S:ShamR:Real Real Moxibustion Sham Moxibustion SBF Temp Pain SBF Temp Pain 5 0 50 30 Max None 5...

Functional　 Characteristics of　 a　 Newly DevelopedSham　 Moxibustion for　 the　 Clinical　 Research

Kawakita K1, Sakai S2, Nakazono Y3,

Kawase S4 and Oshitani T4

1Meiji University of Oriental Medicine, 2 Research

Institute of Oriental Medicine,３Kagoshima School

　 　 of　 Acupuncture, 4Senefa Corporation.

　 Introduction　 　

　　 Moxibustion　is　an　important　and　useful　procedurein　 the　 traditional　 Chinese　 medicine.　 To　 evaluatethe specific effect of moxibustion precisely, shamprocedure is required. In this study the functionalfeatures of a newly developed sham device werecompared with those of real moxibustion (indirectburning　 of　 the　 columnar moxa　 on　 the　 skin).

　 Methods 　 　 Real or sham moxibustion was randomlyapplied to the forearm skin of healthy subjects whogave informed consent. The skin temperaturebeneath the moxibustion was measured by athermo-couple with a time constant of 0.1s, (IT-18,DAT-12, Physitemp Instrument INC).　 The evokedpain magnitude was evaluated by cross-modalitymatching by a hand-made slide resister. The skinblood flow (SBF) nearby moxibustion site wasmeasured by a laser Doppler flow meter　 (ALF-21,Advance).

　 Results-1

　 The shape and flavor during burning were similarand it was not easy to discriminate sham devicefrom the real moxibustion (Fig. 1). The peaktemperature of real one was 46.7± 3.04℃ (mean± SD, n=15) and that of sham was 35.5± 0.87℃.　 The real moxibustion produced sharp pain andincrease of SBF accompanied with clear flareresponse (Fig.2).　 On the other hand, the shammoxibusion induced only warm sensation andpain and the increment of SBF and flare were notdetected.

　 Results-2

　 　 Figure 3 shows typical examples of the changesin SBF, monitored skin temperature (Temp) and painmagnitude induced by real and sham moxibustion.Figure 4 is a summary of the changes of Temp by thereal and sham moxibustion, and Fig. 5 is those ofSBF. Note that increase of SBF occurred slowly.Repetitive application of moxibustion inducedprolonged increase of SBF and after-effect lasted forseveral ten min (Fig.6).

Discussion:

　 　 Moxibustion　 is　 an　 important　 procedure　 oftreatment.　 In　 this　 study,　 moxibustion　 inducesthe　increase　of　skin　blood　flow　and　flare　response.The　flare　response　is　also　produced　by　acupunctureand　is　considered　to　be　the　result　of　antidromicexcitation　of　 the　polymodal　 receptor.　We　haveproposed　a　working　hypothesis　that　acupunctureand　moxibustion　stimulate　a　common　 receptor,the　polymodal　receptor,　and　it　produces　variouseffects　 on　 the　 bio-regulatory　 systems　 (Fig.7).　 More　researches　on　moxibustion　are　requiredto　examine　the　hypothesis　and　the　sham　devicemay　 be　 useful　 for　 the　 concrete　 study.　 　 　 　

　 Conclusion

　 Real moxibustion induced clear increase of SBFand flare response, whereas no such response wasobserved by sham device. It　 is　suggested　 that　 thesham device in the present study may be useful toolfor the clinical research of moxibustion.

S:Sham R:Real

Fig.1 Real and Sham Devices for Moxibustion Columnar moxa is put on the round thick plate with a small hole.

Fig.2　 Flare produced by　 a　 real moxibustion A　black sensor is that of the　 laser Doppler flow meter.　A　clearround flare　 is　 observed　 left　 side of　 the　 sensor.

Real　Moxibustion

Sham　Moxibustion

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Effect of Moxibustion on Skin Temperature

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Time (min)

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Effect　of　Moxibustion　of　Skin　Blood　FLow

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　 Polymodal 　 Receptor 　 Hypothesis 　　

PolymodalReceptor

Bio-regulatory　 SystemsEndogenous　 pain　 inhibition,　autonomic　 and　 endocrine　

systems

Acupuncture(mechanical)

Moxibustion(thermal,chemical)

Responsive　 to　mechanical,thermal　 and　 chemical　 stimuli

Free　 nerve　 endings

Flare　 &　 wheal (axon　 reflex)

Sensitized　 polymodal　 receptor　 is　 candidate　 of　the tender,　 trigger　 and　 acupuncture　 point　

Distributes to the skin, muscle and viscera of entire body

Fig.4　 Effect of Moxibustion on Skin Temperature　　　　　　　　　　　 Data　 are　 shown　 as　 the　mean　 and　 SD　　　　

Fig.3 Changes in Skin Blood Flow, Skin Temperature and Pain Magnitude by Real and Sham Moxibustion SBF:skin blood flow, Temp: skin temperature

Fig.5　 Effect　 of　Moxibustion　 on　 Blood　 Flow　　　◆： Real Moxibustion; ■： Sham　Moxibustion　　　　 Skin　 Blood　 flow　 is　 shown　 as　ml/min/100g

Fig.6 Repetitive Application of Moxibustion 　　 on　 Skin Blood Flow and Pain Magnitude

SBF:Skin blood flow; Temp: Skin temperature; Pain: Magnitude of Pain

　　　　Fig.7 Polymodal Hypothesis of Acupuncture and Moxibustion