A therapeutic trial of acupuncture in neurogenic bladder of spinal cord injured patients – a preliminary report

Abstract

Eighty patients with spinal cord injury (SCI) and neurogenic bladder were studied. Among them, 28 (70%) cases in the control group and 32 (80%) cases in the electroacupuncture group achieved ultimately balanced voiding and were selected for further analysis. The acupuncture group received electroacupuncture at four acupoints: Chung Chi (Conception Vessel CV3), Kuan Yuan (CV4), and bilateral Tzu Liao (Urinary Bladder UB32), in addition to conventional intermittent catheterization program (ICP). Whereas the control group underwent conventional bladder training program with ICP only. The results revealed that the time of achieving balanced voiding was statistically signi®cantly shorter with electroacupuncture than in the control group: 57.1+22.5 vs 85.2+27.4 days (P50.005) for upper motor neuron lesions, and 55.4+22.6 vs 83.4+26.1 days (P50.01) for lower motor neuron lesions. However, there was almost no di erence between upper motor neuron lesions and lower motor neuron lesions. When acupuncture commenced was also a factor to in¯uence the results. Those who received acupuncture within 3 weeks after injury had signi®cantly shortened the total days to achieve a balanced bladder, as compared to those who received acupuncture 3 weeks after injury (46.6+13.2 vs 65.8+15.4 days, P50.005). Our study implied that acupuncture might be bene®cial in the management of neurogenic bladder of SCI, and the earlier the patient received electro-acupuncture therapy, the sooner the bladder balanced. On the other hand, we also found that complete spinal cord injury, either with pronounced detrusor-sphincter dyssynergia in upper motor nueron lesion or with persistent are¯exic bladder in lower motor neuron lesion, was not a ected by acupuncture.

The Status and Future of Acupuncture Clinical Research

“…28 Meanwhile, two other good-quality RCTs, although underpowered, reported nonsignificant results, 29,30 while two relatively inferior-quality studies reported significance. 31,32 Meanwhile, most acupuncture studies for bladder control in patients with spinal-cord injury, including two RCTs 33,34 and two case series, 35,36 indicated favorable outcomes despite limited quality. All in all, the recommendation rating for pain and bladder control in patients with spinal-cord injury is close to C with potential toward B.…”

Electro-acupuncture Reduces Neuronal Apoptosis Linked to Bax and Bcl-2 Expression in the Spinal Cords of Cats Subjected to Partial Dorsal Root Ganglionectomy

“…Electro-acupuncture (EA) is an effective method of acupuncture, and has been showed to increase the number of axonal synaptic terminals from spared L 6 dorsal root ganglion (DRG) following adjacent dorsal root ganglionectomy in spinal lamina II and nucleus dorsalis (ND) by regulating neurotrophins [23][24][25][26][27][28], as well as promoting recovery from injured spinal cord and brain in clinical cases [29][30][31]. However, the underlying mechanisms are yet to be elucidated.…”

Effects of Electro-acupuncture on PDGF Expression in Spared Dorsal Root Ganglion and Associated Dorsal Horn Subjected to Partial Dorsal Root Ganglionectomy in Cats

“…Electro-acupuncture (EA), is an effective method of acupuncture, and has been demonstrated to increase the number of axonal synaptic terminals from spared L 6 dorsal root ganglion (DRG) following adjacent dorsal root ganglionectomy in spinal lamina II and nucleus dorsalis (ND) [13][14][15], as well as promoting recovery from injured spinal cord and brain in clinical cases [16][17][18], but the underlying mechanisms are yet to be elucidated.…”