Acupuncture, which is one of the treatment methods used in traditional Chinese medicine today, gives hope to more patients with the help of developing technology. Pain control is one of them…
The history of acupuncture dates back to 5000 years. Although the first application of acupuncture, which is a combination of the words acus (dry needle) and puncture (plumbing), is known as North China, according to the findings, it was used by Uyghur Turks before. This method, which contains information about which diseases and how it was used from the inscriptions of the Chinese Emperor, has started to be applied in more areas with the help of technology as it has come to the present day.
Stating that acupuncture plays an important role in the bioregulation of the body, Yeditepe University Koşuyolu Hospital Algology Specialist Prof. Dr. İlhan Öztekin said, “Bioregulation refers to the fulfillment of the disturbed balance of the body. Every animate or inanimate being has an energy on earth. These energy fields can be visualized with techniques developed in Russia. In traditional Chinese medicine, it is accepted that energy flows over 12 double, two single classical energy meridians in the body. The Chinese call this energy, which is defined as life energy, 'chi'. As life energy flows through these channels, each channel is named in relation to its target organ: Small intestine meridian, large intestine meridian, stomach meridian... It is accepted that two hours of active energy circulates on these meridians. The circulation in the body is also completed in 24 hours. Which energy is impaired is understood by tongue and pulse examination. Accordingly, the disorders in these meridians can bring this energy into balance by stimulating approximately 360 classical acupuncture points on the meridians. The essence of acupuncture is to balance the energy imbalance that occurs as a result of a disrupted system in the body by stimulating the use of the relevant meridians and points.
“Acupuncture can be beneficial in the treatment of very severe depressions as well as physical ailments. Successful results can be obtained from acupuncture treatment in addition to existing drugs.”
Acupuncture can be used in the treatment of diseases that occur as a result of a condition defined as a dysfunctional disorder in medicine. Especially in cancer patients, it comes to the forefront in helping the main treatments, strengthening the body, eliminating fatigue and exhaustion, and increasing life energy. It can also be used to control pain and regulate appetite. Reminding that in 2017, two scientists who are experts in this field published the most common indications for acupuncture, Prof. Dr. Öztekin continues: “According to this information, acupuncture treatment of allergic rhinitis, calcification of the knee joints, relief of nausea and vomiting in patients receiving chemotherapy, prevention of migraine attacks, treatment of chronic tension-type headaches, post-operative nausea, vomiting and chronic low back pain. and in the treatment of post-operative pain. Its effectiveness in these indications is also recognized by the World Health Organization. Acupuncture anesthesia is used in 25% of surgeries performed in China today, and patients can be discharged earlier. Apart from these, it can also be used for obesity, anxiety, restlessness, insomnia complaints during and after menopause, and joint pain caused by aromatic suppressants.
This treatment; It can be applied in the form of manual therapy by inserting a dry needle and turning it by hand, as the Chinese do. Today, however, with the development of technology, electrestemination devices are also used in addition to these traditional methods. Especially in chronic pain or in cases where the acupuncture effect needs to be strengthened, this device is used by attaching electrodes to the needles at certain points with clips. The sessions of the patients, who are given an electric current of 2-10 Hz at an average of 30-45 minutes intervals, vary between 20-45 minutes. Underlining that laser acupuncture can be applied, especially in young children or people with needle phobia, Prof. Dr. Öztekin said, “In magnet acupuncture, acupuncture points are stimulated with magnets. Even if the patient does not feel anything, therapy can be applied to those points.
Many randomized clinical trials evaluating acupuncture are of inadequate methodological quality. The major problem in these studies is the lack of an adequate placebo control. Sham acupuncture is used as a common control procedure. Accordingly, the needles are inserted into unsuitable meridians or areas outside the meridians. In sham acupuncture, more superficial needle insertion is performed than in the real acupuncture group. 1 Linde et al. conducted a meta-analysis of 37 randomized controlled trials evaluating acupuncture. In this analysis, they compared sham with placebo acupuncture (nonspecific effect) and sham with real acupuncture (specific effect). They stated that sham acupuncture was more effective than placebo acupuncture, and real acupuncture was more effective than sham acupuncture.
