Long-term effects of acupuncture
Sammanfattning: In a retrospective follow-up study, n=202, long-term pain relief (>6 months) after a course of acupuncture treatments was found mainly among patients with chronic nociceptive pain while patients with neurogenic or psychogenic pain did not benefit much. In a placebo-controlled randomised single-blind long-term study with independent observer of chronic nociceptive low back pain, n=50, it was found that acupuncture, was significantly superior to true placebo in all outcome measurements, even more than 6 months after the treatment series. Together, these two studies also showed that among patients with chronic nociceptive pain 23-41% got pain relief >6 months after acupuncture even if their pain duration was very long. Significant, subjective as well as objective, improvements among elderly women (n=15) with urge- or mixed type urine incontinence, after a series of manual acupuncture treatments was found even at follow up at three months. In a placebo-controlled randomised crossover single-blind study of manual acupuncture for hyperemesis gravidarum, among 33 women, the addition of active acupuncture to standard fluid therapy, significantly improved the women faster than superficial acupuncture. In an experimental study on gentle segmental manual acupuncture in anaesthetised not stressed rats, a strong inhibition of C-fibre responses in WDR neurones, outlasting the period of acupuncture for more than 30 minutes was shown in half of the neurones. A hypothesis of possible mechanisms for therapeutic acupuncture, local improved function and central hormonal for long-term relief is described and discussed as it is argued that almost all earlier experimental animal research in fact only shows stress-induced analgesia or activation of diffuse noxious inhibitory control. Key words: Acupuncture, randomised placebo-controlled trial, chronic low back pain, long term effects, pain categories, manual acupuncture, WDR neurons, C-fibre response,urine incontinence, hyperemesis gravidarum, nausea, vomiting, strong vs gentle stimulation, stress-induced analgesia.
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