Quantitative evaluation of microenvironmental changes and efficacy of cupping therapy under different pressures based on photoacoustic imaging

Cupping therapy, a traditional Chinese medicinal practice, has been subjected to scientific scrutiny to validate its effects on local tissue microenvironments. This study provides a quantitative assessment of cupping therapy at different negative pressures using photoacoustic imaging. Low-pressure cupping (-20 kPa) significantly improved local blood circulation, evidenced by increased hemoglobin oxygen saturation and vessel dilation that normalized within two hours. In contrast, high-pressure cupping (-30 kPa) led to capillary rupture, bleeding, and tissue edema, similar to the clinical presentation of cupping bruises. Additionally, our research unveiled that −20 kPa cupping expedited the clearance of indocyanine green dye, suggesting enhanced lymphatic drainage, which was further supported by fluorescence imaging. This indicates a potential mechanism for cupping's pain relief effects. Moreover, cupping showed promising results in improving sepsis outcomes in mice, potentially due to its anti-inflammatory properties. This study establishes a foundation for the objective evaluation of cupping therapy, demonstrating that low-pressure cupping is effective in promoting blood and lymphatic flow while minimizing tissue damage, thereby offering a safer therapeutic approach.