Evaluation of the Effects of Acupuncture on Blood Flow in Humans with Ultrasound Color Doppler Imaging

Hindawi Publishing Corporation Evidence-Based Complementary and Alternative Medicine Volume 2012, Article ID 513638, 8 pages doi:10.1155/2012/513638 Review Article Evaluation of the Effects of Acupuncture on Blood Flow in Humans with Ultrasound Color Doppler Imaging Shin Takayama,1 Masashi Watanabe,1 Hiroko Kusuyama,1 Satoru Nagase,2 Takashi Seki,1 Toru Nakazawa,3 and Nobuo Yaegashi1, 2 1 Department of Traditional Asian Medicine, Graduate School of Medicine, Tohoku University, 2-1, Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan 2 Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan 3 Department of Ophthalmology and Visual Science, Graduate School of Medicine, Tohoku University, Sendai 980-8575, Japan Correspondence should be addressed to Shin Takayama, Received 23 February 2012; Revised 2 April 2012; Accepted 2 April 2012 Academic Editor: Gerhard Litscher Copyright © 2012 Shin Takayama et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Color Doppler imaging (CDI) can be used to noninvasively create images of human blood vessels and quantitatively evaluate blood flow in real-time. The purpose of this study was to assess the effects of acupuncture on the blood flow of the peripheral, mesenteric, and retrobulbar arteries by CDI. Statistical significance was defined as P values less than 0.05. Blood flow in the radial and brachial arteries was significantly lower during needle stimulation on LR3 than before in healthy volunteers, but was significantly higher after needle stimulation than before. LR3 stimulation also resulted in a significant decrease in the vascular resistance of the short posterior ciliary artery and no significant change of blood flow through the superior mesenteric artery (SMA) during acupuncture. In contrast, ST36 stimulation resulted in a significant increase in blood flow through the SMA and no significant change in the vascular resistance of the retrobulbar arteries. Additionally, acupuncture at previously determined acupoints in patients with openangle glaucoma led to a significant reduction in the vascular resistance of the central retinal artery and short posterior ciliary artery. Our results suggest that acupuncture can affect blood flow of the peripheral, mesenteric, and retrobulbar arteries, and CDI can be useful to evaluate hemodynamic changes by acupuncture. 1. Introduction To date, no quantitative evaluation methods have been established for determining the physiological effectiveness of acupuncture. Therefore, researchers conduct experiments using a variety of approaches. In this study, we focused on the physiological reactions to acupuncture and investigated blood flow changes that result from acupuncture [1–5]. Many studies of acupuncture efficacy have been based on the results of animal experiments with anesthesia. These studies indicate that acupuncture works through physiological mechanisms that occur primarily in the autonomic nervous system [6–12]. When acupuncture is performed in human clinical practice, the conditions are very different from those in animal experiments. Additionally, because the invasive examination techniques that are often used to evaluate the results of acupuncture treatments affect the efficacy of those treatments, it is difficult to distinguish physiological reactions caused by acupuncture from those caused by the invasion necessary for examination. To determine the efficacy of acupuncture in humans, it is important that the examination method be noninvasive. We therefore used noninvasive color Doppler imaging (CDI) with ultrasound to evaluate blood flow. CDI is an examination technique that is widely used in the practice and research of Western medicine [13–21]. CDI can quantitatively measure intravascular blood flow in the extremities and in various organs in real-time. It is useful in the investigation of vessels, such as the peripheral, coronary, splenic, adrenal, and superior mesenteric arteries (SMA) [22]. In addition, the reproducibility of real-time and noninvasive hemodynamic measurement with CDI is reported elsewhere [23]. In traditional Chinese medicine, LR3 (Taichong, located on the foot, 1.5–2 units above the web between the 2 Evidence-Based Complementary and Alternative Medicine (a) (b) Figure 1: (a) Ultrasound measurement of the radial artery. 13 MHz linear transducer is fixed along radial artery with a special probe holder (MP-PH0001, Aloka Co., Ltd., Tokyo, Japan). (b) Display of CDI. Left: the vessel image and the position of the artery tracking gate. Right: changes in vessel diameter, Doppler flow, and flow velocity as determined by an automated edge-detection device and computer analysis software (e-Tracking system; Aloka Co., Ltd., Tokyo, Japan). (a) (b) Figure 2: (a) Ultrasound measurement of the brachial artery. 13 MHz linear transducer is fixed along brachial artery with a special probe holder (MP-PH0001, Aloka Co., Ltd., Tokyo, Japan). (b) Display of CDI. Left: image of the vessel image and position of the artery tracking gate. Right: changes in vessel diameter, Doppler flow, and flow velocity, as determined by an automated edge detection device and computer analysis software (e-Tracking system; Aloka Co., Ltd., Tokyo, Japan). first and second toes [24]) is an acupoint on the liver meridian, which has the functions of “soothing the liver,” “regulating the blood,” and “opening into the eyes” [24]. We therefore hypothesized that LR3 acupuncture would affect hemodynamics in the peripheral arteries and the retrobulbar arteries. ST36 (Zusanli, located on the lower leg, 3 units below the lateral “eye” of the knee, approximately 1 finger width lateral to the tibia [24]), in contrast, is an acupoint on the stomach meridian, and is associated with the functions of gastrointestinal organs [25]. We therefore hypothesized that ST36 acupuncture would affect hemodynamics in the SMA. Because glaucoma prognosis and retrobulbar circulation are related [26–29], we also investigated the effects of acupuncture on retrobulbar circulation in open-angle glaucoma (OAG) patients. In this study, we introduce the noninvasive CDI with ultrasound to evaluate blood flow changes by acupuncture. 2. Materials and Methods 2.1. Ultrasound Technique for Blood Flow Measurement. We measured circulation in the upper limb, SMA, and retrobulbar vessels using an ultrasound system (Prosound α10; Aloka Co., Ltd, Tokyo, Japan). The system had a 13 MHz linear transducer and a 5 MHz convex transducer. We used the linear transducer to examine peripheral arteries and the retrobulbar vessels. We used the convex transducer to measure SMA circulation. The radial artery was examined just medial to the radial styloid process (Figure 1). The brachial artery was monitored immediately proximal to the elbow (Figure (...truncated)