Ye Jiang-Hong, Zuo Wanhong, Li Jing, Fu Rao, Eloy Daniel J, Bekker Alex
Department of Anesthesiology, Rutgers, New Jersey Medical School, Newark, NJ, USA.
Med Acupunct. 2020 Dec 1;32(6):357-361. doi: 10.1089/acu.2020.1478. Epub 2020 Dec 16.
Alcohol use disorder (AUD) is one of the most prevalent chronic relapsing substance use disorders. The negative emotional state, including pain hypersensitivity that often occurs during abstinence, is believed to be a significant driving force for intensive seeking and relapse drinking. Studies have revealed that this may involve the inhibition of midbrain dopamine transmission and activation of the "antireward" system in the lateral habenula (LHb). Acupuncture has been proven effective in reducing pain and certain syndromes associated with AUD. There have been extensive studies conducted on acupuncture. However, the neuroanatomical basis behind acupuncture practice is still unclear. To briefly describe recent research about acupuncture on pain, particularly those related to AUD. Preclinical studies found that electrostimulation of acupoints (electroacupuncture [EA]) effectively relieves hyperalgesia during withdrawal from chronic alcohol administration. This effect is mediated by the μ-opioid receptors in the LHb. Other studies revealed that the analgesic effect of EA could be mediated by mechanisms independent of the opioid system. Other evidence shows that acupuncture's strong anti-inflammatory effect also contributes to its analgesic effect. Acupuncture could alleviate pain, including the pain in alcoholics, through mechanisms either dependent or independent of the opioid system. Since alcohol abuse causes inflammation, which is also a significant cause of pain, the strong anti-inflammatory effect of acupuncture may also contribute to its analgesic effect. Thus, acupuncture is a nonaddictive therapeutic choice for pain related to substance use disorders, including alcohol.
酒精使用障碍(AUD)是最常见的慢性复发性物质使用障碍之一。消极情绪状态,包括戒断期间经常出现的疼痛超敏反应,被认为是强烈寻求和复饮的重要驱动力。研究表明,这可能涉及中脑多巴胺传递的抑制和外侧缰核(LHb)中“抗奖赏”系统的激活。针灸已被证明可有效减轻与AUD相关的疼痛和某些综合征。关于针灸已经进行了广泛的研究。然而,针灸实践背后的神经解剖学基础仍不清楚。为简要介绍近期关于针灸治疗疼痛,特别是与AUD相关疼痛的研究。临床前研究发现,穴位电刺激(电针[EA])可有效缓解慢性酒精给药戒断期间的痛觉过敏。这种作用是由LHb中的μ-阿片受体介导的。其他研究表明,EA的镇痛作用可能由独立于阿片系统的机制介导。其他证据表明,针灸强大的抗炎作用也有助于其镇痛作用。针灸可通过依赖或独立于阿片系统的机制减轻疼痛,包括酗酒者的疼痛。由于酒精滥用会引起炎症,而炎症也是疼痛的重要原因,针灸强大的抗炎作用也可能有助于其镇痛作用。因此,针灸是治疗与物质使用障碍(包括酒精)相关疼痛的一种非成瘾性治疗选择。