Niruthisard Supranee, Ma Qiufu, Napadow Vitaly
Pain Management Research Unit, Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Center of Bioelectronic Medicine, School of Life Sciences, Westlake University, Hangzhou, China.
Pain Rep. 2024 Sep 13;9(5):e1188. doi: 10.1097/PR9.0000000000001188. eCollection 2024 Oct.
Acupuncture therapy has achieved global expansion and shown promise for health promotion and treatment of acute/chronic pain.
To present an update on the existing evidence base for research and clinical practice supporting acupuncture analgesia.
This Clinical Update elaborates on the 2023 International Association for the Study of Pain Global Year for Integrative Pain Care "Factsheet Acupuncture for Pain Relief" and reviews best evidence and practice.
Acupuncture is supported by a large research evidence base and growing utilization. Mechanisms of acupuncture analgesia include local physiological response at the needling site, suppression of nociceptive signaling at spinal and supraspinal levels, and peripheral/central release of endogenous opioids and other biochemical mediators. Acupuncture also produces pain relief by modulating specific brain networks, integral for sensory, affective, and cognitive processing, as demonstrated by neuroimaging research. Importantly, acupuncture does not just manage pain symptoms but may target the sources that drive pain, such as inflammation, partially by modulating autonomic pathways. Contextual factors are important for acupuncture analgesia, which is a complex multifaceted intervention. In clinical practice, historical records and many providers believe that acupuncture efficacy depends on specific acupoints used, the technique of needle placement and stimulation, and the person who delivers the procedure. Clinical research has supported the safety and effectiveness of acupuncture for various pain disorders, including acupuncture as a complementary/integrative therapy with other pain interventions.
Although the quality of supportive evidence is heterogeneous, acupuncture's potential cost-effectiveness and low risk profile under standardized techniques suggest consideration as a neuromodulatory and practical nonpharmacological pain therapy.
针灸疗法已在全球范围内得到推广，并在促进健康和治疗急/慢性疼痛方面显示出前景。
介绍支持针灸镇痛的现有研究和临床实践证据基础的最新情况。
本临床最新进展详细阐述了2023年国际疼痛研究协会综合疼痛护理全球年“针灸缓解疼痛情况说明书”，并回顾了最佳证据和实践。
针灸有大量研究证据支持且其应用不断增加。针灸镇痛机制包括针刺部位的局部生理反应、脊髓和脊髓上水平伤害性信号的抑制，以及内源性阿片类药物和其他生化介质的外周/中枢释放。神经影像学研究表明，针灸还通过调节特定脑网络产生疼痛缓解，这些脑网络对感觉、情感和认知加工不可或缺。重要的是，针灸不仅能控制疼痛症状，还可能针对引发疼痛的源头，如炎症，部分是通过调节自主神经通路。背景因素对针灸镇痛很重要，针灸是一种复杂的多方面干预措施。在临床实践中，历史记录和许多从业者认为针灸疗效取决于所使用的特定穴位、针刺放置和刺激技术以及实施该程序的人员。临床研究支持了针灸对各种疼痛疾病的安全性和有效性，包括针灸作为与其他疼痛干预措施的补充/综合疗法。
尽管支持证据的质量参差不齐，但在标准化技术下针灸潜在的成本效益和低风险表明，可将其视为一种神经调节性且实用的非药物疼痛疗法。
