Study on Acupuncture Treatment of Pain

The basic theory of acupuncture and moxibustion in the treatment of pain is to regulate and balance the physiological functions of the body by stimulating acupuncture points, so as to achieve the purpose of relieving pain. This treatment can be used alone or combined with traditional drug therapy and physical therapy to achieve better curative effect.Abstract: As a traditional Chinese medicine therapy, acupuncture has a long history in treating pain. With the development of modern medical technology, the application of acupuncture has also received more and more attention and research. The purpose of this report is to explore the future development trend of acupuncture and moxibustion in the treatment of pain, including technical innovation, the combination of acupuncture and modern medicine, multidisciplinary cooperation, personalized treatment and so on. We believe that these trends will help to further improve the efficacy and safety of acupuncture in the treatment of pain, promote the application of acupuncture in clinical medicine, and provide better conditions for the international promotion of acupuncture.

Key words: acupuncture; Pain; Mechanism of action; Clinical application.

I. Introduction to the study

I. Purpose and significance of the study

As a traditional therapy of traditional Chinese medicine, acupuncture has been widely used in the field of pain treatment, and has been more and more widely recognized and applied in modern medicine. The purpose of this study is to explore the mechanism, efficacy and safety of acupuncture in treating pain, further promote the clinical application and development of acupuncture in treating pain, and improve the quality of life of patients.

II. Research questions and assumptions

The main problems of this study include

(1) What is the mechanism of acupuncture in treating pain?

(2) What is the curative effect of acupuncture on different types of pain?

(3) How to evaluate the safety of acupuncture in treating pain?

(4) What is the cost-effectiveness of acupuncture in treating pain?

Based on the above problems, we put forward the following assumptions:

(1) The mechanism of acupuncture in treating pain is mainly through activating biological reaction points, regulating neuroendocrine system and improving microcirculation.

(2) The curative effects of acupuncture and moxibustion on different types of pain are different, especially for chronic pain and neuropathic pain.

(3) Acupuncture is safe in treating pain, but attention should be paid to the operating norms and contraindications;

(4) Acupuncture has certain cost-effective advantages in treating pain.

III. Research methods and data sources

In this study, literature review and experimental research will be used to comprehensively analyze the mechanism, efficacy, safety and cost-effectiveness of acupuncture and moxibustion in treating pain.

Specific research methods include:

(1) Collect and screen the literature related to acupuncture and moxibustion treatment of pain, and comprehensively analyze and evaluate the mechanism, efficacy, safety and cost-effectiveness of acupuncture and moxibustion treatment of pain;

(2) Design and conduct a certain number and samples of clinical and experimental research, explore the mechanism and efficacy of acupuncture in treating pain, and evaluate the safety and cost-effectiveness;

(3) Use various statistical analysis methods to analyze and present the research results, including descriptive statistical analysis, variance analysis, regression analysis, etc., and draw conclusions and recommendations.

Data sources mainly include the following:

(1) Relevant documents in Chinese and English databases (such as PubMed and CNKI);

(2) Clinical trial registration centers (such as ClinicalTrials.gov and China clinical trial registration centers, etc.)

Related research registered in;

(3) Relevant experience and information of experts, scholars and medical institutions in the professional field.

In the process of research, we need to pay attention to the following issues:

(1) Strictly control the quality of literature and research, and select materials with high reliability;

(2) Fully consider the limitations and shortcomings of the research, and evaluate the reliability and generalization of the conclusion;

(3) Ensure that experiments and clinical research conform to ethical and legal provisions, and protect the rights and interests of subjects and patients;

(4) Pay attention to the statistical analysis of data and the presentation of results, and reflect the research conclusions and findings as objectively as possible.

II. background of pain and acupuncture treatment

A. Definition and classification of pain

Pain refers to the uncomfortable feeling caused by tissue injury or disease, and it is a protective response of the body. According to the etiology, symptoms, course of disease and pathophysiological mechanism, pain can be divided into many types, such as acute pain, chronic pain, neuropathic pain, inflammatory pain and musculoskeletal pain.

B. Causes and mechanisms of pain

The causes of pain are complex and varied, which may be caused by many factors such as tissue injury, disease, infection, neuropathy and so on. In the process of pain occurrence and conduction, it mainly involves the interaction of various molecules and cells such as neurotransmitters, receptors and ion channels, such as neurons, astrocytes, microglia and white blood cells.

C. history and basic principles of acupuncture and moxibustion treatment

Acupuncture is one of the important therapies of traditional medicine in China, with a long history and rich theoretical system. Acupuncture therapy mainly stimulates the human meridian system and local tissues by puncturing needles at specific points, and regulates the physiological and pathological functions of the body to achieve the purpose of treating diseases.

