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, 14 (12), e0226304
eCollection

Physiological Impact of Nanoporous Acupuncture Needles: Laser Doppler Perfusion Imaging in Healthy Volunteers

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Physiological Impact of Nanoporous Acupuncture Needles: Laser Doppler Perfusion Imaging in Healthy Volunteers

Koh-Woon Kim et al. PLoS One.

Abstract

Background: Recently, porous acupuncture (PA), which is anodized to increase its surface area for higher stimulation intensity, was developed and showed significantly improved therapeutic effects with more comfort as compared with original acupuncture (OA) in vivo. However, the impact of PA on the change of local blood flow as well as its efficacy and acceptability has not yet been confirmed in a clinical trial. In a randomized, controlled crossover clinical trial, we investigated the effects of PA on the change in local blood flow using laser Doppler perfusion imaging and considered the sensation of pain intensity and discomfort severity using a visual analogue scale (VAS) to explore its physiological impact and the possibility of PA in clinical use.

Methods: Twenty-one healthy participants were randomly treated with PA or OA on one side of Zusanli (ST36) and each participant served as his or her own control. Baseline local blood flow and galvanic skin response (GSR) were obtained for 5 min and acupuncture interventions were subsequently performed. Next, local blood flow and GSR were subsequently obtained for 10 min after insertion, 10 min after manipulation, and 5 min after the withdrawal of acupuncture. At the end of the experiment, participants were asked to indicate the sensation of pain intensity at each session of insertion, retention, manipulation, and withdrawal as well as the overall pain intensity and discomfort severity.

Results: PA significantly increased the local blood flow as compared with OA and there was no significant difference in GSR between patients treated with PA versus OA in each phase of insertion and manipulation. No significant difference in pain intensity or discomfort severity was found during manipulation, retention, or withdrawal of acupuncture.

Conclusions: These results indicate that PA increases local blood flow, which can be closely related to the observed enhanced performance, without any associated discomfort or pain, suggesting its applicability in clinical practice.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. The schematic diagram of the experiment.
Study flow (a). After recruitment, participants were randomly allocated into four groups. e.g., five participants were acupunctured with PA on the left side first and, after 30 minutes, with OA on the right side. Flow of each session (b). Participants received an explanation of this experiment, signed the consent form, and filled out the case report form. After a five-minute rest, laser Doppler perfusion imaging and GSR were set and measured for 30 minutes: five minutes for baseline, 10 minutes after the insertion of acupuncture, 10 minutes after manipulation at 2 Hz for 30 seconds, and five minutes after the withdrawal of acupuncture. Manipulation techniques were performed as tonifying and reducing, which involved bidirectional rotation. OA, ordinary acupuncture; PA, porous acupuncture; L, left; R, right; INS, insertion; MAN, manipulation; WITH, withdrawal.
Fig 2
Fig 2. Practical experiment photo.
Laser Doppler perfusion imaging was focused on the subject’s left ST36 acupoint (a). Retention of acupuncture needles of PA (b) and OA (c). Laser Doppler perfusion imaging was estimated within the square region (3.5 × 3.5 cm). Manual rotation of acupuncture needles of PA (d) and OA (e). OA, ordinary acupuncture; PA, porous acupuncture.
Fig 3
Fig 3. Surface of PA and OA by high resolution scanning electron microscope.
Schematic diagram showing the electrochemical anodization step of PA (a). Surface of OA (b). Normal and magnified surface of PA (c). Scale bar represents the 5 μm and 1 μm each. OA, ordinary acupuncture; PA, porous acupuncture.
Fig 4
Fig 4. Changes of skin blood perfusion over time.
The changes of PU from baseline per minute were compared by paired t-test. ** p < 0.01, and *** p < 0.001 between PA and OA. Values presented as means ± standard deviations. OA, ordinary acupuncture; PA, porous acupuncture; PU, perfusion unit; INS, insertion; MAN, manipulation; WITH, withdrawal.
Fig 5
Fig 5. The exemplary blood perfusion imaging in each session (Subject #7) and the changes of skin blood perfusion by session.
Blood skin perfusion imaging in each session of PA (a) and OA (b). The bar on the right represents the blood perfusion unit by color bar. The scale bar below = 350 mm. The mean changes of perfusion unit from baseline for each session were compared by paired t-test (c). *** p < 0.001 between PA and OA. Values presented as means ± standard deviations. OA, ordinary acupuncture; PA, porous acupuncture; PU, perfusion unit; BASE, baseline; INS, insertion; MAN, manipulation; WITH, withdrawal.
Fig 6
Fig 6. The changes of pain ratings by session.
The differences of VAS pain intensity in each session and in the overall session. Values presented as means ± standard deviations. OA, ordinary acupuncture; PA, porous acupuncture; PU, perfusion unit; VAS, visual analogue scale; INS, insertion; RET, retention; MAN, manipulation; WITH, withdrawal.
Fig 7
Fig 7. Changes of GSR in the PA and OA groups.
The GSR was measured at baseline (five minutes) and after insertion (10 minutes), manipulation (10 minutes), and withdrawal (five minutes) of the PA or OA needle. Values presented as means ± standard deviations. OA, ordinary acupuncture; PA, porous acupuncture; BASE, baseline; INS, insertion; MAN, manipulation; WITH, withdrawal.

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Grant support

This research was supported by grants from the National Research Foundation of Korea, funded by the Korean government (2017R1A2B4009963), and the Korea Institute of Oriental Medicine (grant K18182) given to H.J.P. and by grants of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare (HI17C1357), given to S.I.I. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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