Department of Physical Medicine and Rehabilitation, Mayo Clinic, 4500 San Pablo Road, Jacksonville, Florida 32224, USA.
Evid Based Complement Alternat Med. 2011;2011:428108. doi: 10.1093/ecam/nep010. Epub 2010 Oct 25.
Each year, there are an estimated 12 000 individuals who sustain a spinal cord injury (SCI) in the United States. Improved understanding of the pathophysiology of SCI and its sequelae has over the past 50 years led to the development of medical treatments (especially urologic) that have enhanced short- and long-term survival from these injuries. The prevalence of individuals with SCI in this country is ~250 000 individuals; and beyond the incalculable personal consequences of these devastating neurologic injuries, substantial direct and indirect societal costs result from the sequelae of SCI including paralysis, sensory loss, chronic pain, decubiti and bladder and/or bowel incontinence. The purpose of this treatise is to review the allopathic and traditional Chinese medicine (TCM) literature available through MEDLINE, PubMed and eCAM search engines that discuss the potential uses of acupuncture to treat acute and chronic spinal cord injuries and their sequelae, and present the neurophysiologic mechanisms for acupuncture's beneficial effects. There is evidence that use of electroacupuncture in acute SCI may significantly improve long-term neurologic recovery from these injuries both in terms of motor, sensory and bowel/bladder function with essentially no risk. Acupuncture may even improve neurourologic function in individuals with chronic SCI, and help with management with chronic pain associated with these injuries.
每年,美国估计有 12000 人遭受脊髓损伤(SCI)。在过去的 50 年中,对 SCI 的病理生理学及其后遗症的认识不断提高,导致了医疗治疗(特别是泌尿科)的发展,这些治疗方法提高了这些损伤的短期和长期存活率。该国 SCI 患者的患病率约为 25 万人;除了这些毁灭性神经损伤带来的难以估量的个人后果外,SCI 的后遗症,包括瘫痪、感觉丧失、慢性疼痛、压疮以及膀胱和/或肠道失禁,还导致了巨大的直接和间接社会成本。本文的目的是通过 MEDLINE、PubMed 和 eCAM 搜索引擎审查西医和传统中医(TCM)文献,这些文献讨论了针灸治疗急性和慢性脊髓损伤及其后遗症的潜在用途,并提出了针灸有益作用的神经生理学机制。有证据表明,在急性 SCI 中使用电针治疗可能会显著改善这些损伤的长期神经恢复,无论是在运动、感觉和肠道/膀胱功能方面,而且风险极小。针灸甚至可以改善慢性 SCI 患者的神经泌尿功能,并有助于管理与这些损伤相关的慢性疼痛。