Acupuncture as a Complementary Treatment for Leg Ulcers in Sickle-Cell Disease.

Bruno Deltreggia Benites, Heloise Ciol, Sara Teresinha Olalla Saad, Rogerio Oliva Suguitani
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Abstract

Background: Sickle-cell diseases (SCD) are a group of hereditary disorders in which a specific mutation in the gene that encodes the hemoglobin ß chain leads to formation of an anomalous hemoglobin molecule (HbS) with high polymerization power. This leads to sickling of erythrocytes in situations of low oxygen tension, such as in microcirculation, resulting in peripheral microvasculature occlusion, chronic hemolysis, inflammation, and damage to several target organs. Malleolar ulcers are among the most-debilitating complications of the disease, as they are associated with significant pain, secondary infections, and social impact due to their aesthetic impairment. There are no completely satisfactory therapeutic options for this complication; local healing agents, antibiotics, and dressings are used, with high rates of recurrence and complications, such as osteomyelitis and even limb amputation.

Case: This case study evaluated the effect of Traditional Chinese Medicine techniques on chronic malleolar ulcers in a 49-year-old male patient. Ten sessions of systemic acupuncture (combinations involving Source, Master, Energetic Action, and Extraordinary Vessels points), auriculotherapy, and dressing with magnets were conducted.

Results: Although the primary outcome sought was not reached (decrease in ulcer diameters), this patient had great reduction of local pain, a decrease in limb edema, and important reduction of his inflammatory condition, reflected in his decreasing blood levels of C-reactive protein.

Conclusions: These results show that acupuncture should be considered as an important auxiliary treatment for SCD complications.

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针灸作为镰状细胞病腿部溃疡的辅助治疗方法。
背景:镰状细胞病(Sickle-cell diseases,SCD)是一组遗传性疾病,其中编码血红蛋白 ß 链的基因发生特定突变,导致形成具有高聚合能力的异常血红蛋白分子(HbS)。这导致红细胞在微循环等氧张力较低的情况下发生镰状变,造成外周微血管闭塞、慢性溶血、炎症和多个靶器官受损。耳廓溃疡是该病最严重的并发症之一,因为它们会带来明显的疼痛、继发感染以及因影响美观而造成的社会影响。对于这种并发症,目前还没有完全令人满意的治疗方案,只能使用局部愈合剂、抗生素和敷料,但复发率和并发症的发生率很高,如骨髓炎甚至截肢。研究人员对该患者进行了十次系统针灸(包括源穴、主穴、行气活血穴和奇经八脉穴)、耳穴疗法和磁石敷贴:虽然没有达到预期的主要结果(溃疡直径缩小),但该患者的局部疼痛大大减轻,肢体水肿减轻,炎症状况明显减轻,这反映在其血液中 C 反应蛋白水平的下降上:这些结果表明,针灸应被视为治疗 SCD 并发症的重要辅助疗法。
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