The microcirculatory characteristics of the heart and lung meridians: Study protocol clinical trial (SPIRIT Compliant)

Hantong Hu, Yongliang Jiang, Xiaoyu Li, Jiali Lou, Yajun Zhang, Xiaofen He, Junfan Fang, Yuanyuan Wu, Xiaomei Shao, Jianqiao Fang, Hantong Hu, Yongliang Jiang, Xiaoyu Li, Jiali Lou, Yajun Zhang, Xiaofen He, Junfan Fang, Yuanyuan Wu, Xiaomei Shao, Jianqiao Fang

Abstract

Introduction: The aim of the present study is to compare the microcirculatory difference of different meridians by using laser doppler flowmetry and investigate the specificity for the meridian-visceral association and site-to-site association between 2 specific meridians.

Methods and analysis: The Lung and Heart meridians are chosen as 2 specific studied meridians. 120 participants will be enrolled and divided into the healthy control group, chronic stable angina pectoris group and healthy intervention group. Laser doppler flowmetry will be used to assess the blood perfusion of the Heart and Lung meridians. The specificity for the meridian-visceral association will be investigated by comparing the microcirculatory difference between the Heart and Lung meridians in the healthy control group and chronic stable angina pectoris group. Besides, participants in the healthy intervention group will receive 2 sessions of moxibustion in the Heart meridian and Lung meridian, respectively, to explore the specificity for the site-to-site association on the body surface. Primary outcomes will be blood flow curve and blood perfusion units of relevant sites along the Heart and Lung meridians. Statistical analysis will be conducted by third party statisticians.

Ethics and dissemination: Ethics approval (approval No: ZSLL-KY-2019-001A-01) has been obtained from the Ethics Committee of the Third Affiliated Hospital of Zhejiang Chinese Medical University. The study findings will be disseminated through presentation at peer-reviewed medical journals.

Trial registration: ClinicalTrials.gov NCT04244812.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Study design flowchart. CSAP = chronic stable angina pectoris.
Figure 2
Figure 2
The LDF measurement sites of the healthy control group and CSAP group. CSAP = chronic stable angina pectoris, LDF = laser doppler flowmetry.
Figure 3
Figure 3
The intervention procedure of the healthy intervention group. (A) Moxibustion site of the Heart meridian and LDF measurement sites of the Heart and Lung meridians; (B) Moxibustion site of the Lung meridian and LDF measurement sites of the Heart and Lung meridians. CSAP = chronic stable angina pectoris, LDF = laser doppler flowmetry.

