s:shamr:real real moxibustion sham moxibustion sbf temp pain sbf temp pain 5 0 50 30 max none 5...
TRANSCRIPT
Functional Characteristics of a Newly DevelopedSham Moxibustion for the Clinical Research
Kawakita K1, Sakai S2, Nakazono Y3,
Kawase S4 and Oshitani T4
1Meiji University of Oriental Medicine, 2 Research
Institute of Oriental Medicine,3Kagoshima School
of Acupuncture, 4Senefa Corporation.
Introduction
Moxibustion is an important and useful procedurein the traditional Chinese medicine. To evaluatethe specific effect of moxibustion precisely, shamprocedure is required. In this study the functionalfeatures of a newly developed sham device werecompared with those of real moxibustion (indirectburning of the columnar moxa on the skin).
Methods Real or sham moxibustion was randomlyapplied to the forearm skin of healthy subjects whogave informed consent. The skin temperaturebeneath the moxibustion was measured by athermo-couple with a time constant of 0.1s, (IT-18,DAT-12, Physitemp Instrument INC). The evokedpain magnitude was evaluated by cross-modalitymatching by a hand-made slide resister. The skinblood flow (SBF) nearby moxibustion site wasmeasured by a laser Doppler flow meter (ALF-21,Advance).
Results-1
The shape and flavor during burning were similarand it was not easy to discriminate sham devicefrom the real moxibustion (Fig. 1). The peaktemperature of real one was 46.7± 3.04℃ (mean± SD, n=15) and that of sham was 35.5± 0.87℃. The real moxibustion produced sharp pain andincrease of SBF accompanied with clear flareresponse (Fig.2). On the other hand, the shammoxibusion induced only warm sensation andpain and the increment of SBF and flare were notdetected.
Results-2
Figure 3 shows typical examples of the changesin SBF, monitored skin temperature (Temp) and painmagnitude induced by real and sham moxibustion.Figure 4 is a summary of the changes of Temp by thereal and sham moxibustion, and Fig. 5 is those ofSBF. Note that increase of SBF occurred slowly.Repetitive application of moxibustion inducedprolonged increase of SBF and after-effect lasted forseveral ten min (Fig.6).
Discussion:
Moxibustion is an important procedure oftreatment. In this study, moxibustion inducesthe increase of skin blood flow and flare response.The flare response is also produced by acupunctureand is considered to be the result of antidromicexcitation of the polymodal receptor. We haveproposed a working hypothesis that acupunctureand moxibustion stimulate a common receptor,the polymodal receptor, and it produces variouseffects on the bio-regulatory systems (Fig.7). More researches on moxibustion are requiredto examine the hypothesis and the sham devicemay be useful for the concrete study.
Conclusion
Real moxibustion induced clear increase of SBFand flare response, whereas no such response wasobserved by sham device. It is suggested that thesham device in the present study may be useful toolfor the clinical research of moxibustion.
S:Sham R:Real
Fig.1 Real and Sham Devices for Moxibustion Columnar moxa is put on the round thick plate with a small hole.
Fig.2 Flare produced by a real moxibustion A black sensor is that of the laser Doppler flow meter. A clearround flare is observed left side of the sensor.
Real Moxibustion
Sham Moxibustion
SBF
Temp
Pain
SBF
Temp
Pain
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50
30
Max
None
5 ml/min/100g
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None
1 min
5 ml/min/100g
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None
Effect of Moxibustion on Skin Temperature
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0 1 2 3 4 5 6 7 8 9 10
Time (min)
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Real Moxibustion
Sham Moxibustion
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(℃)
Effect of Moxibustion of Skin Blood FLow
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Time (min)
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Pain
ml/min/100g
15
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None
1 min
Polymodal Receptor Hypothesis
PolymodalReceptor
Bio-regulatory SystemsEndogenous pain inhibition, autonomic and endocrine
systems
Acupuncture(mechanical)
Moxibustion(thermal,chemical)
Responsive to mechanical,thermal and chemical stimuli
Free nerve endings
Flare & wheal (axon reflex)
Sensitized polymodal receptor is candidate of the tender, trigger and acupuncture point
Distributes to the skin, muscle and viscera of entire body
Fig.4 Effect of Moxibustion on Skin Temperature Data are shown as the mean and SD
Fig.3 Changes in Skin Blood Flow, Skin Temperature and Pain Magnitude by Real and Sham Moxibustion SBF:skin blood flow, Temp: skin temperature
Fig.5 Effect of Moxibustion on Blood Flow ◆: Real Moxibustion; ■: Sham Moxibustion Skin Blood flow is shown as ml/min/100g
Fig.6 Repetitive Application of Moxibustion on Skin Blood Flow and Pain Magnitude
SBF:Skin blood flow; Temp: Skin temperature; Pain: Magnitude of Pain
Fig.7 Polymodal Hypothesis of Acupuncture and Moxibustion