Acupuncture for immune-mediated disorders

EFFECTS OF AP ON THE IMMUNE SYSTEM AND CLINICAL USES

AP, Electro-AP (EAP) or moxa enhanced the recovery of red and white cell counts (RCC and WCC) to normal or near-normal values in many conditions (11), including experimental radiation sickness (13-17), experimental Vibrio cholerae sensitivity (18). AP post-op in humans enhanced WCC, neutrophil phagocytosis, lymphocyte counts, and bactericidal activity (19). Low Level Laser Therapy (LLLT) increased phagocytosis in chronic wounds in horses (20), improved immune functions and remedied anaemia in children (21). Homoeostatic effects of AP are more obvious when abnormalities exist first (14). AP in patients on long-term cortisone therapy for spastic bronchitis, restored granulocyte migration to almost normal values (22). LLLT decreased the numbers and caused marked degranulation of mast cells in irradiated tissues (23). EAP or moxa enhanced the activity of the reticulo-endothelial system (24,25) but if used too often, adaptation reduced the effect (26-28).

Narcotic medication inhibits local immune response (29). AP or moxa enhanced cellular immunity (29-31), increased lymphocyte proliferation/count (30,32), lymphocyte transformation (LT) (31,33-35), T-cell numbers (36), serum globulins (34), T-cell staining by alpha naphthyl acetate esterase (ANAE) (37,38) and E-rosette formation (29,31,38). AP increased Natural Killer (NK) -cell activity (32). AP increased suppressor/cytotoxic T-cells, E-rosette positive T-cells and Leu 7+NK cells. Leu 11+NK cells decreased (39).

SPECIFIC AND NON-SPECIFIC ANTIBODIES, GLOBULIN, COMPLEMENT, INTERFERON
Globulins and antibodies: AP, LLLT or moxa increased SIgA in the small intestine in mice sensitised against Vibrio cholerae (18), Igs, specific antibodies and faecal IgA in bacillary dysentery (40), plasma IgM in chronic pelvic inflammation (41), beta and gamma globulins and A/G ratio in dogs with g/i helminthiasis (42) and antibody formation in wounded horses (20). AP improved non-specific immunity and regulated hyperactivity of the non-specific immune system in asthmatic and normal subjects (43). AP, LLLT and moxa improved immune parameters in systemic lupus erythematosus (44). Plasma cAMP was low in early malaria, indicating that metabolites of Plasmodia inhibit immune responses. As AP may cure malaria, its actions are thought to involve activation of the immune system and its symptomatic effects (45). AP or moxa increased complement in acute bacillary dysentery (40) and in scleroderma and asthma (46). Moxa increased complement in rabbits (47). AP increased circulating interferon in humans. Stimulation of interferon production may have clinical uses in viral infections and in other diseases (48).

PRE-, PER- AND POST- OPERATIVE INDICATIONS FOR AP: General anaesthesia suppresses antibody response (49) and other immune functions. It markedly reduces lymphocyte blastogenesis, which is not influenced by AP analgesia (50). Reflex analgesia by AP, EAP or TENS enhances immune response (see above) and leaves autonomic functions, including those of the foetus, intact (51,52). Effective methods of pre-, per- and post- op management, if they have immunostimulant effects, would be in the best interests of the patient and would reduce the need for potent drugs (opiates, barbiturates, diazepam, epidurals, gastric sedatives etc) and depress vital functions less (53,54).

Shock, anxiety, anorexia, nausea, vomiting etc are common pre-op. Some patients are hypersensitive to drugs. Pain, shock, abdominal spasm, anxiety, anorexia, wound infection, adhesions, scar TPs, intestinal adhesion, ileus, nausea, vomiting, apnoea, dyspnoea, retention of sputum, laryngitis, decreased renal filtration rate, urinary retention, peripheral ischaemia, pressure ischaemia etc are common post-op. AP pre- and/or post- op can prevent or treat most of those complications. Combination of per- and post-op EAP reduces the demand for post-op analgesic drugs and patients become self-caring more quickly (55,56). In particular, Patterson (53) cited data which showed that the incidence of post-op sepsis was 3% in patients under AP analgesia or electro-analgesia, as compared with 17% under general anaesthetics.

AP, EAP or acupressure at PC06 was more effective in preventing pre- or post- op nausea and vomiting than cyclazine and metoclopramide in patients undergoing surgery (57-59). When given during operation under drug anaesthesia, EAP (5 minutes at 10 Hz) was not effective (60). Nausea and vomiting due to passing a laryngoscope can be prevented in 80% of patients by heavy acupressure on LI04 (61,62). Atropine or conventional anticholinergic agents produce side effects, including dry mouth, blurred vision, dizziness and tachycardia. AP can replace anticholinergics, with few or no side effects, to facilitate gastroscopy or a barium meal (63-67).

AP, EAP or LLLT are useful per-operative analgesics in: high-risk patients (68); coordination of uterine contraction in labour (69,70); Caesarian section (71); gynaecological operations (31) and in hysterectomy. Post-op analgesia persists for 3-4 hours (54).

EAP combined with epidural (55), local or general anaesthesia for surgery reduces the amount of anaesthetic drugs needed (71) and confers neurovegetative protection from the effects of surgical trauma (72). Post-op recovery of spontaneous breathing, consciousness (56), and autonomic function is faster and the immune system is less depressed after combined anaesthesia than after drug anaesthesia without AP (68,73,74).

Similar analgesic and neurovegetative effects occur with post-op use of EAP and TENS (75). AP or EAP post-op stimulates fast recovery of liver function (69) and reduces hallucinations on emerging from ketamine anaesthesia (76). EAP and TENS post-op gave better analgesia than i/v meperidine but EAP analgesia lasted longer than TENS analgesia and increased with repetition of treatment (77). EAP post-op halved the use of pethidine (78). In post-op wound infection, blood vessels near the HuatoJiaJi points become engorged, usually in the scapular or inter-scapular area in the case of infected wounds of the upper limbs or face and in the lumbar area in the case of the lower limbs. One paravertebral needling, to release a few drops of blood from engorged vessels on the back, cured most cases (79).

AP was better than laser-AP or narcotic management of post-op infected wounds as regards analgesia, speed of healing and hospital stay (29). EAP reduced post-op intestinal adhesions (80). EAP or AP rapidly cured urinary retention post-op and in paraparetic cases (81-83) or retention postpartum or post-obstetrical surgery (84). AP restored urinary function in 100% of cases of retention or incontinence due to laceration and spondylosis of sacral vertebrae (85).

AP was effective in 96% of ileus/obstipation cases. Most cases emptied the bowel within 1 hour (86).