低强度激光耳穴疗法对颞下颌关节紊乱病患者躯体和情绪方面的影响：一项盲法、随机、对照临床试验。

Effects of low-power laser auriculotherapy on the physical and emotional aspects in patients with temporomandibular disorders: A blind, randomized, controlled clinical trial.

机构信息

Western State University of Paraná, Rua Universitária, 2069, Cascavel, PR, CEP 85.819-110, Brazil.

出版信息

Complement Ther Med. 2019 Feb;42:340-346. doi: 10.1016/j.ctim.2018.12.010. Epub 2018 Dec 18.

DOI:10.1016/j.ctim.2018.12.010

PMID:30670264

Abstract

OBJECTIVES

This study evaluated the effects of low-power laser auriculotherapy (LA) on the physical and emotional symptoms of patients with temporomandibular disorders (TMDs), in comparison with occlusal splints (OS).

DESIGN

Randomized, blinded, prospective, non-inferiority clinical trial.

INTERVENTIONS

The patients received OS (control group) or LA (experimental group).

MAIN OUTCOME MEASURES

Following the Consolidated Standards of Reporting Trials (CONSORT) guidelines, patients with TMD were evaluated by using axes I and II of the Research Diagnostic Criteria for RDC-TMD. Both intra- and intergroup quantitative variables were analyzed with ANOVA (p < 0.05), while qualitative variables were analyzed with the Kruskal-Wallis (intergroup evaluations; p < 0.05) or Mann-Whitney tests (intragroup analyses; p < 0.05).

RESULTS

OS improved five physical symptoms of TMD (pain in the right temporal muscle, right and left masseter muscles, left joint, and left intraoral region), while LA improved six (jaw functioning; pain in left masseter muscle, right and left joints, and right and left intraoral regions). Similarly, OS improved seven emotional symptoms (degree of depression, degree of non-specific physical symptoms, excluding pain, degree of non-specific physical symptoms including pain, average pain value in the past 6 months, presence of depression, intensity and characteristics of pain, non-specific physical symptoms including pain), while LA improved five (degree of non-specific physical symptoms including pain, presence of depression, intensity and characteristics of pain, non-specific physical symptoms including pain, non-specific physical symptoms excluding pain).

CONCLUSION

LA improved the physical and emotional symptoms of TMD, with results similar to OS.

CLINICAL RELEVANCE

For the physical and emotional symptoms associated with TMD, LA showed similar outcomes as OS.

摘要

目的

本研究评估了低强度激光耳穴疗法（LA）对颞下颌关节紊乱病（TMD）患者躯体和情绪症状的影响，并与咬合夹板（OS）进行了比较。

设计

随机、双盲、前瞻性、非劣效性临床试验。

干预措施

患者接受 OS（对照组）或 LA（实验组）治疗。

主要观察指标

根据临床试验报告的统一标准（CONSORT）指南，采用 RDC-TMD 研究诊断标准的 I 轴和 II 轴评估 TMD 患者。采用方差分析（ANOVA）对组内和组间的定量变量进行分析（p＜0.05），而对定性变量则采用 Kruskal-Wallis 检验（组间评估；p＜0.05）或 Mann-Whitney 检验（组内分析；p＜0.05）。

结果

OS 改善了 TMD 的 5 种躯体症状（右侧颞肌、右侧和左侧咀嚼肌、左侧关节、左侧口腔内区域疼痛），而 LA 则改善了 6 种（咀嚼功能；左侧咀嚼肌、右侧和左侧关节、右侧和左侧口腔内区域疼痛）。同样，OS 改善了 TMD 的 7 种情绪症状（抑郁程度、非特异性躯体症状程度、不包括疼痛、包括疼痛的非特异性躯体症状程度、过去 6 个月平均疼痛值、抑郁存在、疼痛强度和特征、非特异性躯体症状包括疼痛），而 LA 则改善了 5 种（包括疼痛的非特异性躯体症状程度、抑郁存在、疼痛强度和特征、包括疼痛的非特异性躯体症状、不包括疼痛的非特异性躯体症状）。