不同频次针刺治疗颞下颌关节紊乱病疼痛的临床疗效比较  

Clinical efficacy comparison of different acupuncture frequencies for pain of temporomandibular disorders:arandomized controlled trial

作　　者：郦淑婷 付渊博[2,3] 刘璐 王握瑜[1] 林颖 李彬 LI Shuting;FU Yuanbo;LIU Luz;WANG Woyu;LIN Ying;LI Bin(Clinical Medicine College,Beijing University of CM,Beijing 100029,China;Acupuncture-Moxibustion Center,Beijing Hospital of TCM Affiliated to Capital Medical University,Beijing 100010;Beijing Key Laboratory of Acupuncture-Neuromodulation,Beijing 100010)

机构地区：[1]北京中医药大学临床医学院,北京100029 [2]首都医科大学附属北京中医医院针灸中心,北京100010 [3]针灸神经调控北京市重点实验室,北京100010

出　　处：《中国针灸》2025年第4期453-459,共7页Chinese Acupuncture & Moxibustion

基　　金：国家自然科学基金项目:82374575、82074179;北京市自然科学基金项目:7232270;北京市医院管理中心“登峰”人才培养计划团队项目:DFL20241001。

摘　　要：目的:探讨不同频次针刺治疗颞下颌关节紊乱病(TMD)疼痛的疗效差异。方法:将42例TMD疼痛患者随机分为低频次组、中频次组、高频次组,每组14例。各组均采用针刺治疗,取穴双侧合谷、阳陵泉及患侧听宫、颊车、下关,每次30 min。低频次组每周针刺1次,中频次组每周针刺2次,高频次组每周针刺3次,均治疗4周。分别于治疗前后和治疗结束后4周随访比较各组患者慢性疼痛量表(GCPS)、视觉模拟量表(VAS)、下颌功能受限量表-20(JFLS-20)评分和压力疼痛阈值(PPT)。结果:治疗后,各组患者GCPS和JFLS-20评分均较治疗前降低(P<0.05),高频次组和中频次组患者VAS评分较治疗前降低(P<0.05),高频次组患者各部位PPT较治疗前升高(P<0.05);高频次组患者GCPS、JFLS-20及VAS评分低于中频次组和低频次组(P<0.05),部分PPT高于中频次组和低频次组(P<0.05)。随访时,各组患者GCPS、JFLS-20及VAS评分均较治疗前降低(P<0.05),高频次组和中频次组患者各部位PPT均较治疗前升高(P<0.05);高频次组GCPS、JFLS-20及VAS评分低于低频次组和中频次组(P<0.05),各部位PPT高于低频次组和中频次组(P<0.05)。结论:每周针刺3次在改善TMD疼痛强度方面优于每周针刺1次和每周针刺2次,并可缓解一部分下颌功能障碍,其疗效可持续到治疗结束后4周。Objective To explore the efficacy differences among different acupuncture frequencies for pain of temporomandibular disorders(TMD).Methods A total of 42 patients with TMD pain were randomly divided into a low-frequency group,a medium-frequency group,and a high-frequency group,with 14 patients in each group.All groups received acupuncture treatment at bilateral Hegu(LI4)and Yanglingquan(GB34),as well as ipsilateral Tinggong(SI19),Jiache(ST6),and Xiaguan(ST7),with each session lasting 30 minutes.The low-frequency group received acupuncture once per week,the medium-frequency group received acupuncture twice per week,and the high-frequency group received acupuncture three times per week,for a total duration of four weeks.The graded chronic pain scale(GCPS)score,visual analogue scale(VAS)score,jaw functional limitation scale-20(JFLS-20)score,and pressure pain threshold(PPT)were assessed in the three groups before and after treatment,as well as at the four-week follow-up after treatment completion.Results Compared before treatment,GCPS and JFLS-20 scores were significantly decreased in all the groups after treatment(P<0.05),and VAS scores were significantly decreased in the high-frequency and medium-frequency groups(P<0.05),PPT values at dfferent measurement sites were increased significantly in the high-frequency group(P<0.05).Affer treatment,GCPS,JFLS-20,and VAS scores in the high-frequency group were lower than those in the medium-frequency and low-frequency groups(P<0.05),while some PPT values were higher than the other two groups(P<0.05).At follow-up,GCPS,JFLS-20,and VAS scores remained significantly lower in all the groups compared to baseline(P<0.05),PPT values were increased significantly in the high-frequency and medium-frequency groups(P<0.05),with the high-frequency group showing lower GCPS,JFLS-20,and VAS scores and higher PPT values compared to the other two groups(P<0.05).Conclusion Acupuncture three times per week is more effective in reducing TMD pain intensity compared to once or twice per week,and can

关 键 词：颞下颌关节紊乱病 疼痛 针刺 针刺频次 随机对照试验 

分 类 号：R246.2[医药卫生—针灸推拿学]