Understanding Acupoint Sensitization: A Narrative Review on Phenomena, Potential Mechanism, and Clinical Application.

Huijuan Tan,Shuguang Yu,Lizhou Liu,Cathy Chapple,Haiyan Yin,G David Baxter,Steve Tumilty,Suzanne Mcdonough

doi:10.1155/2019/6064358

Abstract

As part of traditional Chinese medicine, acupoints are considered a dynamic functional area, which can reflect the internal condition of the body. When the body is suffering from disease or injury, corresponding acupoints are believed to be activated and manifest in several sensitized forms, including expansion of the receptive field, pain sensitization, and heat sensitization. Such phenomena are believed to gradually disappear concomitantly with recovery from the disease. Acupoint states are therefore changeable according to health status, a phenomenon known as acupoint sensitization. This review aims to provide an overview of acupoint sensitization based on existing research results and determine priorities for future research. Systematic literature retrieval was conducted in Medline, Embase, Cochrane Library, CINAHL, and AMED from inception to 18 July 2018. Current evidence from research findings to date indicate that acupoint sensitization is based on neurogenic inflammation and that stimulation of sensitized acupoints presents a potential trend of generating a better clinical effect when compared with stimulation of unsensitized points.

Highlights

As described in the classical acupuncture monograph Miraculous Pivot [1], the acupoint is the basis of acupuncture: it can, on one hand, reflect the internal condition of the body; on the other hand, it can be chosen to treat disease.Regional anatomy studies have shown no intrinsic difference in structure between routine acupoints and adjacent areas [2,3,4], indicating acupoints represent functional areas, rather than having specific defining structures
While internal pathological factors represent an essential prerequisite for acupoint sensitization, it is important to recognize that an external stimulus plays a role in acupoint sensitization as well [6]
Wang [31] gave mustard oil of different concentrations (5%, 7.5%, 10%, 12.5%, 15%, and 17.5%) to rats anally to induce acute intestinal mucosal injury models; results revealed that the number of extravasated Evans Blue (EB) dye points on the skin were correlated with the concentrations of mustard oil, with the most obvious reactions in the highest concentration group

Summary

Introduction

As described in the classical acupuncture monograph Miraculous Pivot [1], the acupoint is the basis of acupuncture: it can, on one hand, reflect the internal condition of the body; on the other hand, it can be chosen to treat disease. It has been found that when the body is under pathological stress (injury or disease), there are changes in associated acupoints, including sensation threshold and biophysical properties [6,7,8,9] Based on these findings, the concept of “acupoint sensitization” has been proposed: this proposes that the status of acupoints are dynamic and can change from a “silent” to “active” state during pathological processes. One review (which analyzed 3728 acupuncture clinical trials) showed better effectiveness of treatment of pain-sensitized points than stimulation of “extra points” and routine acupoints [6]. (3) Is stimulation of sensitized acupoints more effective than conventional acupuncture treatment using only routine points (refers to 361 regular acupoints on 14 meridians)?. E articles were selected based on following inclusion and exclusion criteria (see Table 1)

Results

Acupoint Sensitization Phenomena

Potential Mechanism of Acupoint Sensitization