Acupuncture effects on autonomic responses to cold pressor and handgrip exercise in healthy humans.

Acupuncture at P6, Liv 3 and Li 4 attenuates the increase in blood pressure during mental stress in healthy humans. The purpose of this study was to test the hypothesis that acupuncture at these points has a generalized depressor effect seen during other stimuli to the autonomic nervous system. Thirty-eight healthy humans (mean age 33 +/- 13 years) performed handgrip exercise (n = 20) or the cold pressor test (n = 18) before and after acupuncture at P6, Liv 3 and Li4. To control for repeated interventions, subjects underwent an identical protocol on a different day, during which acupuncture was replaced by quiet rest. Blood pressure and heart rate increased similarly during the first and repeat intervention (handgrip or cold pressor test). Acupuncture did not attenuate the increase in blood pressure (delta mean arterial pressure [MAP] 9.3 +/- 1.8 vs 7.3 +/- 3.1 mmHg) or the increase in heart rate (delta heart rate [HR] 6.7 +/- 2.1 vs 6.0 +/- 2.0 bpm) during handgrip exercise. Similarly, acupuncture did not attenuate the increase in blood pressure (delta mean arterial pressure [MAP] 14.8 +/- 5.0 vs 14.8 +/- 4.8 mmHg) or the increase in heart rate (delta heart rate [HR] 5.3 +/- 2.1 vs 8.7 +/- 3.6 bpm) during the cold pressor test. In summary, in normal healthy humans, acupuncture at P6, Liv 3 and Li 4 does not attenuate the blood pressure or heart rate responses during handgrip exercise or the cold pressor test.

Introducing integrative East-West medicine to medical students and residents.

Over the last several years, many medical schools and residencies have introduced complementary and alternative medicine (CAM) into their curricula, prompting a discussion as to how CAM should be taught. In this paper, we share our experiences teaching medical trainees integrative East-West medicine, an approach to health and disease that brings together modern Western and Chinese medicine. A 2-week clinical rotation that is intimately tied to our busy clinical program is described in detail as we explore some of the challenges and opportunities involved in teaching a CAM-related field to medical trainees. We also demonstrate how such a clinical experience offers an opportunity to impart on our students a broad view of medicine and to discuss novel approaches to clinical problem-solving.

Acupuncture inhibits sympathetic activation during mental stress in advanced heart failure patients.

BACKGROUND: In heart failure (HF) patients, muscle sympathetic nerve activity is increased, and HF patients with the greatest sympathetic activation have the poorest prognosis. In animals, acupuncture is sympathoinhibitory, and the most profound sympathoinhibition occurs in animals with the highest resting sympathetic nerve activity. The purpose of this study was to test the hypothesis that acupuncture is sympathoinhibitory in humans with HF. METHODS AND RESULTS: Fifteen advanced HF patients underwent acute mental stress testing before and during (1) "real" acupuncture (n = 10), (2) non-acupoint acupuncture (n = 10), and (3) no-needle acupuncture control (n = 10). Muscle sympathetic nerve activity (MSNA) was recorded using peroneal microneurography. Resting MSNA was not different before and after acupuncture (52 +/- 22 versus 50 +/- 21 bursts/min, P = NS). During mental stress, SNA increased significantly. This increase was eliminated following real acupuncture (mean delta MSNA pre-acupuncture versus post-acupuncture: 149 +/- 171 versus -169 +/- 130, P =.03), but not after non-acupoint or no-needle acupuncture controls. The changes in blood pressure and heart rate during mental stress were not attenuated by real or control acupuncture. CONCLUSION: Acute acupuncture attenuates sympathoexcitation during mental stress in advanced HF patients.