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Case Reports
. 2015 Jul;4(4):56-60.
doi: 10.7453/gahmj.2014.081.

Treatment of Posttraumatic Abdominal Autonomic Neuropathy Manifesting as Functional Dyspepsia and Chronic Constipation: An Integrative East-West Approach

Andrew Shubov  1 , Lawrence Taw  1
Affiliations
Case Reports

Treatment of Posttraumatic Abdominal Autonomic Neuropathy Manifesting as Functional Dyspepsia and Chronic Constipation: An Integrative East-West Approach

Andrew Shubov et al. Glob Adv Health Med. 2015 Jul.

Abstract
in English, Chinese, Spanish

A 52-year-old male with a history of spinal cord injury and cauda equina syndrome resulting in neurogenic bladder presented with chronic constipation and functional dyspepsia that was refractory to medical management. He was treated with an integrative East-West approach including acupuncture, trigger point injections, and Tui Na massage. Both his pain and constipation improved after a series of treatments, and this improvement was largely sustained at 2-year follow-up. This patient's symptoms are consistent with damage to the visceral parasympathetic nervous system. Interestingly, many studies evaluating the mechanisms of acupuncture point to restoration of parasympathetic tone as a mechanism of action. In this article, we describe a case of complex functional gastrointestinal disorders associated with posttraumatic autonomic neuropathy that was refractory to pharmacotherapy and was successfully treated with an integrative East-West approach.

一名 52 岁男性因慢性便秘和功 能性消化不良且经内科治疗无效 来诊，患者存在脊髓损伤及马尾 神经综合征继发神经源性膀胱病 史。我们采用东西方结合策略对 患者进行了治疗，其中包括针 灸、激痛点注射和推拿按摩。一 系列治疗之后，患者的疼痛和便 秘均得以缓解，且大部分效果维 持到了 2 年随访时。 该患者 的症状符合内脏副交感神经系 统受损的诊断。有趣的是，很 多针灸机制研究指出，副交感 神经张力的修复是针灸的作用 机制之一。本文描述了一例复 杂的功能性胃肠疾病，该病继 发于外伤后自主神经病变且对 药物治疗无效，但经东西方结 合治疗后成功缓解。.

Un varón de 52 años de edad, con antecedentes de lesiones de la médula espinal y síndrome de cauda equina que dio lugar a vejiga neurogénica se presentó con estreñimiento crónico y dispepsia funcional que eran refractarios al tratamiento médico. Fue tratado con un enfoque integrador este-oeste, que incluyó acupuntura, inyecciones en los puntos gatillo y masaje tuina. Tanto el dolor como el estreñimiento mejoraron después de una serie de tratamientos y esta mejoría se mantuvo en gran medida en el seguimiento a 2 años.Los síntomas de este paciente son coherentes con daño en el sistema nervioso parasimpático visceral. Es interesante saber que muchos estudios en los que se evalúan los mecanismos de la acupuntura señalan el tono parasimpático como un mecanismo de acción. En este artículo, se describe un caso de trastornos gastrointestinales funcionales complejos asociados a neuropatía autonómica postraumática que era refractario a la farmacoterapia y fue tratado con éxito con un enfoque integrador este-oeste.

Keywords: Cauda equina syndrome; Tui Na; acupuncture; autonomic modulation; constipation; functional dyspepsia; myofascial; parasympathetic; trigger point.

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