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AKUPUNKTUR ile İMMÜNMODÜLASYON MÜMKÜN MÜ?. Uz.Dr. Hasan Ali Nogay Sualtı ve Hiperbarik Tıp Uzmanı Akupunkturist HİPEROX Özel Ayak Sağlığı ve Zor Yara Hiperbarik Oksijen Tedavi Merkezi ANTALYA. AKUPUNKTUR. “ Doğru Nokta”yı bulmak sanatıdır

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akupunktur ile mm nmod lasyon m mk n m

AKUPUNKTUR ile İMMÜNMODÜLASYONMÜMKÜN MÜ?

Uz.Dr. Hasan Ali Nogay

Sualtı ve Hiperbarik Tıp Uzmanı

Akupunkturist

HİPEROX Özel Ayak Sağlığı ve Zor Yara

Hiperbarik Oksijen Tedavi Merkezi

ANTALYA

slide3

AKUPUNKTUR

“Doğru Nokta”yı bulmak sanatıdır

O kişi için-O zaman-Doğru nokta

Yeditepe Akupunktur 02.02.08

slide4

İMMÜNOLOJİ ve ENTEGRATİF TIP

Modern Tıp-Holistik Tıp

  • Antibiotic:

Against Life=not against microbes

Ne zaman ENTEGRATİF tıptan faydalanalım?

    • Ayırıcı Teşhis-Tedavi-takip (MR,Lab vs)
      • Nabız,Dil,Kulak,Refleksoloji,Bioenerji,İridoloji

Kinezyoloji

Yeditepe Akupunktur 02.02.08

slide5

İMMÜNOLOJİ ve ENTEGRATİF TIP

Modern Tıp-Holistik Tıp

Diyabetik Ayak

  • Diyabet Regülasyonu :
    • HbA1C, İnsülin,Direnç önleme (Metformin)
  • Antibiotik (Antibiyogram şart)
  • Hiperbarik Oksijen Tedavisi
  • Yara bakımı
  • Multidisipliner yaklaşım
  • Hasta eğitimi

Yeditepe Akupunktur 02.02.08

akupunktur un etki mekanizmas yla ilgili teoriler
Akupunktur’un etki mekanizmasıyla ilgili Teoriler
  • İmmünite teorisi
  • Endorphin teorisi
  • Neurotransmitter teorisi
  • Dolaşım teorisi
  • Kapı kontrol teorisi
  • Motor Kapı Teorisi
  • Homeostasiz teorisi

Yeditepe Akupunktur 02.02.08

mm nmod lasyon 1
İmmünmodülasyon(1)
  • BALB/c Farelerde anteriyör tibial kaslarında yer alan St-36 noktasına üç gün günde 30 dakika olmak üzere uygulanan elektro akupunktur sonunda dalak Natural Killer(NK) hücrelerinin aktivitelerinin belirgin olarak arttığı tespit edilmiştir.

Yeditepe Akupunktur 02.02.08

mm nmod lasyon 2
İmmünmodülasyon (2)

Bir çalışmada tedavi edilen hastaların %45’inde 30 dakika, %100’ünde ise 24 saat sonra monosit fagositozu artmıştır

Yeditepe Akupunktur 02.02.08

mm nmod lasyon 3
İmmünmodülasyon (3)
  • Akupunktur Li4+St36 tedavisinden 30’ sonra hastaların %80’inde CD3,CD4 veCD8 belirgin artış göstermiş ve artış yüksekliği 24 saat devam etmiştir,
  • Bu vakaların %80’inde beta-endorfin düzeyleri de yükselmiş ve 24 saat yüksek kalmıştır.

