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PTSD

עודכן ב: 16 ינו 2019



לפניכם מוצגים מאמרים מאתרים רשמיים מרחבי העולם בנושא PTSD והטיפול בו בעזרת רפואה סינית:

1)

Natural Medicine Journal - Acupuncture for the Treatment of Posttraumatic Stress Disorder: A Review of Evidence-Based Research

"Even though current research studies on the use of acupuncture for the treatment of PTSD is scarce, current research suggests that acupuncture may be an efficacious treatment option for PTSD. One randomized controlled trial on the use of acupuncture for PTSD on the civilian population demonstrated significant reductions in PTSD symptoms scores from baseline to end-treatment in the acupuncture group. Additionally, treatment effects for depression, anxiety, and impairment in the acupuncture group improved significantly more than the WLC group. Studies assessing acupuncture’s role in mitigating individual symptoms of PTSD, such as migraines, anxiety, depression, and insomnia, demonstrate significant reductions in these symptoms for the studies’ participants. Clinical and experimental data also suggest that at least some acupuncture clinical results are mediated in the central nervous system. fMRI and PET studies on acupuncture at specific acupuncture points have demonstrated significant fMRI neuronal signal reduction in the limbic system. This study could possibly explain the sedating effects of acupuncture on patients with anxiety disorders, which could be an effective treatment plan for PTSD patients with severe hyperarousal"

2)

PMC- Acupuncture for Posttraumatic Stress Disorder: A Systematic Review of Randomized Controlled Trials and Prospective Clinical Trials

"The results of this systematic review and meta-analysis suggest that evidence of the effectiveness of acupuncture for PTSD is encouraging but not cogent, because only two RCTs were included in meta-analysis, and it is too small to verify the efficacy of acupuncture. For the future researches, sham-controlled RCTs [52] or comparative effectiveness researches [53] are required to test efficacy and effectiveness of acupuncture for PTSD. To prevent performance bias and detection bias, blinding of participants and outcome assessment should be kept in future trials, too."

3)

PTSD: National Center for PTSD - Complementary and Alternative Medicine (CAM) for PTSD

"Based on the available evidence, it is difficult to draw firm conclusions about the efficacy of any type of CAM for PTSD. Acupuncture appears to have benefit but needs to be evaluated relative to sham acupuncture in order to control for the nonspecific benefits of treatment. Mindfulness-based meditation and relaxation appear to have modest benefit; little is known about the effect of other meditative practices and other CAM modalities"

4)

British Acupuncture Council - Post-traumatic stress disorder

"Research has shown that acupuncture treatment may specifically benefit anxiety disorders and symptoms of anxiety and stress by:Acting on areas of the brain known to reduce sensitivity to pain and stress, as well as promoting relaxation and deactivating the ‘analytical’ brain, which is responsible for anxiety and worry (Hui 2010);Regulating levels of neurotransmitters (or their modulators) and hormones such as serotonin, noradrenaline, dopamine, GABA, neuropeptide Y and ACTH; hence altering the brain’s mood chemistry to help to combat negative affective states (Lee 2009; Zhou 2008);Stimulating production of endogenous opioids that affect the autonomic nervous system (Arranz 2007). Stress activates the sympathetic nervous system, while acupuncture can activate the opposing parasympathetic nervous system, which initiates the relaxation response;Reversing pathological changes in levels of inflammatory cytokines that are associated with stress reactions (Arranz 2007);"

5)

PUBMED - Electroacupuncture inhibition of hyperalgesia in rats with adjuvant arthritis: involvement of cannabinoid receptor 1 and dopamine receptor subtypes in striatum.

