Acupuncture therapy: mechanism of action, efficacy, and safety: a potential intervention for psychogenic disorders?

Abstract

Scientific bases for the mechanism of action of acupuncture in the treatment of pain and the pathogenic mechanism of acupuncture points are briefly summarized. The efficacy and safety of acupuncture therapy is discussed based on the results of German clinical trials. A conclusion on the role for acupuncture in the treatment of psychogenic disorders could not be reached.

Figure 1

Schematic illustrations of endogenous opioid-mediated electro-acupuncture analgesia (EAA). (A) EA at 2 Hz or 100 Hz releases different endogenous opioids, which act on different opioid receptors to induce synergic analgesic effects. (B) Impulses elicited by EA at 2 Hz or 100 Hz project to different brain areas and induce analgesic effects through descending inhibition. Em: endomorphine; Enk: encephalin: β-End: β-endorphin; Dyn: dynorphin; μ: mu-opioid receptors; δ: delta opioid receptor; κ: kappa opioid receptor; PAG: periaqueductal grey matter. Modified from Han 2003 reference [7].

Figure 2

Close relationships among trigger points, acupuncture points, and tender points. Trigger points in patients with myofascial pain syndrome appear close to those of acupuncture points. TP1-5 around the knee joints (bottom left figure) were very similar to acupuncture-point loci. The diagnostic tender points for fibromyalgia patients (dots in the bottom right figure) were also very similar to acupuncture-point loci. Referred pain phenomena might be a possible explanation of meridian (center of bottom figures).

Figure 3

Results of German acupuncture trials for low back pain. Both ART and GERAC studies produced similar results. Response rates were significantly higher than waitlist control (ART) and standard care (GERAC), but no difference between real acupuncture and sham (minimal) acupuncture was identified. Cited from Kawakita 2010 reference [25].