Yeditepe Akupunktur 02.02.08

mm nmod lasyon 4
İmmünmodülasyon (4)

X ışınlarına tabii tutulan kişilere akupunktur uygulandığında düşen total lökosit, lenfosit ve nötrofil sayılarında artış olmaktadır

Yeditepe Akupunktur 02.02.08

mm nmod lasyon 5
İmmünmodülasyon (5)

St36-Li11ve CV6 noktaları kullanıldığında IL-2 seviyeleri ve NK hücre aktiviteleri normal gruba göre düşük olan malignan tümörlü hastalarda 10 günlük tedaviden sonra bu parametrelerde anlamlı derecede artış görülmüştür.

Yeditepe Akupunktur 02.02.08

slide12
[Effect of acupuncture on interleukin-2 level and NK cell immunoactivity of peripheral blood of malignant tumor patients]

Wu B, Zhou RX, Zhou MS.

First Affiliated Hospital, Huaxi Medical University, Chengdu.

This paper deals with the observation of acupuncture therapy affecting

interleukin-2(IL-2) level and natural killer (NK) cell immunoactivity

in the peripheral blood of patients with malignant tumors.

In this clinical-laboratory test research,

randomized double blind method was used.

The patients were divided into an acupuncture treated group (n = 25)

and a control group (n = 20). The former group was treated using points,

ST36,LI11,RN6 and locations of symptomatic points bilaterally.

They received one treatment of 30 minutes daily for 10 days.

The results showed that the IL-2 level and NK cell activity were lower

than normal in patients with malignant tumor, but there was an increase

in the acupuncture group after 10 days of treatment.

Significance was found to be remarkable (P < 0.01).

The difference between the two groups was also significant (P < 0.01).

This increase might be related to the mechanism of acupuncture

that adjusting the body's immune function. Thus, acupuncture therapy

could enhance the cellular immune function of patients with

malignant tumors and providing a beneficial effect in anti-cancer treatment.

Yeditepe Akupunktur 02.02.08

effect of acupuncture on immunomodulation in patients with malignant tumors
[Effect of acupuncture on immunomodulation in patients with malignant tumors]

Wu B, Zhou RX, Zhou MS.

First Affiliated Hospital, West China University of Medical Sciences, Chengdu.

Forty patients were divided randomly into two groups, 20 for each. One group treated with acupuncture and the other one for control.

The acup. group was treated using points PC6, LI4, ST36, RN4 and location of symptomatic points bilaterally, one treatment of 30 min daily for 10 days.

The results showed that there were increased levels of CD3+, CD4+ percentage, CD4+/CD8+ ratio and radioimmunoassay of beta-EP in blood plasma, a decreased level of SIL-2R after acup. The statistical significance was found to be remarkable (P < 0.01), so has a notable difference, the correlation analysis indicated: (1) there was a positive correlation between beta-EP and T-lymphocytes subgroups; (2) a negative correlation between beta-Bp and SIL-2R, so did it between T subgroups and SIL-2R.

Results showed that acupuncture has the effect of enhancing the cellular immunity of patient with malignant tumor.

PMID: 8758833 [PubMed - indexed for MEDLINE]

Yeditepe Akupunktur 02.02.08

effects of acupuncture on immunoglobulins in patients with asthma and rheumatoid arthritis
Effects of acupuncture on immunoglobulins in patients with asthma and rheumatoid arthritis

The effects of acupuncture on immunoglobulins in patients

with asthma and rheumatoid arthritis were studied.

After acupuncture, in 20 patients with asthma,

IgG increased (P < 0.01), IgM and IgE decreased (both P < 0.01),

while IgA did not change markedly (P > 0.05);

in 12 patients with rheumatoid arthritis, after acupuncture

IgG, IgA and IgM decreased (P < 0.05, 0.05, and 0.01, respectively),

while IgE did not change evidently.

The results observed in these 32 patients indicate that

acupuncture exerts modulation action on immunoglobulins

of the human body, and that patients with

asthma and rheumatoid arthritis responded effectively

to acupuncture therapy, the latter might be related to

the reinforcement of the immunological function by acupuncture.

