Electroacupuncture was used to treat patients with
transverse myelitis to help improve bowel and bladder functions. Results of the
clinical study were published in the journal of Acupuncture in Medicine.
Transverse myelitis is a condition in which a section of
the spinal cord becomes inflamed. This neurological disorder often damages the
insulating material myelin, the covering for nerve cell fibers, disrupting the
messages that the spinal cord nerves send throughout the body. As a result,
communications between nerve cells in the spinal cord and the rest of the body
can be interrupted. The exact reason for transverse myelitis is not know. There
are many conditions that appear to initiate the disorder, including infection,
multiple sclerosis etc. Symptoms of transverse myelitis range from back pain to
more serious problems, such as paralysis or loss of bowel control and bladder
dysfunction. There is no cure for transverse myelitis. The treatments to
prevent or minimize the permanent dysfunction include corticosteroid, antiviral
and other immunosuppressive medications. Alternative medications such as
acupuncture have been used to enhance patient’s recovery.
Recently, a small clinical study was conducted to explore
the effect of electroacupuncture on bowel and bladder function of patients with
transverse myelitis. Sixteen participants were recruited. Electroacupuncture
was applied at acupoints bilateral BL32, BL33, and BL35 for 30 min, once a day,
five times a week for the first 4 weeks; and once every other day, three times
a week for the following 4 weeks. Patients were then followed up for 6 months.
Bladder and bowel function were assessed at baseline, 8-week after acupuncture
and 6-month follow respectively.
Data showed that at baseline, all 16 patients had
abnormal voiding and needed assisted measures >50% of the time to empty the
bladders. Following 8-week treatment, five patients (31%) resumed normal
voiding; six patients (38%) achieved partially normal voiding assisted by
pressing the abdomen to empty the bladder without catheterization, and five
patients (31%) didn’t show significant improvement. The residual urine volume (RUV)
markedly decreased by 100 mL (IQR 53–393 mL) in nine patients with bladder
voiding dysfunction. The number of weekly urinary incontinence episodes,
24-hour urinary episodes, and nocturia episodes per night statistical
significantly diminished by 14 (95% CI 5 to 22), 5 (95% CI 1 to 9), and 4 (95%
CI 0 to 7) episodes, respectively in 11 patients with urinary incontinence. Following
8-week acupuncture treatment to eight patients with faecal retention, four (50%)
resumed normal bowel movements, three (38%) regained partially normal bowel
movements, and one (13%) didn’t have any change.
It has been suggested that electroacupuncture stimulation
at BL32 and BL33 might directly or indirectly involved in the S2–3 nerve roots,
which are the parasympathetic centre of the spinal cord, innervate the muscles
in the pelvic area, such as the pelvic floor, urethral sphincters, bladder and
anal sphincter muscles. It is plausible that acupuncture stimulation at S2–S3
might enhance recovery of the muscle function.
The preliminary study showed that electroacupuncture might
be a promising alternative for the management of bladder and bowel dysfunction
in patients with transverse myelitis. Further studies with larger sample and randomized
controlled trials are needed to validate the present results.
Reference
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