Treatment of primary Raynaud's syndrome with traditional Chinese acupuncture

Appiah, Richard; Hiller, Sarah; Caspary, L; Alexander, Klaus; Creutzig, A

doi:10.1046/j.1365-2796.1997.91105000.x

Cited by 57 publications

(30 citation statements)

References 17 publications

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“…A possible explanation is that cold weather is always a contributing factor in initiating the attacks but that, once they have started, the overall decreased sympathetic tone in the blood vessels, nerves and surrounding connective tissue due to consistent myofascial work may reduce their duration and severity. This is in contrast to previous studies using interventions such as acupuncture, which demonstrated a marked decrease in the frequency but not in the duration or severity of each episode (Appiah, 1997). In comparison, studies using the fish-oil supplements found that the onset of PRP episodes following exposure to cold could be delayed through ingestion of omega-3 fatty acids (DiGiacomo et al, 1989).…”

Section: Discussioncontrasting

confidence: 86%

“…One study noted some success in reducing frequency and severity of Raynaud attacks through the use of low level laser therapy (Hirschl et al, 2004). Another examined the use of Chinese acupuncture in the treatment of PRP and it was observed that a reduction in frequency of vasospastic attacks lasted for 10 months following treatments, comparable to the effectiveness of calcium-channel blockers (Appiah, 1997). However, due to the complexity of PRP and the lack of an adequate level of proof with any one of these alternative treatments, it is agreed that the best approach thus far is avoidance of the precipitating factors and conservative lifestyle changes (Block and Sequeira, 2001).…”

Section: Alternative Treatmentsmentioning

confidence: 99%

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Efficacy of myofascial release techniques in the treatment of primary Raynaud's phenomenon

Walton¹

2008

Journal of Bodywork and Movement Therapies

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Section: Discussioncontrasting

confidence: 86%

Section: Alternative Treatmentsmentioning

confidence: 99%

Efficacy of myofascial release techniques in the treatment of primary Raynaud's phenomenon

Walton¹

2008

Journal of Bodywork and Movement Therapies

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“…Biofeedback was also not eff ective. In contrast, two studies investigating the eff ects of acupuncture revealed signifi cant benefi ts [11,12]. In three studies, low level laser therapy reduced the frequency and severity of RP attacks.…”

Section: Non-pharmacologic Approachmentioning

confidence: 98%

“…Although there has been a lack of adequate study data from RP patients with obstructive vascular disease involving the digital arteries, antithrombotic therapy with low-dose aspirin 75 -100 mg daily has been recommended for all patients with concomitant peripheral arterial occlusive disease [ESM 2,12]. In patients who develop critical digital ischaemia despite vasodilator therapy that is believed to be due to new onset of arterial occlusion, therapeutic-dose anticoagulation with either low-molecular-weight heparin (LMWH) or UFH might be considered to reduce the extent of ischaemic injury by preventing clot …”

Section: Antiplatelet and Anticoagulant Therapymentioning

confidence: 99%

Raynaud’s phenomenon and digital ischaemia - pharmacologic approach and alternative treatment options

Linnemann

Erbe

2016

Vasa

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Summary:The primary goal of therapy is to reduce the frequency and intensity of Raynaud's attacks and to minimize the related morbidity rather than to cure the underlying condition. Treatment strategies depend on whether Raynaud's phenomenon (RP) is primary or secondary. All patients should be instructed about general measures to maintain body warmth and to avoid triggers of RP attacks. Pharmacologic intervention can be useful for patients with severe and frequent RP episodes that impair the patient's quality of life. Calcium channel blockers are currently the most prescribed and studied medications for this purpose. There has been limited evidence for the effi cacy of alpha-1-adrenergic receptor antagonists, angiotensin receptor blockers, topical nitrates or fl uoxetine to treat RP. The intravenously administered prostacyclin analogue iloprost can reduce the frequency and severity of RP attacks and is considered a second-line therapy in patients with markedly impaired quality of life, critical digital ischaemia and skin ulcers who are at risk for substantial tissue loss and amputation. Phosphodiesterase inhibitors (e.g., sildenafi l) can also improve RP symptoms and ulcer healing whereas endothelin-1 receptor antagonists (e.g., bosentan) are mainly considered treatment options in secondary prevention for patients with digital skin ulcers related to systemic sclerosis. However, their use in clinical practice has been limited by their high cost. Antiplatelet therapy with low-dose aspirin is recommended for all patients who suffer from secondary RP due to ischaemia caused by structural vessel damage. Anticoagulant therapy can be considered during the acute phase of digital ischaemia in patients with suspected vascular occlusive disease attributed to the occurrence of new thromboses. In patients with critical digital ischaemia, consideration should be given to hospitalisation, optimisation of medical treatment in accordance with the underlying disease and evaluation for a secondary, possibly reversible process that is causing or aggravating the clinical symptoms.

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“…42 Behavioral modification with biofeedback has helped many patients, and acupuncture has even proved beneficial in one small study. 43,44 We empirically treat patients with digital ulcers with pentoxifylline until their ulcers have resolved. The digital ulcers are treated with local care and judicious use of antibiotics for cellulitis.…”

Section: Treatment and Outcomementioning

confidence: 99%