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Friday, February 24, 2012

Neuromodulation in the Gut: Part II

Dr. Takahashi was kind enough to send me PDF of his paper discussed here.
It is a comprehensive look at the research, both animal and human, involved in acupuncture neuromodulation of the gastrointestional tract. There were many interesting tidbits, but I'll stick to the most usable ones, and the results pertaining to HRV (my area of interest.)
Electroacupuncture at Stomach 36 stimulates gastric motility. This is fascinating to me because when I was getting my acupuncture training, my teachers insisted that this point was contraindicated in someone dieting. The science confirms this teaching.
Acupuncture on the abdomen inhibits gastric motility. This is also of interest since the traditional treatment for profuse, watery diarrhea is moxa at the umbilicus. Takahashi reports that electroacupuncture at Stomach 25 inhibits gastric emptying.
Electroacupuncture at St36 and PC6 accelerates gastic emptying and increases the regularity of gastice slow waves in the stomach.
Electroacupuncture at St36 decreases the LF/HF HRV ratio in rats, suggesting that the gastric responses are mediated via the vagus nerves.
Electroacupuncture at St25 increases the LF/HF ratio in rats.

So what does this all mean? LF/HF ratio is a proxy for the subjects' stress repsonse. When LF/HF decreases, that means stress response is lowered. So it would make sense that if you're encouraging gastric emptying, you're encouraging the restorative arm of the autonomic nervous system, not the excitatory or "flight or fight" arm. Indeed, alert readers will recognize that the point combination of St36 and PC6 is the combination recommended to treat hypertension by Longhurst et al. (Personally, I can't imagine doing electroacupuncture at PC6, ouch!)

One other anecdote to share. In my poster for the ISAMS I charted one particular case where I was treating a patient for PCOS (Polycystic Ovary Syndrome.) The Stener-Vitorin protocol calls for strong electroacupuncture (2 HZ) on the abdomen at CV3 and CV4 and St25. My HRV monitoring showed an increase in LFR/HFR (increase stress response) with each treatment. When I stopped the electroacupuncture in an attempt to improve the stress response, the LFR/HFR decreased. Okay. Interesting and this is in line with the studies outlined here.
But even MORE interesting is that I've been treating a patient for intractable insomnia (many years duration.) She also has PCOS. She had been getting some benefit from the acupuncture treatments, but then I added in the electroacupuncture for the PCOS and she lost any of the calming benefit of the acupuncture. She figured this out and when she mentioned it to me, I remembered the previous case that I had presented at the ISAMS. We stopped doing the electroacupuncture and hopefully she'll get the improved response.

More information on my practice here.

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