Medici T C
Departement für Innere Medizin, Universitätsspital Zürich.
Schweiz Med Wochenschr Suppl. 1994;62:39-48.
Complementary and alternative medicine is a widespread phenomenon. On the one hand it is demanded by the patients. On the other, practising physicians want to know more about it. The common motive for their interest is the perception that conventional medicine has its limits. This is obvious in the case of bronchial asthma, whose underlying cause is largely unknown despite decades of research, and whose treatment is symptomatic. Furthermore, asthma mortality is not declining. In these circumstances it is legitimate to look for alternatives. One alternative therapy is acupuncture. Although there are many published studies on acupuncture and asthma, few meet the scientific tests necessary to prove the effectiveness of acupuncture. From these studies it emerges that short term effects of acupuncture are better documented than long term ones. Nor is it possible to predict what proportion of asthmatics will respond to acupuncture. Allergic eosinophilic inflammation of the respiratory tract is foremost among present day hypotheses concerning the pathogenesis and pathophysiology of asthma. It is interesting that there are no known clinical or experimental investigations into the effect of acupuncture on allergic inflammation of the asthmatic's bronchial mucosa. In view of these facts we are conducting a long term controlled study of the acute and chronic effects of acupuncture on both allergic inflammation of the bronchial mucosa and asthmatics' clinical symptoms, bronchial hyperreactivity and consumption of medication. To establish responders and non-responders, lung function tests and measurement of microcirculation and skin temperature are carried out before and after acupuncture treatment. If we can show that acupuncture has an effect on the allergic inflammation, this is not only a new pathophysiologic aspect and a further explanation of how the acupuncture effect on asthma comes about. The result also has far-reaching implications for the asthmatic by improving the disease, limiting consumption of medication, preventing side effects and lowering drug costs.
补充和替代医学是一种普遍现象。一方面，患者有这方面的需求。另一方面，执业医师也想对此有更多了解。他们产生兴趣的共同动机是认为传统医学有其局限性。这在支气管哮喘的病例中很明显，尽管经过数十年研究，其根本病因仍很大程度上不明，且治疗只是对症治疗。此外，哮喘死亡率并未下降。在这种情况下，寻找替代方法是合理的。一种替代疗法是针灸。虽然有许多关于针灸与哮喘的已发表研究，但很少有符合证明针灸有效性所需科学检验的。从这些研究中可以看出，针灸的短期效果比长期效果有更好的记录。也无法预测哮喘患者中对针灸有反应的比例。呼吸道过敏性嗜酸性炎症是目前关于哮喘发病机制和病理生理学的主要假说之一。有趣的是，尚无已知的关于针灸对哮喘患者支气管黏膜过敏性炎症影响的临床或实验研究。鉴于这些事实，我们正在进行一项长期对照研究，以探讨针灸对支气管黏膜过敏性炎症以及哮喘患者临床症状、支气管高反应性和药物消耗量的急性和慢性影响。为了确定有反应者和无反应者，在针灸治疗前后进行肺功能测试、微循环测量和皮肤温度测量。如果我们能证明针灸对过敏性炎症有影响，这不仅是一个新的病理生理学方面，也是对针灸治疗哮喘效果机制的进一步解释。该结果对哮喘患者也具有深远意义，可改善病情、限制药物消耗、预防副作用并降低药物成本。