Different hypotheses have been proposed to explain the analgesic effects of acupuncture based on human and animal studies. These effects are complex and largely the result of the interaction of neurochemical, physiological and psychological factors associated with patients' expectations. The analgesic effects of acupuncture are largely the result of the interaction of neurochemical, physiological and psychological factors associated with patients' expectations. 0019 There is evidence to support the role of endogenous opioids (encephalin, dynorphin, endorphin, and endomorphin) and serotonin (5-HT) in acupuncture analgesia. Mayer et al. and Pomeranz et al. showed that Acupuncture Analgesia was blocked with Naloxone, supporting the role of endogenous opioids in mice and humans.
Muscle (stimulation of small diameter nerves)
-> Medulla spinalis Chemical transmitters (monoamines such as endorphins, serotonin, NA etc.)
-> midbrain
-> Block the pituitary pain transmission (Bruce Pomeranz, 1987)
Positron emission tomography (PET) studies show an increase in the binding of opioids at mu receptors in the brain after acupuncture application.5 In addition, fMRI basal anterior brain, limbic system, and other areas of the brain associated with affective and somatosensory functions have been shown to activate with acupuncture treatment.6 Cerebral, which is effective in acupuncture analgesia The role of the neurotransmitters Capicolaminas and Cerotoninas is being investigated. The release of these neurotransmitters can produce analgesic, muscle relaxation, anti-inflammatory, mild anxiolytic and
However, there are some reservations about creating a control group, placebo and blind studies due to the shape of the method. However, the effectiveness of acupuncture has been proven in the suppression of toothache, postoperative and post-chemotherapy nausea and vomiting. There is very strong evidence that it is beneficial in carpal tunnel syndrome, low back pain, fibromyalgia and myofascial pain, tennis elbow, headache, stroke rehabilitation, drug addiction.
It is stated that EA is also effective in the treatment of pancreatic cancer pain. Chen H. et al. patients applied EA to T8-T12 bilateral Jiaji (Ex-B2) points for 30 minutes once a day for 3 days. There was a significant decrease in pain intensity in the EA group compared to the control group (p<0.001). 10 , 11 It is stated that there is no difference between conventional analgesia and acupuncture in the first 10 days of treatment in gastric cancer.
It is stated that acupuncture reduces pain and opioid use on the first postoperative day. Thus, the use of acupuncture as an adjuvant therapy in the treatment of postoperative pain is recommended.13 The list of indications published in 2017 by John McDonald and Stephen Janz, Authorities of the “Acupuncture Evidence Project”, is given below.
It also helps those who want to quit smoking
It is also possible to benefit from acupuncture to quit smoking, which has an important role in the emergence of many diseases, especially respiratory diseases and cancer. prof. Dr. İlhan Öztekin says that this method, which also has a place in the projects carried out by the Ministry of Health, helps smokers to break their relationship with cigarettes.
Moxa (Moxa) therapy is one of the traditional Chinese medical treatment methods that is done by stimulating the acupuncture points directly or indirectly with the burning dry plant Artemisia vulgaris (mugwort). With moksa treatment, it is possible to dissolve pathological cold, warm meridians, regulate collaterals, stimulate blood circulation, remove obstruction, support yang, dissolve blood stasis, and prevent diseases. Moxa can be used in the treatment of many diseases such as arthritis, gastrointestinal diseases, gynecological problems, pain. When Moksa is applied, the skin temperature reaches 130 ° C outside and 56 ° C inside. Therefore, moxa is considered an inflammatory response with heat stimulation. The inflammatory response stimulates vascular changes. Vasoconstriction occurs in the skin area where Moksa is applied, and vasodilation occurs around this area. Histamine and substance P are responsible for vasodilation in the skin. The histamine released during moksa treatment causes vasodilation on the skin. As a result of increased permability, degranulation occurs in mast cells. Substance P and galanin are neurotransmitters released by acupuncture and mox therapy. These neurotransmitters are known to play a role in neurological diseases such as pain, spasm, anxiety and depression.
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