The basic principles of acupuncture therapy include

(1) meridian theory, that is, the meridian system in the human body is a channel that connects various tissues and organs and regulates the physiological and pathological state of the body.

(2) the theory of qi and blood, that is, the balance and regulation of qi and blood in human body is important to health.

(3) Yin-Yang theory, that is, the balance and harmony between Yin and Yang in human body is the key to health.

(4) Five elements theory, that is, the relationship and function of the five elements in the human body have an impact on health.

III. Clinical application of acupuncture in treating pain

A. the effect of acupuncture on different types of pain

(1) Headache and migraine: Acupuncture can relieve headache and migraine by regulating nerve and blood circulation.

In clinical research, acupuncture has been proved to significantly reduce the frequency and intensity of headache and migraine.

Here are some commonly used acupuncture points:

Dragon Boat Festival: Located at the center line of the head, the highest point of hair growth.

Temples: located at the lateral depression of eyebrows, 2 fingers upward.

Wind pool: located on both sides of the neck, two horizontal fingers upward at the depression below the ear.

Wind: located above the eyebrows, at the junction of eyebrows and forehead.

Shenmen: located at the center line of the head, 4 horizontal fingers upward from the center of the front hairline.

(2) Cervical pain: Acupuncture can relieve the pain caused by cervical spondylosis by relaxing muscles, improving blood circulation and reducing inflammation. In some studies, acupuncture has been proved to significantly reduce the pain and local tenderness of patients with cervical spondylosis.

Here are some commonly used acupuncture points:

Fengchi (Fengchi): located at the bottom of the neck, a depression where the carotid arteries pulsate on both sides. Massage and stimulation of Fengchi point can relieve neck pain and stiffness.

Tianzhu: Located in the muscle next to the first vertebra of cervical vertebra. Massage and stimulation of Tianzhu point can relieve headache and neck stiffness caused by cervical spondylosis.

Jingming (Jingming): located above the eyebrows, a depression on the inside of the orbit. Massage and stimulation of Jingming point can relieve eye fatigue and dryness caused by cervical spondylosis.

Temple: It is located at the temple, that is, the intersection of the outer eyebrows and the upper edge of the cheekbones. Massage and temple stimulation can relieve headache and eye discomfort caused by cervical spondylosis.

(3) Arthritis: Acupuncture can alleviate the pain caused by arthritis by relieving inflammation around joints and improving joint movement. In some studies, acupuncture has been proved to significantly reduce the pain and joint dysfunction of arthritis patients.

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Here are some commonly used acupoints

Knee pain: Zusanli point (at the width of three fingers below the knee on the outside of the calf) and Yanglingquan point (at the width of three fingers below the knee on the inside of the knee).

Shoulder pain: Jianjing point (at the upper edge of scapula, below the transverse process of the first thoracic vertebra) and Quchi point (at the elbow of the armMedial, between ulna and humerus)Cervical spondylosis: Fengchi point (on both sides of the cervical vertebra, below the spinous process of the first cervical vertebra) and Tianzhu point (at the protrusion of the seventh cervical vertebra).

Osteoarthritis: Guanyuan point (at the width of four fingers under the midline of abdomen) and Zusanli point.

(4) Lumbago and sciatica: Acupuncture can relieve lumbago and sciatica by relaxing muscles and improving blood circulation. In some studies, acupuncture has been proved to significantly reduce the pain and symptoms of patients with low back pain and sciatica.

Here are some acupuncture points that may relieve pain:

Yaoshu point (BL23): Located in the posterior depression of lumbar kyphosis, it is the main point for treating low back pain.

Da Chang Shu (BL25): Located at the junction of the lower edge of lumbar spine and sacrum, it can relieve low back pain and sciatica.

Fengchi point (GB20): Located at the back of cervical vertebra and head, it can relieve headache and neck pain, and also relieve low back pain.

Zhongwan (CV12): Located in the midline of abdomen, it can relieve low back pain and stomach discomfort.

Liangqiu point (GB34): It is located on the lateral side below the knee, which can relieve knee pain and low back pain.

Yuji, Yaoyangguan, Dayao, Jinsuo, Weizhong, Zhongwan and Liangqiu.

(5) Menstrual pain and menopausal symptoms: Acupuncture can relieve menstrual pain and menopausal symptoms by regulating neuroendocrine system and improving qi and blood circulation.

The following are some commonly used acupoints:

Menstrual pain:

Guanyuan point: located in the center of navel, it is helpful to regulate uterine function and relieve menstrual pain.

Uterine point: located in the lower abdomen of the belly line, it can relieve dysmenorrhea and regulate menstruation.

Sanyinjiao point: located on the inside of instep, it can regulate menstrual cycle and relieve menstrual pain.

Qihai point: located in the center of the abdomen, it helps to regulate blood circulation and relieve menstrual pain.

