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 Uz.Dr.Hasan Ali Nogay

O kişi için-O zaman-Doğru nokta AKUPUNKTUR “Doğru Nokta”yı bulmak sanatıdır O kişi için-O zaman-Doğru nokta Uz.Dr.Hasan Ali Nogay Yeditepe Akupunktur 02.02.08 Uz.Dr.Hasan Ali Nogay

İMMÜNOLOJİ ve ENTEGRATİF TIP Ne zaman ENTEGRATİF tıptan faydalanalım? 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 Uz.Dr.Hasan Ali Nogay Yeditepe Akupunktur 02.02.08 Uz.Dr.Hasan Ali Nogay

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 Uz.Dr.Hasan Ali Nogay Yeditepe Akupunktur 02.02.08 Uz.Dr.Hasan Ali Nogay

Akupunktur’un etki mekanizmasıyla ilgili Teoriler İmmünite teorisi Endorphin teorisi Neurotransmitter teorisi Dolaşım teorisi Kapı kontrol teorisi Motor Kapı Teorisi Homeostasiz teorisi Uz.Dr.Hasan Ali Nogay Yeditepe Akupunktur 02.02.08 Uz.Dr.Hasan Ali Nogay

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. Uz.Dr.Hasan Ali Nogay Yeditepe Akupunktur 02.02.08 Uz.Dr.Hasan Ali Nogay

İmmünmodülasyon (2) Bir çalışmada tedavi edilen hastaların %45’inde 30 dakika, %100’ünde ise 24 saat sonra monosit fagositozu artmıştır Uz.Dr.Hasan Ali Nogay Yeditepe Akupunktur 02.02.08 Uz.Dr.Hasan Ali Nogay

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. Uz.Dr.Hasan Ali Nogay Yeditepe Akupunktur 02.02.08 Uz.Dr.Hasan Ali Nogay

İmmünmodülasyon (4) X ışınlarına tabii tutulan kişilere akupunktur uygulandığında düşen total lökosit, lenfosit ve nötrofil sayılarında artış olmaktadır Uz.Dr.Hasan Ali Nogay Yeditepe Akupunktur 02.02.08 Uz.Dr.Hasan Ali Nogay

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. Uz.Dr.Hasan Ali Nogay Yeditepe Akupunktur 02.02.08 Uz.Dr.Hasan Ali Nogay

[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. Uz.Dr.Hasan Ali Nogay Yeditepe Akupunktur 02.02.08 Uz.Dr.Hasan Ali Nogay

[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] Uz.Dr.Hasan Ali Nogay Yeditepe Akupunktur 02.02.08 Uz.Dr.Hasan Ali Nogay

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. Uz.Dr.Hasan Ali Nogay Yeditepe Akupunktur 02.02.08 Uz.Dr.Hasan Ali Nogay

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. Uz.Dr.Hasan Ali Nogay Yeditepe Akupunktur 02.02.08 Uz.Dr.Hasan Ali Nogay

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 Uz.Dr.Hasan Ali Nogay Yeditepe Akupunktur 02.02.08 Uz.Dr.Hasan Ali Nogay

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 Uz.Dr.Hasan Ali Nogay Yeditepe Akupunktur 02.02.08 Uz.Dr.Hasan Ali Nogay

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. Uz.Dr.Hasan Ali Nogay Yeditepe Akupunktur 02.02.08 Uz.Dr.Hasan Ali Nogay

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 Uz.Dr.Hasan Ali Nogay Yeditepe Akupunktur 02.02.08 Uz.Dr.Hasan Ali Nogay

St36 (Zusanli) T lenfositlerini Li4 ve Sp6 ile beraber artırmış. 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 lenfositlerini Li4 ve Sp6 ile beraber artırmış. Serum elektroforezinde Gama-Globulin artışı (antikor yapımı) Solunum sistemine etkisi: Solunum kapasitesi % 20 artmıştır. Uz.Dr.Hasan Ali Nogay Yeditepe Akupunktur 02.02.08 Uz.Dr.Hasan Ali Nogay

Confluent Points (Ba Mai Jiao Hui Xue) Synonyms: Tuning points, Cardinal Points Ayar noktaları Uz.Dr.Hasan Ali Nogay Yeditepe Akupunktur 02.02.08 Uz.Dr.Hasan Ali Nogay

KARDİNAL NOKTALAR Psikonöroimmünregülasyon 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 Uz.Dr.Hasan Ali Nogay Yeditepe Akupunktur 02.02.08 Uz.Dr.Hasan Ali Nogay

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 Uz.Dr.Hasan Ali Nogay Yeditepe Akupunktur 02.02.08 Uz.Dr.Hasan Ali Nogay

Romatoid Artritte GB41 PGE1 Uz.Dr.Hasan Ali Nogay Yeditepe Akupunktur 02.02.08 Uz.Dr.Hasan Ali Nogay

SI3-Genel Mukoza Uyarıcı Dumai=GV için Kardinal Si3-Li3 : immünstimülan etkiyi uyarır Si3-Bl62: Psikonöroimmün uyarı Uz.Dr.Hasan Ali Nogay Yeditepe Akupunktur 02.02.08 Uz.Dr.Hasan Ali Nogay