segunda-feira, 14 de janeiro de 2008

Medical Acupuncture - Present and Future

Norton Moritz Carneiro, M.D.

In the last three decades, the scientific research produced a considerable amount of data that elucidate the mechanisms of action, the clinical efficacy and the safety of the medical use of Acupuncture. The advantages of the use of this millenary medical technology on the treatment of different clinical conditions was demonstrated, and its benefits include, beside efficacy, lower costs and smaller rate of adverse effects, comparing with other therapeutic methods.

The method consists on the modulating stimulation of structures of the peripheral nervous system - receptors, effectors and nervous fibers, with a therapeutic purpose. The neural responses involve physiological processes in the local, segmental and encephalic levels of the nervous system, and promote the restoration of the physiological patterns of all aspects of the organism that are under influence of the nervous system.

The therapeutic effects include inhibition of the nociception (thus inducing analgesia), normalization of motor and autonomic functions, increase of the immune and regenerative abilities, and the activation of homeostatic systems (thus promoting an improvement of the biological capabilities of the organism). The physiology of neuromodulation, the basic mechanism of Acupuncture explains the results of this method of peripheral neural stimulation.

The therapeutic resources available for the specialist include the temporary implant and manipulation of acupuncture needles, the percutaneous or transcutaneous appliance of electro-stimulation, as well as the injections, at different levels of depth, of anesthetic agents, in anatomically defined sites of the body.

Consolidated by the recognition of its physiologic bases and clinic tests, the use of Acupuncture is recommended to be included in the treatment of painful syndromes and functional disorders, as fibromyalgia syndrome and migraine, as well as sleep disorders, and many digestive, circulatory, urinary, immune, and psycho-neuro endocrine disorders. In some painful and dysfunctional conditions, as the myofascial syndrome, Medical Acupuncture is a first line therapeutic choice.

The history of Acupuncture, its origins in the ancient China and its recent evolution is well known. Until the last decades of the 20th century, the practice of Acupuncture was strictly close into the old Chinese civilization cultural context (lately a mixture of ancient texts with an official simplification), and not linked to the medico-scientific context. Than, the evolution of the scientific approach provided ground for an accelerate development of the Contemporary Medical Acupuncture.

Many physicians and health authorities still think Acupuncture as inseparable of the closed cultural context of the Traditional Chinese Medicine, and this fact has kept Acupuncture outside the main stream of modern medicine. But, the recognition of the scientific foundations of Medical Acupuncture leads, in a near future, to the inclusion of the method in the medical education programs, and to its adoption as a current practice in the attention to ambulatory and hospitalized patients, for the benefit of those who suffer and of the society.

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