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Wissenschaftliche Grundlagen der Akupunktur

  • B. Pomeranz

Zusammenfassung

In diesem Kapitel werden 230 neuere Forschungsarbeiten über Akupunktur aufgearbeitet. Da sich die Forschung in der Hauptsache auf die Akupunkturanalgesie (AA) konzentriert hat, wird diese das Hauptthema sein. Zwei wesentliche Schlußfolgerungen werden gezogen: Zum einen, daß die Akupunkturanalgesie in der Behandlung chronischer Schmerzzustände wirksam ist (besser als Placebo), und zum zweiten, daß die Einsicht in die neurologischen Wirkungszusammenhänge der AA rapide wächst. Wir kommen zu dem Ergebnis, daß Akupunktur dünne myelinisierte Nervenfasern im Muskel aktiviert, die Impulse zum Rückenmark leiten, wodurch drei in der Analgesie zusammenwirkende Zentren aktiviert werden: das Rückenmark, das Mittelhirn und die Funktionseinheit Hypothalamus-Hypophyse. Im Rückenmark werden die afferenten Schmerzreize mit Hilfe von Enkephalin und Dynorphin blockiert. Im Mittelhirn wird das absteigende Raphesystem durch Enkephalin aktiviert, welches die Schmerzweiterleitung im Rückenmark mit Hilfe der Monoamine Serotonin und Noradrenalin unterdrückt. Das dritte Zentrum, die Funktionseinheit Hypothalamus-Hypophyse, setzt β-Endorphin ins Blut und in den Liquor frei und übt so eine analgetische „Fernwirkung“ aus. So spielen alle drei Endorphinarten (Enkephalin, β-Endorphin und Dynorphin) eine Rolle in der AA; außerdem sind zwei Monoamine (Serotonin und Noradrenalin) beteiligt. Wenn hochfrequente Stimulation mit niedriger Stromstärke angewendet wird, tritt ein nicht-endorphinabhängiger Typ von Analgesie ein.

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