Revealing the magic of acupuncture based on biological mechanisms: A literature review

Acupuncture represents one of the oldest therapeutic practices in the world, having been used for more than 3,000 years in China and other Asian countries to treat various health conditions. This ancient technique has gained increasing acceptance in the West and is recognized by the World Health Organization, which expanded its list of conditions treatable with acupuncture from 43 diseases in 1979 to 63 in 1996. Currently, 103 of the 194 WHO member countries use acupuncture as a treatment, demonstrating its growing importance in healthcare systems worldwide. The technique consists of inserting fine needles through the skin at specific points on the body, known as acupuncture points, located along meridians according to traditional Chinese theory, with the goal of improving the body's energy flow and maintaining overall health.

The objective of this scientific review was to investigate and describe the biological mechanisms through which acupuncture exerts its therapeutic effects in four common clinical conditions: chronic low back pain, ischemic stroke, depression, and irritable bowel syndrome. The researchers conducted a narrative review of the scientific literature, analyzing basic and clinical studies published in the last two decades that investigated the molecular and physiological mechanisms of acupuncture. The methodology included identifying the acupuncture points most frequently used for each condition and analyzing evidence on how acupuncture influences specific biological processes such as inflammation, neurotransmitters, oxidative stress, and neural plasticity.

The results revealed that acupuncture exerts multiple therapeutic actions through complex and interconnected biological mechanisms. For chronic low back pain, the main points used include BL-23, BL-25, BL-60, GB-30, and KI-3, and the mechanisms involve anti-inflammatory action through the reduction of pro-inflammatory cytokines, relief of central sensitization through changes in neural plasticity of the primary somatosensory cortex, and regulation of ATP and adenosine metabolism. In the treatment of ischemic stroke, points such as GV-20, ST-36, LI-11, and GV-26 proved effective, with mechanisms that include promotion of neurogenesis through proliferation and differentiation of neural stem cells, reduction of neuroinflammation, inhibition of neuronal apoptosis, and regulation of oxidative stress. For depression, the most commonly used points are GV-20, EX-HN-3, LR-3, and HT-7, with mechanisms involving modulation of the hypothalamic-pituitary-adrenal axis, reduction of neuroinflammation, and restoration of hippocampal synaptic plasticity through the regulation of neurotransmitters such as serotonin and dopamine.

In irritable bowel syndrome, points such as ST-25, ST-36, CV-12, and SP-6 demonstrated efficacy through the relief of visceral hypersensitivity, modulation of the brain-gut axis, and regulation of the intestinal microbiota.

The clinical implications of these findings are significant for both patients and healthcare professionals. For patients, the results indicate that acupuncture offers a safe and effective therapeutic alternative for conditions that often present limitations with conventional treatment, such as chronic pain, post-stroke sequelae, medication-resistant depression, and functional gastrointestinal disorders. Acupuncture demonstrated the ability to modulate multiple biological systems simultaneously, offering holistic benefits that go beyond symptomatic relief. For healthcare professionals, this scientific evidence provides a rational basis for integrating acupuncture into treatment protocols, especially considering that many countries have already developed evidence-based clinical guidelines for the use of acupuncture.

Understanding the biological mechanisms also allows for more precise selection of acupuncture points and personalized treatment protocols for each clinical condition.

Despite significant advances in the scientific understanding of acupuncture, several important limitations must be considered. Most studies on biological mechanisms have still been conducted in animal models, requiring more clinical research in humans to confirm the findings. Standardization of acupuncture protocols remains a challenge, as different studies use variations in the selected points, stimulation techniques, and duration of treatment. In addition, the methodological quality of some clinical studies on acupuncture still presents limitations, including difficulties in implementing double-blind studies due to the nature of the intervention.

The complete integration of acupuncture into the Western medical paradigm still faces challenges related to the difference between the explanatory models of traditional Chinese medicine and evidence-based medicine. Despite these limitations, the growing body of scientific evidence demonstrates that acupuncture represents a promising therapeutic modality that deserves further investigation and consideration in modern clinical practice, offering patients a treatment option with a solid scientific basis and favorable safety profile.