Ichida Michelle Cristina, Zemuner Mariana, Hosomi Jorge, Pai Hong Jin, Teixeira Manoel Jacobsen, de Siqueira José Tadeu Tesseroli, de Siqueira Silvia R D T
Neurology Department, Medical School, University of São Paulo, São Paulo, 05403-010, Brazil.
Group of Acupuncture, Interdisciplinary Pain Group of the Neurology Division, Clinical Hospital, Medical School, University of São Paulo, São Paulo, 05403-010, Brazil.
Chin J Integr Med. 2017 Nov;23(11):829-836. doi: 10.1007/s11655-017-2786-0. Epub 2017 Oct 28.
To evaluate the treatment effect of acupuncture on patients with idiopathic trigeminal neuralgia (ITN) by case-control longitudinal blinded study.
Sixty ITN patients and 30 healthy subjects were included. The ITN patients were randomly assigned to acupuncture group (15 cases), sham-acupuncture group (15 cases) and carbamazepine group (30 cases), respectively. Clinical orofacial evaluation (including pain intensity and medication doses), research diagnostic criteria for temporomandibular disorders (RDC/TMD) and Helkimo indexes (for functional evaluation of the masticatory system), and quantitative sensory testing for sensory thresholds (gustative, olfactory, cold, warm, touch, vibration and superficial and deep pain) were evaluated before treatment, immediately after treatment, and 6 months after treatment.
The mean pain intensity by the Visual Analogue Scale only decreased in the acupuncture group at the last evaluation (P=0.012). Patients in the sham-acupuncture group had an increase in carbamazepine doses according to the prescriptions (P<0.01). There was a reduction in secondary myofascial pain and mandibular limitations at the acupuncture and sham-acupuncture groups, however only the acupuncture group kept the changes after 6 months (P<0.01, P=0.023). There was a decrease in mechanical thresholds in the acupuncture group (tactile, P<0.01; vibration, P=0.027) and an increase in deep pain thresholds in both acupuncture and sham-acupuncture groups (P=0.013).
Acupuncture can be an option in the treatment of ITN due to its analgesic effect in both ITN and secondary myofascial pain associated with it.
通过病例对照纵向双盲研究评估针刺治疗特发性三叉神经痛(ITN)患者的疗效。
纳入60例ITN患者和30例健康受试者。ITN患者分别随机分为针刺组(15例)、假针刺组(15例)和卡马西平组(30例)。在治疗前、治疗后即刻和治疗后6个月,评估临床口腔面部评价(包括疼痛强度和药物剂量)、颞下颌关节紊乱研究诊断标准(RDC/TMD)和赫尔基莫指数(用于咀嚼系统功能评价),以及感觉阈值的定量感觉测试(味觉、嗅觉、冷觉、温觉、触觉、振动觉以及浅感觉和深感觉疼痛)。
在最后一次评估时,仅针刺组的视觉模拟量表平均疼痛强度降低(P = 0.012)。根据处方,假针刺组患者的卡马西平剂量增加(P < 0.01)。针刺组和假针刺组的继发性肌筋膜疼痛和下颌运动受限有所减轻,但只有针刺组在6个月后仍保持这些变化(P < 0.01,P = 0.023)。针刺组的机械阈值降低(触觉,P < 0.01;振动觉,P = 0.027),针刺组和假针刺组的深部疼痛阈值均升高(P = 0.013)。
由于针刺对ITN及其相关的继发性肌筋膜疼痛均有镇痛作用,因此可作为ITN治疗的一种选择。