Wu S Ly, Leung A Wn, Yew D Tw
School of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
Schools of Biomedical Sciences and Chinese Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
East Asian Arch Psychiatry. 2016 Jun;26(2):70-6.
Opioid is a popular drug of abuse and addiction. We evaluated acupuncture as a non-pharmacological treatment with a focus on managing withdrawal symptoms. Electrical stimulation at a low frequency (2 Hz) accelerates endorphin and encephalin production. High-frequency stimulation (100 Hz) up-regulates the dynorphin level that in turn suppresses withdrawal at the spinal level. The effect of 100-Hz electroacupuncture may be associated with brain-derived neurotrophic factor activation at the ventral tegmental area, down-regulation of cAMP response element-binding protein, and enhanced dynorphin synthesis in the spinal cord, periaqueductal grey, and hypothalamus. Clinical trials of acupuncture for the management of different withdrawal symptoms were reviewed. The potential of acupuncture to allay opioid-associated depression and anxiety, and its possible use as an adjuvant treatment were evident. A lack of effect was indicated for opioid craving. Most studies were hampered by inadequate reporting details and heterogeneity, thus future well-designed studies are needed to confirm the efficacy of acupuncture in opioid addiction treatment.
阿片类药物是一种常见的滥用和成瘾药物。我们评估了针灸作为一种非药物治疗方法，重点是管理戒断症状。低频（2赫兹）电刺激可加速内啡肽和脑啡肽的产生。高频刺激（100赫兹）上调强啡肽水平，进而在脊髓水平抑制戒断反应。100赫兹电针的作用可能与腹侧被盖区脑源性神经营养因子的激活、环磷酸腺苷反应元件结合蛋白的下调以及脊髓、导水管周围灰质和下丘脑强啡肽合成的增强有关。综述了针灸治疗不同戒断症状的临床试验。针灸缓解阿片类药物相关抑郁和焦虑的潜力及其作为辅助治疗的可能用途是明显的。对于阿片类药物渴求，表明缺乏效果。大多数研究因报告细节不足和异质性而受阻，因此需要未来设计良好的研究来证实针灸在阿片类药物成瘾治疗中的疗效。
