Zotelli Vera Lr, Grillo Cássia M, Gil Maria Lb, Wada Ronaldo S, Sato Jorge E, da Luz Rosário de Sousa Maria
Department of Social Dentistry of the Piracicaba Dental School, State University of Campinas, São Paulo, Brazil.
Department of Social Dentistry of the Piracicaba Dental School, State University of Campinas, São Paulo, Brazil.
J Acupunct Meridian Stud. 2017 Oct;10(5):351-359. doi: 10.1016/j.jams.2017.08.005. Epub 2017 Sep 22.
Temporomandibular disorders (TMD), recognized as the most common conditions of chronic orofacial pain, have a multifactorial etiology. Acupuncture can help to relieve the pain and discomfort associated with these conditions, because it can rebalance the energy (Qi) circulating in the meridians. The aim of the study was to verify the effectiveness of acupuncture in treating the pain; mouth opening limitation, and energy circulating in the meridians of patients with TMD of muscular or mixed origin. This was a controlled, randomized, double-blind clinical trial conducted at the Piracicaba Dental School (FOP/Unicamp), in Piracicaba SP, Brazil. The Treatment Group received acupuncture with real penetration of the needle, and the Placebo Group received a sham treatment without needle penetration. The acupoints used were: ST6, ST7, SI18, GV20, GB20, BL10, and LI4, during treatment performed for four weekly sessions. The TMD and mouth opening were evaluated according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC). The measurements of the energy at the meridians were performed by the Ryodoraku method, before and after acupuncture in all of the sessions in both groups. The results showed no decrease in pain in the Treatment Group when compared with the Placebo Group (p = 0.2261). There was no increase in the oral opening limit in the Treatment Group compared with the Placebo Group (p > 0.05). Regarding the energy levels, after acupuncture, there was a decrease in Yang energy in all sessions (p < 0.05), in both groups, however, only real acupuncture was effective in maintaining the Yin energy average throughout the four sessions, with significant difference between groups (p = 0.0198). In conclusion, volunteers with TMD presented a pattern of energy deficiency and the most prevalent imbalance patterns identified were in the meridians coupled to the kidney and bladder, and in the Shao Yin (heart/kidney) and Shao Yang (triple energizer/gall bladder) energetic planes. The acupuncture points used were equally effective in reducing pain in both groups; increasing the unassisted mouth opening limitation without pain in the Treatment Group, and were also effective in preserving the Yin energy in the Treatment Group. The Yang energy decreased equally in both groups.
颞下颌关节紊乱病（TMD）被认为是慢性口面部疼痛最常见的病症，其病因是多因素的。针灸有助于缓解与这些病症相关的疼痛和不适，因为它可以重新平衡经络中循环的能量（气）。本研究的目的是验证针灸治疗肌肉型或混合型TMD患者的疼痛、张口受限以及经络中能量循环的有效性。这是一项在巴西圣保罗州皮拉西卡巴市的皮拉西卡巴牙科学院（FOP/Unicamp）进行的对照、随机、双盲临床试验。治疗组接受真正进针的针灸治疗，安慰剂组接受不进针的假治疗。治疗期间每周进行一次，共四次，使用的穴位为：ST6、ST7、SI18、GV20、GB20、BL10和LI4。根据颞下颌关节紊乱病研究诊断标准（RDC）对TMD和张口情况进行评估。两组在所有疗程的针灸前后均采用良导络法测量经络能量。结果显示，与安慰剂组相比，治疗组的疼痛没有减轻（p = 0.2261）。与安慰剂组相比，治疗组的张口受限没有增加（p > 0.05）。关于能量水平，针灸后，两组在所有疗程中阳气均下降（p < 0.05），然而，只有真正的针灸在整个四个疗程中有效地维持了阴气平均值，组间差异显著（p = 0.0198）。总之，TMD志愿者呈现出能量不足的模式，最普遍的失衡模式出现在与肾和膀胱相关的经络以及少阴（心/肾）和少阳（三焦/胆）能量平面。所使用的穴位在两组中减轻疼痛的效果相同；治疗组在无痛情况下增加了自主张口受限，并且在治疗组中也有效地保存了阴气。两组的阳气下降程度相同。
