Acupuncture and Related Therapies最新文献

The tibialis anterior, the main dorsiflexor muscle of the foot, is innervated by the peroneal nerve. Common peroneal nerve lesion represent the most common nerve lesions of the lower limb and can be due to several causative mechanisms. Although the most frequent cause is a common peroneal neuropathy at the neck of the fibula, other causes include anterior horn cell disease, lumbar plexopathies, L5 radiculopathy and partial sciatic neuropathy secondary to total hip replacement. People with common peroneal nerve lesion have a foot drop. In this article we studied the temporal, kinetic and kinematic aspect of gait in a group of nine people who had a chronic foot drop (more than 2 years from the acute event), before and after treatment with focal repetitive muscle vibration on tibial anterior.

Amitriptyline and electroacupuncture (EA) have been used in the management of neuropathic pain. This study examines whether the use of an intraperitoneal injection of amitriptyline changes the effectiveness of EA to reduce neuropathic pain in rats. Changes in the nociceptive threshold of intraperitoneal saline (0.8 ml/kg)- or amitriptyline (0.8 mg/kg)-treated rats were evaluated using the tail-flick test and a model of neuropathic pain before, during and after a 20-min period of 2 Hz EA applied to the Zusanli and Sanynjiao acupoints. The experiments were conducted two or seven days after a sham or chronic constriction injury (CCI) of the sciatic nerve. Amitriptyline had no effect against thermal or neuropathic pain in sham EA-stimulated rats. Two Hz EA increased the tail-flick latency and reduced the mechanical hyperalgesia evoked by the CCI and was more effective against mechanical hyperalgesia when used at the earlier phase of the neuropathic pain than at the later phase. These effects of EA were significantly increased in intensity in the tail-flick test and lasted longer in neuropathic rats after intraperitoneal amitriptyline. The duration of the analgesic effect of 2 Hz EA in the operated hind paws of saline- or amitriptyline-treated rats was longer at two than at seven days after nerve injury. The analgesic effect of EA and its combination with amitriptyline were detected in both sham and CCI rats. The combined effect of amitriptyline and EA may represent an alternative for prolonging the efficacy of EA in the management of neuropathic pain.

Acupuncture is a complex intervention, and there are both specific and non-specific influences associated with its therapeutic benefit. Although large randomized controlled trials (RCT) and systematic reviews have demonstrated the efficacy of acupuncture, the conclusions are controversial due to the lack of a significant difference in the results between real and sham acupuncture. This similarity may be due to the omission of important components of the acupuncture treatment itself, such as the needling sensation. The needling sensation is considered to represent an important component of acupuncture. Despite this importance, several RCTs have lacked data on whether the needling sensation has been achieved. From a Traditional Chinese Medicine (TCM) perspective, the needling sensation, deQi, is a combination of unique sensations that are interpreted as the flow of Qi, or “vital energy.” Furthermore, acupuncture is believed to be successful only upon the arrival of “vital energy,” Qi. This state is suggested to be essential to the specific therapeutic effect of acupuncture. From a biomedical perspective, acupuncture excites sensory receptors and nerve fibers in the stimulated tissue, resulting in a needling sensation. Moreover, acupuncture induces both the deactivation of a limbic–paralimbic–neocortical network in the brain (the default mode network and the anti-correlated task-positive network) and the activation of somatosensory regions. A distinct needling sensation is associated with a marked deactivation of these brain networks, whereas the lack of a needling sensation (as during sham needling) is associated with significantly less deactivation. Conversely, when acupuncture induces sharp pain sensations, there is an activation of these networks instead. In a clinical context, this difference means that the therapist needs to identify a stimulation intensity that is scaled to the needling response of each patient, i.e., a sharp uncomfortable pain sensation during the needle stimulation should be avoided.

Both the empirical bases of TCM and biomedical acupuncture research suggest that the therapist should strive for a needling sensation during an acupuncture treatment. If such a sensation is not achieved, are the specific effects of acupuncture likely smaller? This conclusion suggests that deQi is part of a proper acupuncture treatment and that the experience of a needling sensation should universally be assessed and reported in all types of clinical and experimental trials.

Acupuncture is widely used for the treatment of chronic (long-term) pain. In a recent study, Vickers et al. characterized the analgesic effect of acupuncture in four different chronic pain conditions, back and neck pain, osteoarthritis, headache, and shoulder pain, and concluded that acupuncture is an effective type of treatment for these chronic pain states.

Significant differences between true and sham acupuncture indicate that acupuncture induces superior effects. However, these differences were reported to be relatively modest, suggesting that non-specific effects, in addition to the specific effects of the needle stimulation, are important contributors to the therapeutic effects of acupuncture. It has been demonstrated that two factors that are seen as non-specific are related to individual therapists’ interaction with the patient and the patients’ positive expectation of the treatment effect.

The therapist–patient interaction has been shown to be unrelated to empathy but may be attributable to the ability to express compassion. Compassion implies being attuned to undeserved suffering, but it is also a signaling behavior related to care giving that has physiological responses that orient the individual to social interaction. It is possible that therapists that report good treatment outcomes are more compassionate in their interaction with their patient compared to the therapist reporting poor outcomes.

Neural therapy, or therapeutic local anesthesia (TLA), is the diagnostic and therapeutic use of local anesthetics. This review summarizes the scientific and clinical evidence, indications, methods of application, and possible future research.

In the literature, there is a gap between the multitude of data supporting a number of different molecular effects and the few clinical trials that are available. The available clinical studies and case reports, however, show effectiveness in acute and chronic pain, functional disorders, vegetative diseases such as the complex regional pain syndrome (CRPS), and chronic inflammation.

Five administration methods are described: local, segmental, regional, and systemic application, as well as injections into the so called “stoerfeld” (disturbance field, interference field).

Local anesthetics have been used for therapy for over 120 years, which suggests that this therapy may be an important, effective, and efficient therapy that has few side-effects. Possible clinical studies to reveal the potential effectiveness and benefit-risk ratio of this holistic approach are described.