Homeostasis—the dynamic equilibrium of the internal environment—is a core principle of physiology and a cornerstone of traditional Chinese medical thought. Disruptions in this balance, whether excessive or insufficient, can lead to disease. Conventional biomedical interventions often act directly on effector organs, sometimes bypassing endogenous feedback systems. In contrast, acupuncture has long been described as capable of restoring balance in opposite pathological states, a concept known as “bidirectional regulation.” However, this notion has often been applied broadly without sufficient mechanistic clarity. Based on these challenges or due to these unresolved questions, there is a need to conduct in-depth research into how acupuncture modulates physiological process.
Researchers from the Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, reported their findings (DOI: 10.13702/j.1000-0607.20250005) in May 2025 in the journal of Acupuncture Research. The study systematically analyzed experimental and clinical evidence to elucidate how acupuncture recruits autonomic and central regulatory circuitry to sustain homeostasis. By integrating neurophysiology, homeostatic theory, and clinical observations, the authors propose a refined model in which different acupoints activate distinct neural circuits, collectively contributing to the stabilization of physiological set points rather than producing contradictory effects through a single pathway.
The study demonstrates that physiological stability depends on bidirectional regulatory mechanisms comparable to opposing yet coordinated forces, such as sympathetic and parasympathetic activity. Acupuncture exerts its effects by engaging these mechanisms through somatic afferent inputs that converge on integration centers within the nervous system, including but not limited to the brain. Experimental evidence shows that stimulation of acupoints located in specific spinal segments can produce segmental sympathetic reflexes, while stimulation at other sites triggers systemic responses mediated by supraspinal centers.
Importantly, the research distinguishes between two functional modes of acupoint action. The first type, referred to as “homotopic acupoints,” exerts specific regulatory effects on target organs innervated by the same spinal segment through somatic–sympathetic–visceral reflex pathways. The second type, known as “heterotopic acupoints,” modulates organ function across spinal segments via somatic–parasympathetic–visceral reflexes. This framework explains why the same acupoint may appear to produce opposite clinical effects—such as alleviating both diarrhea and constipation—by acting on different target organs or regulatory loops. The findings also clarify why acupuncture often shows greater efficacy in conditions characterized by regulatory insufficiency rather than excessive pathological activity.
According to the study’s author, acupuncture should not be understood as a single stimulus producing inherently opposite outcomes. Instead, its effects emerge from structured interactions between somatic inputs and autonomic regulation. “Overextending the concept of bidirectional regulation risks obscuring the true biological logic of acupuncture,” the author noted. By grounding acupuncture theory in established neurophysiological principles, the study provides a clearer scientific basis for acupoint selection and challenges assumptions that have limited both experimental reproducibility and clinical interpretation.
This refined understanding of acupuncture’s regulatory mechanisms has important implications for both research and clinical practice. By distinguishing segment-specific from system-level effects, practitioners can design more precise treatment strategies aligned with the underlying neural pathways of disease. For researchers, the framework offers testable hypotheses that bridge traditional concepts with modern neuroscience, potentially improving experimental design. More broadly, this study provide a solid and objective scientific explanation for the bidirectional regulatory effect of acupuncture from the perspectives of modern neuroscience and life sciences, and the articulation of the homeostatic negative feedback regulatory loop and the classification theory of unit acupoints–collective acupoints lays a foundation for constructing a modern theoretical framework for acupuncture and for advancing its clinical standardization.
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References
DOI
10.13702/j.1000-0607.20250005
Original Source URL
https://www.zhenciyanjiu.cn/thesisDetails#10.13702/j.1000-0607.20250005&lang=en
Funding Information
Key Project of the National Natural Science Foundation of China (No. 82230123).
About Acupuncture Research
Acupuncture Research is a peer-reviewed monthly journal established in 1976 and supervised by the National Administration of Traditional Chinese Medicine. It is jointly sponsored by the Institute of Acupuncture and Moxibustion of the China Academy of Chinese Medical Sciences and the China Association of Acupuncture and Moxibustion. The journal focuses primarily on basic experimental research, while also covering clinical and theoretical studies, and is the only Chinese journal dedicated to systematic investigation of acupuncture mechanisms. It publishes original research articles, reviews, and academic communications in areas such as mechanism exploration, clinical research, acupuncture anesthesia, meridians and acupoints, and research methods. Supported by an international editorial board and a rigorous editorial team, Acupuncture Research maintains a selective acceptance rate and is widely indexed in major domestic and international databases, reflecting its strong academic influence.