Benites Bruno Deltreggia, Ciol Heloise, Saad Sara Teresinha Olalla, Suguitani Rogerio Oliva
Hematology and Transfusion Medicine Center, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
Centro de Estudos de Terapias Naturais-CETN (Center of Study of Natural Therapies), Campinas, São Paulo, Brazil.
Med Acupunct. 2024 Feb 1;36(1):39-44. doi: 10.1089/acu.2023.0046. Epub 2024 Feb 13.
Sickle-cell diseases (SCD) are a group of hereditary disorders in which a specific mutation in the gene that encodes the hemoglobin ß chain leads to formation of an anomalous hemoglobin molecule (HbS) with high polymerization power. This leads to sickling of erythrocytes in situations of low oxygen tension, such as in microcirculation, resulting in peripheral microvasculature occlusion, chronic hemolysis, inflammation, and damage to several target organs. Malleolar ulcers are among the most-debilitating complications of the disease, as they are associated with significant pain, secondary infections, and social impact due to their aesthetic impairment. There are no completely satisfactory therapeutic options for this complication; local healing agents, antibiotics, and dressings are used, with high rates of recurrence and complications, such as osteomyelitis and even limb amputation.
This case study evaluated the effect of Traditional Chinese Medicine techniques on chronic malleolar ulcers in a 49-year-old male patient. Ten sessions of systemic acupuncture (combinations involving Source, Master, Energetic Action, and Extraordinary Vessels points), auriculotherapy, and dressing with magnets were conducted.
Although the primary outcome sought was not reached (decrease in ulcer diameters), this patient had great reduction of local pain, a decrease in limb edema, and important reduction of his inflammatory condition, reflected in his decreasing blood levels of C-reactive protein.
These results show that acupuncture should be considered as an important auxiliary treatment for SCD complications.
镰状细胞病（SCD）是一组遗传性疾病，其中编码血红蛋白β链的基因发生特定突变，导致形成具有高聚合能力的异常血红蛋白分子（HbS）。这会在低氧张力情况下，如微循环中，导致红细胞镰变，进而引起外周微血管阻塞、慢性溶血、炎症以及对多个靶器官的损害。踝部溃疡是该疾病最使人衰弱的并发症之一，因为它们会带来严重疼痛、继发感染，并且因其美观受损而产生社会影响。对于这种并发症，目前尚无完全令人满意的治疗选择；使用局部愈合剂、抗生素和敷料治疗时，复发率和并发症发生率都很高，如骨髓炎甚至肢体截肢。
本病例研究评估了中医技术对一名49岁男性患者慢性踝部溃疡的疗效。进行了十次全身针刺治疗（涉及原穴、母穴、经气作用穴和奇经八脉穴位的组合）、耳穴疗法以及磁体敷料治疗。
尽管未达到预期的主要结果（溃疡直径减小），但该患者局部疼痛大幅减轻，肢体水肿减轻，炎症状况明显改善，这体现在其血液中C反应蛋白水平降低。
这些结果表明，针刺应被视为镰状细胞病并发症的一种重要辅助治疗方法。
