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A review of the role of nitric oxide (NO) signalling at acupuncture points outlines its important contributions to the specificity of the points themselves and the techniques used to stimulate them, both of which are important in traditional theories of how acupuncture works. NO is a major signalling molecule in the nervous and immune systems, and one of its most important effects is in the circulatory system as a vasodilator. Recent evidence shows that NO levels are elevated at acupoints and that this is associated with enhanced expression of the enzyme NO synthase in the local tissue. Acupuncture induces an elevation of NO release in the skin, and this elevated NO improves local circulation, which allows for the influx of substances that lead to pain relief and inflammation resolution. The review collates further evidence showing that heat treatment, gentle manual acupuncture and low frequency electro-acupuncture (EA), all of which which are traditionally used as tonifying methods, produce increased NO release over acupoints. However EA with higher frequency, a reducing method, causes inhibition of NO generation.

Nitric oxide signaling molecules in acupoints: Toward mechanisms of acupuncture. Chin J Integr Med. 2017 Nov;23(11):812-815.


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