MEDICAL REHABILITATION OF PATIENTS WITH PHANTOM LIMB PAIN SYNDROME USING AURICULOPUNCTURE

Background. The aetiology and pathogenesis of phantom limb pain (PLP) is currently considered from the perspective of various theories, which can be conditionally divided into peripheral and central. Auriculotherapy is a form of reflexology based on the idea that the ear is a microsystem reflecting the entire body represented on the auricle. Irritation of biologically active points with acupuncture needles causes the accumulation of enkephalins, serotonin, substance R. Acupuncture triggers the mechanism of an antinociceptive reaction. According to E.S. Velhover [1], auriculopuncture closes reflex arcs through the cerebral cortex, stem and subcortical structures. The high effectiveness of auriculopuncture is explained by the effect on the central nervous system structures, which are mainly involved in the formation of phantom pain syndrome. Purpose. To evaluate the effectiveness of auriculotherapy in the complex medical rehabilitation of patients with PLP. Materials and methods. The research was conducted on the basis of Branch No. 2, National Medical Research Center for High Medical Technologies named after A.A. Vishnevsky of the Russian Ministry of Defense. 200 patients with PLP were under observation. The study included male patients aged 20 to 50 years, with phantom limb pain of various localization, lasting from 2 to 6 months, who had not previously undergone acupuncture treatment. The exclusion criteria were patients with a history of strokes and brain and spinal cord injuries at the time of initiation of treatment, with chronic diseases of the nervous system that worsen the course of phantom pain syndrome, with depressive syndrome and a negative attitude towards treatment. Results. Pain reduction in patients of the main group (MG) with the use of auriculotherapy was achieved in 74% of cases, in the control group(CG) — in 59% of cases. The obtained results persisted in patients from (MG) for up to 6 months, from (CG) — up to 3 months. Conclusion. The inclusion of auriculopuncture in the comprehensive medical rehabilitation of patients with phantom limb pain makes it possible to reduce the manifestation of the syndrome, shorten the duration of prosthetics and thereby increase the effectiveness of rehabilitation programs.