Yeditepe Akupunktur 02.02.08

slide15

Factors that influence the applicability of sham needle in acupuncture trials: two randomized, single-blind, crossover trials with acupuncture-experienced subjects.

METHODS: (a LI-4 trial and a BL-23 trial).

The subjects received two sessions of different stimulations in each trial.

A Park Sham Needle was used in one session,

a genuine acupuncture needle in the other.

RESULTS: In the LI-4 trial, all of the 21 subjects (100%)

felt penetration with the genuine needle,

but only 7 of the 20 subjects (35%) felt a similar sensation

with the sham needle (P=0.0002).

Fifteen of the 21 subjects (71%) felt a dull sensation with the genuine needle,

but only 4 of the 20 subjects (20%) felt a similar sensation

with the sham needle (P=0.01). In the BL-23 trial,

14 of the 20 subjects (70%) felt penetration with the genuine needle

and 10 of the 20 subjects (50%) felt "penetration" with the sham needle (P=0.39).

Eight of the 20 subjects (40%) felt a dull sensation with the genuine needle

and 2 of the 20 subjects (10%) did with the sham needle (P=0.109).

CONCLUSIONS: Potential factors that influence the applicability of

"placebo" needling include not only inter-tester variability

but also the patient's knowledge and experience of acupuncture,

acupuncture point selection, the visual impact of needling, and so on.

Clin J Pain. 2006 May;22(4):346-9.

Yeditepe Akupunktur 02.02.08

characterization of the deqi response in acupuncture
Characterization of the "Deqi" Response in Acupuncture.

Acupuncture stimulation elicits deqi, a composite of unique sensations

that is essential for clinical efficacy according to traditional Chinese medicine (TCM).

METHODS: Manual acupuncture was performed at LI4, ST36 and LV3

on the extremities in randomized order during fMRI

in 42 acupuncture naive healthy adult volunteers.

RESULTS: The deqi response was elicited in 71% of the acupuncture procedures

compared with 24% for tactile stimulation when thresholded

at a minimum total score of 3 for all the sensations.

The frequency and intensity of individual sensations were

significantly higher in acupuncture. Among the sensations typically

associated with deqi, aching, soreness and pressure were most common,

followed by tingling, numbness, dull pain, heaviness, warmth, fullness and coolness.

The study provides scientific data on the characteristics of the

'deqi' response in acupuncture and its association with distinct nerve fibers.

The findings are clinically relevant and consistent with modern concepts

BMC Complement Altern Med. 2007 Oct 31;7(1):33

Yeditepe Akupunktur 02.02.08

li 4 noktas
Li- 4 noktası
  • Kalın barsak noktası analjezik amaçlı olarak iğnelenmişitir.
  • Sürekli ağrısı olmayan 134 gönüllü üzerinde yapılan çalışmada deneklerin 11’inden de qi hissi alınmış, bu 11 kişide fMRI’de somatosensoriyel kortekste sinyal artışı izlenmiştir.
  • Nükleus accumbens, amigdala, hippocampus,hipotalamus, ventral tegmental saha, insula,ve anteriyör cingulate’te sinyal azalması görülmüştür.(Yani limbik sistem ağrı işlevinde görev almaktadır).
  • İki denekte ağrı hissi uyandırılınca anteriyör singulate ve insula aktivitelerinde artma oluşturmuştur.
  • Hui et al (2000) Human Brain Mapping, 9, 13-25.
  • Replication in Wu et al Radiology 1999 Jul;212(1):133-41 using LI 4 and St 36

Yeditepe Akupunktur 02.02.08

fmri ve akupunktur
fMRI ve akupunktur
  • Ayakta bulunana gözle ilgili akupunktur noktaları (UB-60-67) uyarılınca visual kortekste gerçek

(vizüel) görme stimulusu gibi

aktivasyon oluşturmuştur,

  • Ayakta akupunktur noktası olmayan yerlerin iğnelenmesiyle oksipital loplarda aktivasyon izlenmemiştir.
  • Cho et al (1998). Proceedings of the National Academy of Science, 95, 2670-2673.