Climacteric symptoms:

Shenque point: located at the upper part of the sternum, it can relieve menopausal symptoms such as hot flashes and sweating.

Neiguan point: located at the wrist, it can regulate the endocrine system and relieve menopausal symptoms.

Taixi point: located on the inner side of the calf, it helps to regulate blood circulation and relieve menopausal symptoms.

Atrium point: located in the center of the sternum, it can regulate the autonomic nervous system and relieve menopausal symptoms.

B. Mechanism of acupuncture in treating pain

(1) Neuroregulation: Acupuncture can relieve pain by regulating the nervous system. Acupuncture can activate subcutaneous nerve and deep nerve, and achieve analgesic effect by regulating neurotransmitters, reducing nerve excitability and reducing neuron activity.

(2) Circulation regulation: Acupuncture can relieve pain by improving local blood circulation, increasing tissue oxygen supply and metabolism, and reducing tissue hypoxia and malnutrition.

(3) Inflammation regulation: Acupuncture can regulate inflammatory reaction, inhibit the release of inflammatory mediators, and reduce the damage and pain of inflammation to surrounding tissues.

(4) Neuroplasticity regulation: Acupuncture can improve the efficiency of natural pain regulation system by influencing the plasticity of cranial nerves, changing the functions of neurons and synapses, and thus alleviating pain.

C. Precautions and contraindications for acupuncture and moxibustion in the treatment of pain

(1) Before treatment, it is necessary to know the patient's medical history, pain type and degree, and so on and so forth.

(2) Acupuncture operation should be carried out under clean and hygienic conditions to avoid cross infection and other complications.

(3) Acupuncture treatment needs to be adjusted individually according to individual differences of patients to avoid excessive stimulation and tissue damage.

(4) After acupuncture treatment, patients' reactions and symptoms should be observed, and discomfort and complications should be dealt with in time.

Acupuncture treatment has some contraindications.

(1) Patients with dermatoses, hemorrhagic diseases and malignant tumors are not suitable for acupuncture treatment.

(2) Pregnant women, heart patients, epilepsy patients and other specific groups need to be carefully treated with acupuncture under the guidance of doctors.

IV. research progress of acupuncture and moxibustion in treating pain

A. Clinical study on acupuncture and moxibustion for pain treatment

(1) Design the research plan: First, we need to determine the purpose, object, sample size, setting of experimental group and control group, treatment time, evaluation index, etc.

(2) Recruiting research subjects: determine the inclusion and exclusion criteria of research subjects, and conduct appropriate publicity to recruit qualified subjects.

(3) Grouping experiment: The subjects were randomly assigned to the experimental group and the control group, and were treated according to different acupuncture schemes.

(4) Evaluation index: Evaluate the pain symptoms, quality of life and drug use of the subjects.

(5) Data analysis: The collected data are statistically analyzed to evaluate the effectiveness and safety of acupuncture in treating pain.

B. experimental study on acupuncture and moxibustion for pain treatment

(1) Animal model: Establish an appropriate animal pain model, such as neuropathic pain and inflammatory pain.

(2) Experimental design: design an experimental plan, such as the curative effect of acupuncture compared with placebo, the curative effect comparison of different acupuncture schemes, etc.

(3) Experimental operation: Conduct experimental operation according to the experimental plan and record relevant data.

(4) Data analysis: The experimental data were statistically analyzed to evaluate the mechanism and efficacy of acupuncture in treating pain.

C. pharmacological study on acupuncture and moxibustion for pain treatment

C. pharmacological study on acupuncture and moxibustion for pain;

(1) Separation of acupuncture substances: the acupuncture drugs are separated and extracted, and the substances are identified and the structure is analyzed.

(2) Study on mechanism of action: Using molecular biology and cytology technology, the mechanism of action of acupuncture drugs on nervous system, immune system and endocrine system was studied.

(3) Efficacy evaluation: Evaluate the efficacy of acupuncture drugs, including its effect on pain relief, side effects and safety.

V. quality evaluation of acupuncture and moxibustion for pain treatment

A. evaluation of the therapeutic effect of acupuncture on pain

(1) Randomized controlled trial: By comparing the acupuncture treatment group with the placebo treatment group and observing the therapeutic effects of the two groups of patients, we can evaluate the therapeutic effect of acupuncture on pain.(2) Systematic review and Meta-analysis: A comprehensive analysis of the published related studies can obtain a more accurate estimate of the therapeutic effect.

(3) Case-control study: The curative effect of acupuncture treatment can be evaluated by comparing the symptoms and pain degree of patients who received acupuncture treatment with those who did not receive treatment.

(4) Questionnaire survey: Through the questionnaire survey of patients receiving acupuncture treatment, we can evaluate patients' feelings and effects on acupuncture treatment.

