segunda-feira, 14 de janeiro de 2008

The Treatment of Stress and Functional Disorders: the Contemporary Medical Acupuncture Approach

Norton Moritz Carneiro, M.D.

The response to stress is a physiologic phenomenon that occurs in the presence of a threatening factor. It involves a complex series of adaptive measures mediated by the nervous system, which leads to autonomic, neuroendocrine, somatic and behavioral changes.

Two concepts founded the modern study of stress: the General Adaptive Syndrome (Selye, 1936) describing the hormonal pathway, and the “fight or flight” reaction (Cannon, 1938), that elucidated the autonomic participation. The response is designed as a short-lived change, but too intensive or prolonged stressful responses also produce pathological changes, which result in functional disorders, that can evolve to structural modifications.

Any physical or environmental, real or perceived challenge that can disturb homeostasis represents a trigger for the stress reaction. The physiologic phenomena involves a nervous system-mediated complex series of adaptive processes, which lead to autonomic, neuro-endocrine, somatic and behavioral changes.

Different kinds of stressors, physical or psychological, painful or not, activate the stress response systems from specific neural structures. At the rostral aspect of central nervous system, the pre-optic area and the brain cortex excite neurons of the peri-ventricular nucleus of hypothalamus (PVN). In the temporal lobe, the limbic system, specifically the amygdales, are also implicated in the stress response.

Contemporary Medical Acupuncture is an evolution of the traditional acupuncture. In its present development it is defined as a peripheral neuromodulator intervention. Its purpose is to promote general health and to reduce the suffering caused by diseases, by means of interventions that at once relieve the pain and restore the functional patterns.

The eligible sites for these interventions are peripheral nerve branches, segmental reflex zones, and neuromuscular sites (mechanoceptors and motor points).

Solid evidences of the efficacy of the peripheral neuromodulation have been published, allowing the use of Contemporary Medical Acupuncture to be considered as crucial for the treatment of pain, stress, and functional disorders.

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