Unger Kendra, Pilkerton Courtney
Department of Family Medicine, West Virginia University, Morgantown, West Virginia, USA.
Med Acupunct. 2024 Oct 21;36(5):289-295. doi: 10.1089/acu.2023.0138. eCollection 2024 Oct.
Stiff person syndrome (SPS) is a rare neurological disorder. Treatments are limited, and non-pharmacologic therapies are recommended based on symptomatology. A G2P2002 post-menopausal 60-year-old female with hypertension, obesity, and type II diabetes, and SPS secondary to a paraneoplastic process cause by endometrioid ovarian adenocarcinoma who presented to acupuncture clinic seeking treatment for SPS and its sequela. Her main complaints upon presentation included muscles spasticity causing low back pain, hip flexor pain, insomnia and chemotherapy induced peripheral neuropathy. Her mood and quality of life were also noted to be poor at presentation.
A case report of implementation and customization of acupuncture treatment protocol for the sequelae of SPS including painful spasticity, insomnia, and reduced quality of life is discussed. Outcomes included measures of stiffness (degree of stiffness, distribution of stiffness, heightened sensitivity score) at each visit and health-related quality of life 14 item index at baseline. These outcomes were measured at the initiation of the acupuncture intervention (baseline) and after 9 weeks of weekly acupuncture treatments. These treatments included body acupuncture, electro acupuncture and auricular acupuncture. Acupuncture was performed in addition to her ongoing IVIG therapy.
Forward bending increased with maximal benefit observed by treatment 3. Lateral bending showed significant improvement with maximal effect by treatment 4. Timed activity testing (walk and stair climb) initially did not improve but showed a significant and sustained improvement following acupuncture protocol change following week 5. The self-rated quality of life outcome measure of overall health was unchanged ("good" at baseline and at follow-up), but all other quality of life outcome measures showed improvements.
SPS is a rare disorder causing substantial impairment for patients affected. The evidence supporting the use of acupuncture specifically for SPS is at most limited, however, the evidence supports the use of acupuncture for many of the symptoms experienced by those with SPS. This case illustrates how acupuncture can be considered as an adjunct therapy to improve the quality of life and function of these patients. More studies are needed to further investigate and optimize acupuncture treatment protocols for this rare disease.
僵人综合征（SPS）是一种罕见的神经系统疾病。治疗方法有限，基于症状推荐非药物疗法。一名60岁绝经后女性，G2P2002，患有高血压、肥胖症和II型糖尿病，因子宫内膜样卵巢腺癌导致的副肿瘤性过程继发SPS，前来针灸诊所寻求SPS及其后遗症的治疗。她就诊时的主要主诉包括肌肉痉挛导致的腰痛、髋屈肌疼痛、失眠以及化疗引起的周围神经病变。就诊时还注意到她的情绪和生活质量较差。
讨论了针对SPS后遗症（包括疼痛性痉挛、失眠和生活质量下降）实施和定制针灸治疗方案的病例报告。结果包括每次就诊时的僵硬程度测量（僵硬程度、僵硬分布、敏感性增高评分）以及基线时与健康相关的生活质量14项指标。这些结果在针灸干预开始时（基线）以及每周进行9周针灸治疗后进行测量。这些治疗包括体针、电针和耳针。除了她正在进行的静脉注射免疫球蛋白治疗外，还进行了针灸治疗。
前屈在第3次治疗时增加，观察到最大益处。侧屈在第4次治疗时显示出显著改善，效果最大。定时活动测试（行走和爬楼梯）最初没有改善，但在第5周后针灸方案改变后显示出显著且持续的改善。总体健康的自评生活质量结果测量在基线和随访时保持不变（均为“良好”），但所有其他生活质量结果测量均显示有所改善。
SPS是一种罕见疾病，会给受影响的患者带来严重损害。支持专门将针灸用于SPS的证据最多有限，然而，证据支持将针灸用于SPS患者所经历的许多症状。本病例说明了如何将针灸视为一种辅助疗法来改善这些患者的生活质量和功能。需要更多研究来进一步调查并优化针对这种罕见疾病的针灸治疗方案。
