Jellinger K A
Ludwig Boltzmann-Institut für Klinische Neurobiologie, Wien.
Wien Med Wochenschr. 2000;150(13-14):278-85.
Acupuncture is a valuable method of complementary medicine with broad application in neurology. It is based on the experiences of traditional Chinese medicine as well as on experimentally proven biological (biochemical and neurophysiological) effects. Acupuncture-induced analgesia is mediated by inhibition of pain transmission at a spinal level and activation of central pain-modulating centers by release of opioids and other peptides that can be prevented by opioid antagonists (naloxone). Modern neuroimaging methods (functional MRI) confirmed the activation of subcortical and cortical centers, while transcranial Doppler sonography and SPECT showed an increase of cerebral blood flow and cerebral oxygen supply in normal subjects. Clinical experience and controlled studies confirmed the efficacy of acupuncture in various pain syndromes (tension headache, migraine, trigeminal neuralgia, posttraumatic pain, lumbar syndrome, ischialgia, etc.) and suggest favorable effects in the rehabilitation of peripheral facial nerve palsy and after stroke. Appropriate techniques, hygiene safeguards and knowledge of contraindications will minimize the risks of rare side effects of acupuncture which represents a valuable adjunction to the treatment repertoire in modern neurology. There is sufficient evidence of acupuncture to expand its use into conventional medicine and to encourage further studies of its pathophysiology and clinical value.
针灸是一种重要的补充医学方法，在神经病学领域有广泛应用。它基于传统中医的经验以及经实验证实的生物学（生物化学和神经生理学）效应。针刺镇痛是通过抑制脊髓水平的疼痛传递以及释放阿片类物质和其他肽激活中枢疼痛调节中枢来介导的，而阿片类拮抗剂（纳洛酮）可以阻止这种作用。现代神经影像学方法（功能磁共振成像）证实了皮层下和皮层中枢的激活，而经颅多普勒超声和单光子发射计算机断层扫描显示正常受试者脑血流量和脑氧供应增加。临床经验和对照研究证实了针灸在各种疼痛综合征（紧张性头痛、偏头痛、三叉神经痛、创伤后疼痛、腰椎综合征、坐骨神经痛等）中的疗效，并提示其对面部周围性面神经麻痹和中风后的康复有积极作用。适当的技术、卫生防护措施以及对禁忌证的了解将使针灸罕见副作用的风险降至最低，针灸是现代神经病学治疗方法中的一种有价值的辅助手段。有充分证据表明可将针灸的应用扩展到传统医学领域，并鼓励进一步研究其病理生理学和临床价值。
