Kuliah 2 Accupuncture

8/11/2019 Kuliah 2 Accupuncture

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Fakultas kedokteran dan Ilmu Kesehatan,

Universitas Muhammadiyah Yogyakarta.

Outlines

Theory of medical acupuncture

Safety acupuncture


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Theory of Medical

Acupuncture


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Definition

Acupuncture can be defined as thestimulation of a certain point orpoints on the surface of the body, by

the insertion of needles, to prevent ormodify the perception of pain tonormalize physiological functions,

including pain control, for thetreatment of certain diseases


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Most acupuncture studies haveconcentrated in analgesia (Mann, 1973)

Blocking of nociception Endogenous opioid must be the

mechanism of acupuncture pain control

Acupuncture as a neuromodulating inputinto CNS that can activate multipleanalgesia systems in the spinal cord andbrain

Stimulating the endogenous painsuppresion system to releaseneurotransmitter

Filshie, J. Medical Acupuncture 1998


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Anonymous, The miracle of acupuncture,1993

When a nerve is blocked by local anesthetic,acupuncture is ineffective in the territorysupplied by that nerve

Acupuncture effect is conducted along the nerve(Cheng, 1973)

309 acupoints : on or very closed to nerves 286 acupoints : on or very closed to major blood

vessels

Sympathetic nerve also be involved (Goulden1921)

many acupoints correlate closely with triggerpoints (Travell & Simon1983), correspond withmotor points of muscles (Liu, Varela & Oswald1977)


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Acupoints

A researcher by the name of Niboyet wrote of a correlation

between acupoints and lowered skin electrical resistance in the

1940s and 1950s. The points followed the traditional Chinese

channel pattern: they were symmetrical, except those along the

bodys midline.

In 1962, another researcher by the name of Grall supported

Niboyets hypothesis with similar findings on the face and

forearms. Studies performed by Rabischong and Bossy in 1975

concluded that the lowered electrical resistance was dependenton moisture and electrolytes (and not entirely on an intact

nervous system) by their work on fresh cadavers.


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Channels

In an attempt to trace the channels, a

researcher by the name of Darras injected

technitium99 into acupuncture points and non-

acupuncture points. The radioisotope diffusedfrom the acupoints in a topographical pattern,

mimicking the traditional channel paths. The

tracer that had been injected into non-

acupoints diffused in a centrifugal pattern.


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Universitas Muhammadiyah Yogyakarta.WHO, Standard Acupuncture Nomenclature, 1993


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Acupuncture biomoleculer model

Acupoint Organ

Meridian

Primary stimulus Spesific path Spesific effects

Active cell Electron current Morphofunctional

In acupoint Material current

Concept of Concept of Concept of

Biochemical Intercelluler Stimulation and

Messenger Signaling Supression


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Copyright 2007Lippincott Williams & Wilkins


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Nociceptive Pathway

1. Transduction : mechanic, thermic orchemis stimulation change to electricactivities

2. Transmission : distribution of impuls insensoric pathway after transduction phase

3. Modulation : the interaction betweenendogenous analgetic system with paininput in posterior corn of medulla spinalis

4. Perception : end phase were someone cangive perception about pain


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Universitas Muhammadiyah Yogyakarta.Yun Taoma, Biomedical Acupuncture for Pain Management, 2005

Zang Hee Cho ResearchfMRI LI-4 (Hegu)


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Analgesic acupuncture

= Endogenous Opionid Substances

1. Endorphine

2. Enkephaline

3. Dinorphine


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Analgesic Acupuncture

1. Hegu (L14) : EA 4 Hz in 30 minutes,

decrease pain in contralateral

mandibule

2. Neiguan (Pc 6) : EA in 30 minutes,

will give analgesic efek in thoracis

wall equal with morphine 3 mg/kgBB

sc


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Analgesic Acupunture

1. Zusanli (St 36) : EA 2 Hz in 30

minutes, decrease pain in epigastric

area.

2. Sanyinjiao (Sp 6) : EA stimulasi 2 Hz

in 30 minutes, decrease pain 67,8%

more than control group


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Acupunture pathophysiologi in

cancer

1. Increase humoral immune system

2. Increase endogenous morphine

decrease pain sensation3. Increase the production of blood

cells

4. Increase organ function (stomach,

large intestine, heart and lung)


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When can Acupuncture be Useful?

According to WHO:

Pain(chronic, surgical, arthritic, malignant, headache,backache).

Organic Lesions(cardiovascular, respiratory, GI, skin,

urological).

Neurological (peripheral & central).

Substance abuse(drugs, nicotine, food & alcohol).

Gynecological disorders

Psychiatric (depression & anxiety).

1Art of Acupuncture: 369KB


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Substance abuse
http://127.0.0.1:1818/9FF22http://127.0.0.1:1818/9FF23


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Filiform stainless steel needle : handle, tail,

root, body dan tip.

Tail : the part at the end of the handle

Handle : the part webbed with filigree

either of copper or stainless steel

Root : the demarcation line between

the body and the handle

Body : the part between the handle

and the tip

Tip : the sharp point of the needle


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Universitas Muhammadiyah Yogyakarta.10/12/2014 4:11AM

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Acupunture needle insertion

900 of insertion : most of acupoint

Oblique insertion : usually near

vesceral organ

45

0

skin surface Transversal insertion : thin muscle

face skin, anterior thoracis


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Fakultas kedokteran dan Ilmu Kesehatan,Universitas Muhammadiyah Yogyakarta.

Safety Acupuncture


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Safety acupuncture

Acupunture treatment is safe if be done by

someone who has trained dan competent

in medical acupunture

Incompetent terapist : high risk for medicalerror in needle insertion, contra indication,

complication etc


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Risk of acupuncture treatment

Infection transmission (HIV,

hepatitis)

Unpredictable reaction Needle : crooked and broken

Pain

Internal organ damage


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Contra indication :

Pregnancy : labour induction (hegu,

sanyinjiao, kunlun, dan zhinyin).

Medical emergency

In blood vessel

Spesific area (eye, umbilical, sex

organ) Baby vertex (mayor fontanella)


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Infection control :

Clean area

Hand-hygiene

Aseptic technique Sterile needle

Disposal of used needle and cutton

Single use needle (disposableneedle)


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Unpredicted reaction: Collaps

Cause of mental tension,

exhausted, powerful manipulation

(palpitation, vertigo, pale,sweating, cold extremities)

Stop insertion, lay down

Treat as medical emergency

di d i k


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Unpredicted reaction : Stuck

needle

Cause : muscular spasm,

powerful manipulation, wrong

manipulation

Stop manipulation, remove follow

the path dont remove directly

If broken : remove with forcep

di d i


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U i it M h di h Y k t

Unpredicted reaction :

haematoma

Cause : puncture blood vessel,

not suppresed after remove

needle

Will be disappear

Light massage, warm compres,

topical medicine

Kuliah 2 Accupuncture

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