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ISSN Печать: 0896-2960
ISSN Онлайн: 2162-6553
Indexed in
A Review of Acupuncture's Mechanisms of Action in the Management of Lymphedema
Краткое описание
Physiological rationale supporting the use of acupuncture in the management of lymphedema secondary to cancer treatment is limited. A review of the literature was conducted to answer the question, What is known from the existing evidence about acupuncture's physiological mechanisms of action for the management of edema or lymphedema? A scoping review of the literature was used to characterize existing research, identify and summarize physiological mechanisms of treatment action, and establish directions for future research. Acupuncture's physiological mechanisms of action when used for the management of lymphedema secondary to cancer treatment are poorly described in clinical research. Mechanistic studies using animal models of acute inflammatory edema, however, have identified a number of therapeutic acupuncture-mediated treatment responses that occur via stimulation of the hypothalamic-pituitary-adrenal axis, the endogenous opioid system, and the peripheral nervous system. Associated "antiedemic" outcomes were attributed to increases in anti-inflammatory mediators, reductions in proinflammatory mediators, and increased neuro-mediated contractility of lymphatic and smooth muscle. Animal research, although not necessarily applicable to cancer patients with lymphedema, raises the possibility that lymphedema may benefit from a number of interrelated, acupuncture-mediated mechanisms of action. Future research involving human subjects with cancer-related lymphedema should include physiological rationale for acupuncture protocol parameters and use outcome measures associated with proposed mechanisms of treatment action.