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SHORT COMMUNICATION
KEYWORDS
CPSP;
Stroke;
Bee venom;
Apipuncture;
Post stroke
Summary
Objective: We investigated apipuncture, or acupuncture point injection with diluted bee venom,
as a promising new treatment for central post stroke pain (CPSP).
Methods: Bee venom, diluted to 0.005% in normal saline, was administered to the treatment
group, and normal saline given to control group as twice-weekly injections for three weeks.
The points were LI15, GB21, LI11, GB31, ST36 and GB39 of the affected side and the amount of
injection was 0.05 ml at each point.
Results: Eight patients in each group were included in the analysis. After three weeks there
were signicant decreases in visual analogue pain scores compared with baseline in both groups
and the treatment group improved more signicantly than the control group (p = 0.009).
Conclusion: Apipuncture signicantly improved CPSP in this pilot trial. Further studies of its
mechanisms and a larger and long-term follow-up trial will be needed to determine more
denitely the efcacy of apipuncture and to elucidate duration of improvement.
2013 Elsevier Ltd. All rights reserved.
Introduction
Central post stroke pain (CPSP), a neuropathic pain syndrome that can occur after a cerebrovascular accident, is
due to a lesion of the somatosensory pathways within the
central nervous system.1,2 The prevalence of CPSP is known
to be between 1% and 12%, and treatment methods such
as pharmacologic agents and neurostimulation therapy do
Corresponding author at: Department of Cardiology and Neurology of Korean Medicine, Kyung Hee University Hospital at Gangdong,
#149 Sangil-dong, Gangdong-gu, Seoul 134-727, Republic of Korea.
Tel.: +82 2 440 6217; fax: +82 2 440 6217.
E-mail address: happyomd@khu.ac.kr (S.-U. Park).
not work well in many patients.24 Apipuncture, the subcutaneous injection of diluted bee venom into an acupoint,
is used mainly to relieve pain produced by inammatory
diseases such as rheumatoid arthritis and osteoarthritis.4
Previous studies have shown analgesic activity in a neuropathic pain model,5,6 and there was a case report of CPSP
using apipuncture.4 In this study, we intended to investigate
the possibility of apipuncture, acupuncture point injection
with diluted bee venom, as a new promising treatment for
central post stroke pain (CPSP).
Methods
This study was performed in accordance with the ethical
standards of the Helsinki Declaration. The protocol was
0965-2299/$ see front matter 2013 Elsevier Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.ctim.2013.02.001
156
Results
Discussion
References
1. Klit H, Finnerup NB, Overvad K, Andersen G, Jensen TS. Pain
following stroke: a population-based follow-up study. PLoS ONE
2011;6:e27607.
2. Klit H, Finnerup NB, Jensen TS. Central post-stroke pain: clinical characteristics, pathophysiology, and management. Lancet
Neurology 2009;8:85768.
3. Hansen AP, Marcussen NS, Klit H, Andersen G, Finnerup NB,
Jensen TS. Pain following stroke: a prospective study. European
Journal of Pain 2012;16:112836.
4. Yun SP, Sun BC. Apipuncture treatment for central post-stroke
pain. Journal of Alternative and Complementary Medicine
2010;16:2234.
5. Kim HW, Kwon YB, Han HJ, Yang IS, Beitz AJ, Lee JH. Antinociceptive mechanisms associated with diluted bee venom acupuncture
(apipuncture) in the rat formalin test: involvement of descending adrenergic and serotonergic pathways. Pharmacological
Research 2005;51:1838.
6. Yoon SY, Roh DH, Kwon YB, Kim HW, Seo HS, Han HJ, et al.
Acupoint stimulation with diluted bee venom (apipuncture)
potentiates the analgesic effect of intrathecal clonidine in the
157
acupuncture point in mice: role of alpha(2) adrenoceptors. Neuroscience Letters 2001;308:1337.
9. Roh DH, Kwon YB, Kim HW, Ham TW, Yoon SY, Kang SY, et al.
Acupoint stimulation with diluted bee venom (apipuncture) alleviates thermal hyperalgesia in a rodent neuropathic pain model:
involvement of spinal alpha 2-adrenoceptors. Journal of Pain
2004;5:297303.
2013 Elsevier