"Electroacupuncture (EA) has been regarded as an alternative treatment for inflammatory pain for several decades. However, the molecular mechanisms underlying the antinociceptive effect of EA have not been thoroughly clarified. Previous studies have shown that cannabinoid CB1 receptors are related to pain relief. Accumulating evidence has shown that the CB1 and dopamine systems sometimes interact and may operate synergistically in rat striatum. To our knowledge, dopamine D1/D2 receptors are involved in EA analgesia. In this study, we found that repeated EA at Zusanli (ST36) and Kunlun (BL60) acupoints resulted in marked improvements in thermal hyperalgesia. Both western blot assays and FQ-PCR analysis results showed that the levels of CB1 expression in the repeated-EA group were much higher than those in any other group (P = 0.001). The CB1-selective antagonist AM251 inhibited the effects of repeated EA by attenuating the increases in CB1 expression. The two kinds of dopamine receptors imparted different actions on the EA-induced CB1 upregulation in AA rat model. These results suggested that the strong activation of the CB1 receptor after repeated EA resulted in the concomitant phenomenon of the upregulation of D1 and D2 levels of gene expression"

6)

PUBMED - Acupuncture and endorphins.

"Acupuncture and electroacupuncture (EA) as complementary and alternative medicine have been accepted worldwide mainly for the treatment of acute and chronic pain. Studies on the mechanisms of action have revealed that endogenous opioid peptides in the central nervous system play an essential role in mediating the analgesic effect of EA. Further studies have shown that different kinds of neuropeptides are released by EA with different frequencies. For example, EA of 2 Hz accelerates the release of enkephalin, beta-endorphin and endomorphin, while that of 100 Hz selectively increases the release of dynorphin. A combination of the two frequencies produces a simultaneous release of all four opioid peptides, resulting in a maximal therapeutic effect. This finding has been verified in clinical studies in patients with various kinds of chronic pain including low back pain and diabetic neuropathic pain."

7)

Pacific College of Oriental Medicine - Acupuncture for PTSD

"Studies conducted by the Pentagon have revealed that most soldiers affected by PTSD would be more inclined to accept non-exposure treatments such as acupuncture for PTSD. The biggest reason for this is because the soldiers need not share such traumatic experiences with their psychiatrist. Besides, acupuncture has been revealed to provide rapid benefits to patients through faster healing. Ear acupuncture on veteran soldiers located in Vermont has helped many overcome sleep disorders originating due to PTSD. The benefits of acupuncture for PTSD has translated into greater word of mouth as more people recommend acupuncture as a successful alternative medicine and treatment to conventional treatments."

8)

ResearchGate - Acupuncture for posttraumatic stress disorder - A randomized controlled pilot trial

"Acupuncture and CBT patients expressed the same level of satisfaction with care on 7 of the 10 items, including the global satisfaction with care item (acupuncture mean rating 9.2 vs. CBT 9.7 on a 0 to 10 scale where 10 is highest satisfaction, p 0.11). Participants in the acupuncture group compared with the CBT group more strongly agreed that they felt good about doing what they were supposed to do between treatment sessions (means 9.20 vs. 8.38, F 1, 39 4.31, p 0.04). Participants in the CBT group more strongly agreed that they understood the reason for the treatment they received (means 9.90 vs. 9.15, F 1, 39 7.03, p 0.01), and more strongly agreed that their treating clinician helped them understand why the treatTABLE 2.ment they received might be helpful (means 9.76 vs. 8.60, F 1, 39 8.62, p  0.01). However, both groups expressed high satisfaction on all 10 items."

9)

Natioal Center for PTSD - Complementary and Alternative Treatments for PTSD

"Acupuncture, a modality of Chinese medicine, encompasses a group of therapies in which needles are inserted into subcutaneous tissue in order to restore balance within body systems. For those interested, Hollifield (2011) provides an accessible summary of the conceptual rationale and proposed biological mechanisms in support of the potential efficacy of acupuncture for PTSD. One good-quality studyidentified in the Strauss et al. (2011) review found that improvement in PTSD following 12 weeks of biweekly, 60-minute acupuncture sessions was comparable to a group CBT and greater than waitlist control in a predominantly male, non-Veteran sample (Hollifield, Sinclair-Lian, Warner, & Hammerschlag, 2007). Treatment gains following acupuncture were retained at the 24-month follow-up. Although the study was methodologically rigorous, strong conclusions cannot be drawn from a single RCT. This study also highlights the challenge of selecting an adequate comparison condition for these novel interventions. The control that was used, a group intervention that included psychoeducation, CBT skills (e.g., behavioral activation, activity planning, cognitive restructuring), and exposure exercises, may have been selected to provide a comparison to treatment as usual or minimal good treatment. Nonetheless, it does not control for critical features of the technique, such as application of needles. To understand whether or not study results could be driven by different expectations about the treatments, a control such as placing needles in sham sites would be necessary. Thus, we believe that proof-of-concept has been established for acupuncture, but recommend withholding judgment about its effectiveness for PTSD until additional controlled trials have been conducted."