B. Safety evaluation of acupuncture for pain treatment

(1) Observation of side effects: Observe whether the patient has any side effects such as pain, bleeding, infection and allergy during acupuncture.

(2) Statistics of patients' adverse reactions: Follow-up and record the patients receiving treatment, and statistics of patients' adverse reactions after treatment.

(3) Comparing the safety of different acupuncture treatment methods: Comparing different acupuncture treatment methods can evaluate the safety of different methods.

C. Cost-benefit evaluation of acupuncture for pain treatment

(1) Comparing the costs of different treatment methods: By comparing the costs of different treatment methods, the economic benefits of acupuncture treatment are evaluated.

(2) Assessing patients' productivity: Assessing patients' productivity changes before and after treatment can evaluate the cost-effectiveness of acupuncture treatment.

(3) Calculation of patients' social cost: Assessing the changes of patients' social cost before and after treatment can evaluate the cost-effectiveness of acupuncture treatment.

VI. Conclusions and prospects

A. Research conclusions and contributions

(1) Acupuncture has a certain curative effect on pain, especially in the treatment of chronic pain.

(2) The mechanism of acupuncture in treating pain may be related to neural regulation, metabolic regulation and other aspects.

(3) Safety should be paid attention to in the clinical application of acupuncture for pain treatment, especially in the aspects of acupuncture operation and needle disinfection.

B. Research limitations and shortcomings

(1) Limited data sources: This study is mainly based on literature review. The data sources are relatively limited and there may be selective bias.

(2) The research method is not perfect: this study lacks the verification of experimental research and clinical practice, and the conclusion may be affected to some extent.

(3) The research angle is not comprehensive enough: This study mainly focuses on the efficacy and safety of acupuncture in treating pain, without considering the influence of other factors, such as treatment cost and patients' psychological state.

C. future development trend of acupuncture and moxibustion for pain treatment

(1) Development of acupuncture and moxibustion technology: The acupuncture and moxibustion technology has been continuously developed, including new needles, acupuncture techniques and acupuncture schemes. For example, new acupuncture techniques such as high-tech acupuncture, laser acupuncture and electric acupuncture have been applied, which can not only improve the accuracy and safety of acupuncture, but also increase the curative effect of acupuncture.

(2) Combining modern medicine: Combining acupuncture therapy with modern medicine, especially acupuncture with neuroscience, imaging and other technologies, we can understand the mechanism of acupuncture more scientifically and determine the treatment plan of diseases more accurately. At the same time, combining the advantages of traditional Chinese and western medicine can improve the effect of acupuncture therapy.

(3) Multidisciplinary cooperation: Acupuncture treatment of pain requires multidisciplinary cooperation, including professionals in many fields such as Chinese medicine, neuroscience, rehabilitation medicine and pain medicine. Through multidisciplinary cooperation, we can better understand the mechanism of acupuncture treatment and further improve the curative effect of acupuncture treatment of pain.

(4) Multi-center research: Through multi-center research, the efficacy and safety of acupuncture in treating pain can be evaluated more objectively. At the same time, multi-center research can further promote acupuncture therapy and improve its clinical application.

(5) Individualized treatment: With the development of genetic testing technology and the continuous progress of clinical medicine, the individualized treatment of acupuncture and moxibustion for pain will be paid more and more attention. Personalized treatment can better meet the specific needs of patients and improve the treatment effect.

The future development trend of acupuncture and moxibustion treatment of pain will continue to develop in the direction of multidisciplinary cooperation, modern medicine, technological innovation and personalized treatment, which will help to improve the effect and safety of acupuncture and moxibustion treatment of pain and further promote the application of acupuncture and moxibustion in clinical medicine.

Reference essay

[1] On February 20th, 2017, JAMA Internal Medicine(IF=20.786), a top international medical journal, published a research paper entitled "The long-term effect of acupuncture for migraine a randomized clinical trial" from Professor Liang Fanrong of Chengdu University of Traditional Chinese Medicine.

[2] The researchers have published the results in Archives of Internal Medicine, indicating that acupuncture is better than comfort treatment and standard care in patients with osteoarthritis, migraine and chronic back, neck and shoulder pain.

[3] Zhao Wenbin, Li Xiaoxia. "Research progress in acupuncture treatment of cervical spondylosis." Journal of Clinical Acupuncture, vol. 34, no.5, 2018, pp. 91-94.

[4] Li Bo, Wei Shaojie, Wang Xinliang. Clinical analysis of acupuncture at auricular points and plum blossom for primary dysmenorrhea [J]. China Acupuncture, 2010, 30(2):125-128.

Wang Hongwei, Deng Huaizhong, Wu Xiaoliang. Clinical study of "one-time-divided" acupoint application therapy on cervical headache [J]. China Acupuncture, 2010, 30(2):117-120.