The di-zhen (DZ) is an ancient type of acupuncture needle with a history dating back more than 2000 years. Unlike modern acupuncture needles, the DZ is not inserted subcutaneously, and is safely and commonly used at the bedside. The mechanisms underlying its effects are not known. In this study, we measured sublingual and cutaneous body temperature, pulse rate, oxygen pressure (PO 2), oxygen saturation (sO 2) and carbon dioxide pressure (PCO 2) before and after DZ application in 25 healthy male volunteers. Serum levels of catecholamines (adrenaline, noradrenaline and dopamine) and white blood cells (WBCs; ratio and number) were traced for one week. Soon after DZ application, pulse rate, body temperature, PO 2 and sO 2 all decreased. The serum levels of adrenaline and noradrenaline increased, indicating sympathetic dominance, and the number of granulocytes was elevated. One week after DZ application, the number of lymphocyte increased. We therefore suggest that DZ affects body temperature, pulse rate, catecholamine secretion and immune function by inducing transient sympathetic dominance via actions on the autonomic nervous system. These effects are similar to the effects observed with modern needles, which are inserted subcutaneously. Therefore, we consider DZ treatment to be advantageous and safe in modern clinical practice, especially in post-surgical and terminal care, as it avoids the issues with infection and tissue damage sometimes seen with modern acupuncture needles.
Findings from the Tyrolean Iceman, who had tattoos at acupuncture points along the Bladder Meridian, have been suggested to possibly reflect the ancient origin of acupuncture [
Twenty-five healthy male volunteers, 24 to 60 years of age, participated in this study. Written informed consent was obtained from all subjects and the study was approved by the institutional review board of Niigata University.
The DZ needles were made of stainless steel and had a column-like body and a flat head (Soken Medical Co. Ltd., Toshima, Japan). An autoclaved DZ was softly pressed vertically onto the body surface for 5 minutes (diameter 5.0 mm, 37.3 g/mm2) (
For measurement of body temperature and pulse rate before and after DZ treatment, the subjects were divided randomly into two age-matched groups. Half of the subjects (n = 13; 37.4 ± 12.6 years) received DZ application and the matched controls (n = 12; 37.8 ± 13.7 years) received no treatment. For measurements other than body temperature and pulse rate, six randomly selected subjects (34.5 ± 10.9 years) received DZ treatment and were compared to six age-matched controls (33.1 ± 14.3 years).
Core temperature (sublingual) was measured with a clinical mercury thermometer (FAVOR, Nihon Keiryoki Kogyo Co. Ltd., Chiyoda, Japan) before and after DZ application. The cutaneous body temperature was measured using a contactless digital thermometer (Microlife, IR 1DA1, microlife, Switzerland) before and after DZ at five locations: Yintang (on the forehead, mid-way between the medial ends of the eyebrows), LI4 (Hegu; on the dorsum of the right and left hands, radial to the mid-point of the second metacarpal bone), LR3 (Taichong; on the
dorsum of the right and left feet, between the first and second metatarsal bones, in the depression distal to the junction of the bases of the two bones, over the dorsalis pedis artery) (
Fresh venous blood was obtained before and after the DZ application for the measurement of PO2, SO2, PCO2 and hemoglobin, using i-STAT 300 F (i-STAT Corporation, East Windsor, NJ, USA) as previously described [4-7]. WBCs were measured using a hemocytometer and the May-Grünwald Giemsa stain method. Concentrations of catecholamines (adrenaline, noradrenaline and dopamine) were measured by high-performance liquid chromatography (SRL, Inc., Tokyo, Japan). Additionally WBCs and catecholamines were examined at one week after DZ application.
The statistical significance of differences between values was tested using paired t-tests or repeated-measures two-factor ANOVA and a Bonferroni/Dunn post-hoc test. P values of less than 0.05 were considered to be statisticcally significant.
Pulse rate and sublingual body temperature were measured before and soon after DZ application. The pulse rate showed a prominent decrease after DZ application (from 71.4 ± 4.7 to 66.2 ± 5.4 /min, P < 0.05), but the body temperature did not change significantly (36.8 ± 0.3 versus 36.6˚C ± 0.4˚C, P > 0.05). No changes were seen in the control group (
Because a drop in pulse rate might affect blood circulation and thereby cause a decrease in the oxygen content of venous blood, we measured oxygen and carbon dioxide pressure (PO2 and PCO2) and oxygen saturation (SO2). We found that PO2 and sO2 both decreased significantly after DZ application (28.9 ± 10.9 to 19.4 ± 10.5 mmHg, P < 0.05; and 46.8% ± 9.4% to 24.8% ± 9.1%, P < 0.05, respectively). These changes tended to recover within 60 minutes after DZ application; however, this apparent return to baseline was not statistically significant owing to high inter-subject variability (data not shown). Neither PCO2 nor Hb showed any prominent changes. In the control group, no changes were observed in any of the parameters (
It has been reported that rapid changes in core temperature is associated with changes in cutaneous blood flow mediated by the autonomic nervous system (ANS) [
changes were not statistically significant (P > 0.05) (
The levels of catecholamines are known to reflect the status of the ANS [9-11]; thus, these were measured before and after the DZ application. We found that the serum levels of adrenaline and noradrenaline were significantly elevated after DZ treatment (from 33 ± 7 to 39 ± 10 pg/mL, P < 0.05; and from 216 ± 69 to 306 ± 92 pg/mL, P < 0.05; respectively). Dopamine did not change significantly (
The above finding of an elevation in adrenaline and noradrenaline indicates dominance of sympathetic nervous activity. Mori et al. reported that electric acupuncture affected ANS status and had an immunomodulatory effect [
After DZ application the ratio of granulocytes appeared to increase (66% ± 6% to 61% ± 9%, P > 0.05) while that of lymphocyte tend to decrease though they were not
statistically significant (33% ± 6% to 37% ± 8%, P > 0.05) (
In a series of previous studies, we have found body temperature to be an important parameter in understanding metabolic conditions induced by changes in ANS activity and immune status [6,10,11]. The sublingual and cutaneous temperature decreased after DZ application though they were not statistically significant (Figures 2(a) and 3), while the levels of adrenaline and noradrenaline increased (
A continuous state of high sympathetic activity induces adaptive responses to maintain homeostasis [10,11, 14,15]. However, the responses caused by DZ application were transient, with recovery of the cutaneous hypothermia seen within 20 minutes (
DZ application induced a rapid change in the WBC profile. The number of lymphocytes did not change on the day of the application but showed a step-like elevation after one week (
We recently investigated the effect of skin rubdown with a dry towel (SRDT), which stimulated almost the same part of the skin [
In this study we have shown that the use of the 2000- year-old acupuncture needle DZ exerted effects on body temperature, pulse rate, catecholamine secretion and immune system function via ANS modulation. Moreover, although the DZ is not inserted subcutaneously like modern needles, the observed effects of DZ treatment were similar to effects of application of modern needles, which are inserted under the skin. Therefore, despite its ancient origins, DZ is useful in modern clinical practice, especially in the case of postsurgical care, infection and terminal stage care. As infection and tissue damage caused by subcutaneous insertion of acupuncture needles can be a problem [17,18], DZ application may provide a better solution that avoids these issues.
The authors thank Ms. Hiromi Ishiwatari (Soken Medical Co. Ltd.), Mr. Taiki Hashimoto and Ms. Kaori Yamamoto (Yushima-Shimizuzaka Clinic), Dr. Ryoko Fukuda (Fukuda Clinic), Dr. Takahiro Kobayashi and Urahigashi Veterinary Clinic for arrangement of the clinical research.