10)

Seminole Heights Community Acupuncture- Acupuncture and the US Military

"The connection between the military and acupuncture worlds extends beyond direct patient care. In 2013, the New England School of Acupuncture completed a three year study on acupuncture for Gulf War veterans. (Dale and I are both graduates of NESA.) The Department of Defense provided a grant in excess of $1.2 million to fund this first-of-its-kind clinical trial: The Effectiveness of Acupuncture in the Treatment of Gulf War Illness (GWI). GWI is a complex syndrome characterized by many symptoms, including fatigue, musculoskeletal pain, headaches, dizziness, memory problems, indigestion, skin problems, shortness of breath, and mood disorders. More than 100,000 of the 700,000 Gulf War veterans to date have reported GWI symptoms"

11)

Congressionally Directed Medical Research Programs (CDMRP)- Effectiveness of Acupuncture in the Treatment of Gulf War Illness

"The goal of this study is to help identify whether acupuncture is an effective treatment for Gulf War Syndrome. Acupuncture is likely to be helpful in treating GWI because it has already been used successfully to reduce many of its key symptoms -- fatigue, irritability, anxiety, insomnia, and pain. Acupuncture treatment is designed to treat each individual's symptoms, making it very well suited for treating the varied symptoms of GWI. Veterans will receive care that is directed specifically at their most distressing symptom. Though the specific etiology of CMI is unknown, acupuncture's analgesic and anti-inflammatory effects are likely to be helpful. Acupuncture seems to work, in part, on peripheral nerves near the site of injury, in the brain, central nervous system, and on the endocrine system, in ways that promote the body's own efforts to reduce pain and heal even chronic injuries. Numerous studies have shown acupuncture is well tolerated by patients, safe, and cost-effective compared to routine care. Acupuncture will be provided by licensed acupuncturists, with at least 5 years of clinical experience, who have received 20 hours of training related to symptoms of GWI."

12)

STARS AND STRIPES- Military turns to acupuncture as alternative to prescription painkillers

"White, an Army major and director of LRMC’s pain center, said acupuncture isn’t a cure-all for everyone. For about one-third of his patients, it’s a “home run” and their pain goes away completely. With another third, the pain diminishes but doesn’t disappear. And for a third, he says, “you strike out” — they feel no change.

As Niemtzow emphasizes, “It’s not a magic bullet. Patients may find themselves being able to enjoy pain-free periods or reduced-pain periods, or combined with medication, a better lifestyle.”

The science behind how acupuncture works is not fully understood, experts say. One theory, White said, is that acupuncture taps into nerve pathways to the brain. With the reception of dual pain and acupuncture signals, the brain’s information processing gets muddled and pain is disrupted or dulled."

לסיכום בעברית:

דיקור סיני נמצא יעיל לטיפול בפוסט טראומה ברבים מהמקרים.

בחלק מהמחקרים נמצאו תוצאות זהות בין אלו שהשתמשו בתרופות "מערביות" לטיפול בסימפטומי הטראומה. עם זאת יש לזכור שהתרופות האלו מלוות בתופעות לוואי שונות ומגוונות, בעוד לדיקור סיני אין תופעות לוואי והוא בטוח לגמרי לשימוש.

באופן אישי יצא לי לטפל במקרים רבים של חרדה, אינסומניה, מחשבות טורדניות, תחושת "עוררות וחוסר שקט", בעיות ריכוז וסטרס ולראות תוצאות מדהימות!

למען האמת, גם במקרים בהם אני מטפל בתופעה פיזית יותר, כמו כאבי גב, או נקע בקרסול למשל, המטופלים מדווחים בנוסף על השיפור בכאבים גם על נינוחות ותחושת רוגע מתמשכת בסיום הטיפולים.


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