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/ 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.
[1] Bin Zhao, Yong Chen, Shi-min Liao, Jian-ying Zheng, Shi-hua Yan, Dong-shu Zhang. Successfully treated recalcitrant atopic eczema with acupoint autohemotherapy: A case report and hypothesized mechanism of the therapy. Journal of Integrative Medicine, 2022, 20(2): 182-186.
[2] Rui-jin Qiu, Min Li, Jia-yuan Hu, Jing Chen, Hong-cai Shang. Methods for development of a core outcome set for clinical trials integrating traditional Chinese medicine and Western medicine. Journal of Integrative Medicine, 2021, 19(5): 389-394.
[3] Luciana Aikawa, Alexandre Massao Yoshizumi, Mirian Matsura Shirassu, Marcia Kiyomi Koike. Rapid acupuncture for musculoskeletal pain in the emergency room of the Hospital Servidor Publico Estadual, Brazil: A quasi-experimental study. Journal of Integrative Medicine, 2020, 18(4): 313-318.
[4] Arthur Yin Fan, Hui Ouyang, Xinru Qian, Hui Wei, David Dehui Wang, Deguang He, Haihe Tian, Changzhen Gong, Amy Matecki, Sarah Faggert Alemi. Discussions on real-world acupuncture treatments for chronic low-back pain in older adults. Journal of Integrative Medicine, 2019, 17(2): 71-76.
[5] Shahnaz Karkon Varnosfaderani, Fataneh Hashem-Dabaghian, Gholamreza Amin, Mahbubeh Bozorgi, Ghazaleh Heydarirad, Esmaeil Nazem, Mohsen Nasiri Toosi, Seyed Hamdollah Mosavat. Efficacy and safety of Amla (Phyllanthus emblica L.) in non-erosive reflux disease: A double-blind, randomized, placebo-controlled clinical trial. Journal of Integrative Medicine, 2018, 16(2): 126-131.
[6] Maria T.Chao, AlexandraChang, SanjayReddy, James D.Harrison, JosephAcquah, MiriaToveg, TrilceSantana, Frederick M.Hecht. Adjunctive acupuncture for pain and symptom management in the inpatient setting: Protocol for a pilot hybrid effectiveness-implementation study. Journal of Integrative Medicine, 2016, 14(3): 228-238.
[7] Paulo AraujoDias, André Brito Bastos Guimarães, Andrea de Oliveira Albuquerque, Karoline Lucasde Oliveira, Maria Luzete CostaCavalcante, Sergio BotelhoGuimarães. Short-term complementary and alternative medicine on quality of life in women with fibromyalgia. Journal of Integrative Medicine, 2016, 14(1): 29-35.
[8] Bosch Peggy, van den Noort Maurits, Yeo Sujung, Lim Sabina, Coenen Anton, van Luijtelaar Gilles. The effect of acupuncture on mood and working memory in patients with depression and schizophrenia. Journal of Integrative Medicine, 2015, 13(6): 380-390.
[9] Sung Min Lim, Sook-Hyun Lee. Effectiveness of bee venom acupuncture in alleviating post-stroke shoulder pain: A systematic review and meta-analysis. Journal of Integrative Medicine, 2015, 13(4): 241-247.
[10] Marco Gemma, Elisa Nicelli, Luigi Gioia, Elena Moizo, Luigi Beretta, Maria Rosa Calvi. Acupuncture accelerates recovery after general anesthesia: A prospective randomized controlled trial. Journal of Integrative Medicine, 2015, 13(2): 99-104.
[11] Kwan Leung Chia. Symptomatic Tarlov cyst and electroacupuncture: More studies required. Journal of Integrative Medicine, 2015, 13(1): 58-60.
[12] Subhranil Saha​, Munmun Koley​, Subhasish Ganguly​, Prasanta Rath​, Pulak Roy Chowdhury, Seikh Intaj Hossain. Developing the criteria for evaluating quality of individualization in homeopathic clinical trialreporting: A preliminary study. Journal of Integrative Medicine, 2014, 12(1): 13-19.
[13] Dagmar Ehling. Integrative techniques using acupuncture, Chinese herbal medicine, diet, and supplements for polycystic ovary syndrome: A case report. Journal of Chinese Integrative Medicine, 2013, 11(6): 422-427.
[14] Hidetoshi Mori, Hiroshi Kuge, Tim Hideaki Tanaka, Eiichi Taniwaki, Kazuyo Hanyu, Tateyuki Morisawa. Effects of acupuncture treatment on natural killer cell activity, pulse rate, and pain reduction for older adults: An uncontrolled, observational study. Journal of Chinese Integrative Medicine, 2013, 11(2): 101-105.
[15] Zhang-ling Zhou, Cheng-xin Li, Yue-bo Jiang, Cong Zuo, Yun Cai, Rui Wang. Correlation between facial nerve functional evaluation and efficacy evaluation of acupuncture treatment for Bell’s palsy. Journal of Chinese Integrative Medicine, 2012, 10(9): 997-1002.
Full text



[1] Wei-xiong Liang. Problems-solving strategies in clinical treatment guideline for traditional Chinese medicine and integrative medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 1-4
[2] Zhao-guo Li. Discussion on English translation of commonly used sentences in traditional Chinese medicine: part one. Journal of Chinese Integrative Medicine, 2008, 6(1): 107-110
[3] Jun Hu, Jian-ping Liu. Non-invasive physical treatments for chronic/recurrent headache. Journal of Chinese Integrative Medicine, 2008, 6(1): 31
[4] Xue-mei Liu, Qi-fu Huang, Yun-ling Zhang, Jin-li Lou, Hong-sheng Liu, Hong Zheng. Effects of Tribulus terrestris L. saponion on apoptosis of cortical neurons induced by hypoxia-reoxygenation in rats. Journal of Chinese Integrative Medicine, 2008, 6(1): 45-50
[5] . Uniform requirements for manuscripts submitted to biomedical journals: Writing and editing for biomedical publication (Chinese version, part two). Journal of Chinese Integrative Medicine, 2010, 8(11): 1001-1005
[6] Daniel Weber, Janelle M Wheat, Geoffrey M Currie. Inflammation and cancer: Tumor initiation, progression and metastasis,and Chinese botanical medicines. Journal of Chinese Integrative Medicine, 2010, 8(11): 1006-1013
[7] Hong Liu , Guo-liang Zhang, Li Shen , Zhen Zeng, Bao-luo Zhou, Cheng-hai Liu, Guang Nie . Application and evaluation of a pseudotyped virus assay for screening herbs for anti-H5Nl avian influenza virus. Journal of Chinese Integrative Medicine, 2010, 8(11): 1036-1040
[8] Zhao-guo Li . A discussion of English translation of 1995 and 1997 Chinese National Standards of Traditional Chinese Medical Terminologies for Clinical Diagnosis and Treatment. Journal of Chinese Integrative Medicine, 2010, 8(11): 1090-1096
[9] Rui Jin, Bing Zhang. A complexity analysis of Chinese herbal property theory: the multiple formations of herbal property (Part 1). Journal of Chinese Integrative Medicine, 2012, 10(11): 1198-1205
[10] Hui-min Liu, Xian-bo Wang, Yu-juan Chang, Li-li Gu. Systematic review and meta-analysis of randomized controlled trials of integrative medicine therapy for treatment of chronic severe hepatitis. Journal of Chinese Integrative Medicine, 2012, 10(11): 1211-1228