Yeditepe Akupunktur 02.02.08

li 4 hegu thalamus noktas
Li- 4 (Hegu=Thalamus) noktası

Analjezik etkisi en baskın olan etkisidir:

St44 ile birlikte şiddetli ağrılarda çok etkindir.

  • Sedatif etkisi:

GV20; H7; UB 62 ile birlikte.

  • Homeostatik etkisi: Li11; St36; Sp6
  • İmmünmodülatör etkisi: GV14; Li11; St36; Sp6 ile
  • Vazodilatasyon : Tw5 ile

Yeditepe Akupunktur 02.02.08

st36 zusanli
St36 (Zusanli)

Li4 ile birlikte Staph. aureus’un Nötrofiller ile FAGOSİTOZU 2 kat artmıştır:

  • Endokrin etkisi:

Li4 ile birlikte ACTH artmış; eozinofiller azalmıştır.

  • Homeostatik etkisi: Li11; Li4; Sp6 ile eritrositler artar ve ESR düşer
  • İmmünmodülatör etkisi: GV14 ve Li4 ile nötrofiller %20-50 oranında artmıştır.
  • Li11 ile beraber NK ve IL2 aktivitesini artırdığı gösterilmiştir
  • T lenfositleriniLi4 ve Sp6 ile beraber artırmış.
  • Serum elektroforezinde Gama-Globulin artışı (antikor yapımı)
  • Solunum sistemine etkisi: Solunum kapasitesi % 20 artmıştır.

Yeditepe Akupunktur 02.02.08

slide21

Confluent Points(Ba Mai Jiao Hui Xue)Synonyms:Tuning points, Cardinal PointsAyar noktaları

Yeditepe Akupunktur 02.02.08

kard nal noktalar psikon roimm nreg lasyon
KARDİNAL NOKTALARPsikonöroimmünregülasyon

Si 3 (Du Mai)

0 Retro-Coeliac

BI 62 (Yang Qiao Mai)

Pineal-Epifiz bezi

Lu 7 (Ren Mai)

Akciğer alanı

Ki 6 (Yin Qiau Mai)

Diazepam

P 6 (Yin Wei Mai)

Stellat ganglion

GB 41 (Dai Mai)

PGE1 noktası

Sp 4 (Chong Mai)

İnterferon

SJ 5 (Yang Wei Mai)

Timus

Yeditepe Akupunktur 02.02.08

tw5 sj5 t mus romatizmal hastal klarda master
Tw5=SJ5=TİMUS Romatizmal hastalıklarda Master

Kulaktaki yerleri

Timus SJ5 :T3-4 düzeyinde

İnsülin SJ4 :T10-12 düzeyinde

Kortizon SJ3 :T12-L1 düzeyinde

Tiroid SJ6 :C6-7 düzeyinde

Paratiroid SJ7:C5-6 düzeyinde

Yeditepe Akupunktur 02.02.08

slide24

Romatoid

Artritte GB41

PGE1

Yeditepe Akupunktur 02.02.08

si3 genel mukoza uyar c dumai gv i in kardinal
SI3-Genel Mukoza UyarıcıDumai=GV için Kardinal

Si3-Li3 : immünstimülan etkiyi uyarır

Si3-Bl62: Psikonöroimmün uyarı

Yeditepe Akupunktur 02.02.08

interferon sp4 ve histamin bl40
Interferon (SP4) veHistamin (BL40)

Histamin-Alerji

Shen men

Ayak alerji

Timus

İnterferon

Valium(K6)

Epifiz

?

?

Alerji

B40

Ayak

Alerji

Shen men

Dalak

Timus

TW5

İnterferon

Sp4

Valium

K6

Epifiz

B62

Yeditepe Akupunktur 02.02.08