References

    1. Yuan QL, Wang P, Liu L, et al. Acupuncture for musculoskeletal pain: a meta-analysis and meta-regression of sham-controlled randomized clinical trials. Sci Rep 2016;6:30675.
    1. Vickers AJ, Vertosick EA, Lewith G, et al. Acupuncture for chronic pain: update of an individual patient data meta-analysis. J Pain 2018;19:455–74.
    1. Su L, Meng L, Chen R, et al. Acupoint application for asthma therapy in adults: a systematic review and meta-analysis of randomized controlled trials. Forsch Komplementmed 2016;23:16–21.
    1. Hsieh PC, Yang MC, Wu YK, et al. Acupuncture therapy improves health-related quality of life in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis. Complement Ther Clin Pract 2019;35:208–18.
    1. Yang M, Sun M, Du T, et al. The efficacy of acupuncture for stable angina pectoris: a systematic review and meta-analysis. Eur J Prev Cardiol 2019;17: 2047487319876761.
    1. Liu Y, Meng HY, Khurwolah MR, et al. Acupuncture therapy for the treatment of stable angina pectoris: An updated meta-analysis of randomized controlled trials. Complement Ther Clin Pract 2019;34:247–53.
    1. Lan L, Zeng F, Liu GJ, et al. Acupuncture for functional dyspepsia. Cochrane Database Syst Rev 2014;13:Cd008487.
    1. Zheng H, Chen R. Comparison between the effects of acupuncture relative to other controls on irritable bowel syndrome. a meta-analysis. Pain Res Manag 2019;2019:2871505.
    1. Wang GJ, Ayati MH, Zhang WB. Meridian studies in China: a systematic review. J Acupunct Meridian Stud 2010;3:1–9.
    1. Litscher G. Infrared thermography fails to visualize stimulation-induced meridian-like structures. Biomed Eng Online 2005;4:38.
    1. Haake M, Muller HH, Schade-Brittinger C, et al. German Acupuncture Trials (GERAC) for chronic low back pain: randomized, multicenter, blinded, parallel-group trial with 3 groups. Arch Intern Med 2007;167:1892–8.
    1. Yang J, Zeng F, Feng Y, et al. A PET-CT study on the specificity of acupoints through acupuncture treatment in migraine patients. BMC Complement Altern Med 2012;12:123.
    1. Ovadia-Tirosh Z, Kornowski R, Walden R, et al. An integrated noninvasive system for monitoring the microcirculatory effects of vasoactive drugs: an experimental study. Microvasc Res 1997;53:14–21.
    1. Kouadio AA, Jordana F, Koffi NJ, et al. The use of laser Doppler flowmetry to evaluate oral soft tissue blood flow in humans: a review. Arch Oral Biol 2018;86:58–71.
    1. Xu JS, Pan XH, Hu XL, et al. Comparison between governor meridian and Its bilateral control points in microcirculatory blood perfusion in 53 volunteer subjects. Zhen Ci Yan Jiu 2008;33:321–5.
    1. Zheng SX, Xu JS, Pan XH, et al. Comparison of microcirculatory blood perfusion between acupoints of the stomach meridian and their bilateral control points and changes of blood flow after electroacupuncture in 21 volunteer subjects. Zhen Ci Yan Jiu 2012;1:53–8.
    1. Hsiu H, Huang SM, Chao PT, et al. Microcirculatory characteristics of acupuncture points obtained by laser Doppler flowmetry. Physiol Meas 2007;28:N77–86.
    1. Ahn AC, Colbert AP, Anderson BJ, et al. Electrical properties of acupuncture points and meridians: a systematic review. Bioelectromagnetics 2008;29:245–56.
    1. Ahn AC, Park M, Shaw JR, et al. Electrical impedance of acupuncture meridians: the relevance of subcutaneous collagenous bands. PloS one 2010;5:e11907.
    1. Gow BJ, Cheng JL, Baikie ID, et al. Electrical potential of acupuncture points: use of a noncontact scanning Kelvin probe. Evid Based Complement Alternat Med 2012;2012:632838.
    1. Ha Y, Kim M, Nah J, et al. Measurements of location-dependent nitric oxide levels on skin surface in relation to acupuncture Point. Evid Based Complement Alternat Med 2012;2012:781460.
    1. Ma SX, Li XY, Sakurai T, et al. Evidence of enhanced non-enzymatic generation of nitric oxide on the skin surface of acupuncture points: an innovative approach in humans. Nitric Oxide 2007;17:60–8.
    1. Zhang WB, Tian YY, Zhu ZX, et al. The distribution of transcutaneous CO2 emission and correlation with the points along the pericardium meridian. J Acupunct Meridian Stud 2009;2:197–201.
    1. Beissner F, Marzolff I. Investigation of acupuncture sensation patterns under sensory deprivation using a geographic information system. Evid Based Complement Alternat Med 2012;2012:591304.
    1. Langevin HM, Churchill DL, Wu J, et al. Evidence of connective tissue involvement in acupuncture. FASEB J 2002;16:872–4.
    1. Langevin HM, Yandow JA. Relationship of acupuncture points and meridians to connective tissue planes. Anat Rec 2002;269:257–65.
    1. Gao XY, Li YH, Liu K, et al. Acupuncture-like stimulation at auricular point Heart evokes cardiovascular inhibition via activating the cardiac-related neurons in the nucleus tractus solitarius. Brain Res 2011;1397:19–27.
    1. Minagawa M, Kurono Y, Ishigami T, et al. Site-specific organ-selective effect of epifascial acupuncture on cardiac and gastric autonomic functions. Auton Neurosci 2013;179:151–4.
    1. Cho ZH, Chung SC, Jones JP, et al. New findings of the correlation between acupoints and corresponding brain cortices using functional MRI. Proc Natl Acad Sci U S A 1998;95:2670–3.
    1. Hsiu H, Hsu WC, Hsu CL, et al. Assessing the effects of acupuncture by comparing needling the hegu acupoint and needling nearby nonacupoints by spectral analysis of microcirculatory laser Doppler signals. Evid Based Complement Alternat Med 2011;2011:435928.
    1. Wang G-j, Tian Y-y, Jia S-y, et al. Laterality and coherence analysis of Laser Doppler Flowmetry signals in bilateral Nèi guān (PC 6): a potential non-invasive method to assess microdrculatory changes of people in different ages. World J Acupunct Moxibustion 2017;27:47–52.
    1. Hsieh CL, Chang YM, Tang NY, et al. Time course of changes in nail fold microcirculation induced by acupuncture stimulation at the Waiguan acupoints. Am J Chin Med 2006;34:777–85.
    1. Zhang WB, Wang YP, Li HY. Analysis on correlation between meridians and viscera in book the Yellow Emperor's Internal Classic. Zhen Ci Yan Jiu 2018;43:424–9.
    1. Liu WT, Zhang LP, Zheng MF. Current researches and ideas regarding correlation between meridians and viscera. Zhen Ci Yan Jiu 2018;43:430–2.
    1. Kong J, Kaptchuk TJ, Webb JM, et al. Functional neuroanatomical investigation of vision-related acupuncture point specificity--a multisession fMRI study. Hum Brain Mapp 2009;30:38–46.
    1. Fan H, Zhao L, Cui J, et al. Effects of acupuncture at acupoints on heart rate variability in patients with chronic stable angina pectoris. Chin J Tradit Chin Med Pharm 2017;32:1798–803.
    1. Rong P, Zhu B, Li Y, et al. Mechanism of acupuncture regulating visceral sensation and mobility. Front Med 2011;5:151–6.

Source: PubMed

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