Peripheral receptors and neuromediators involved in the antihyperalgesic effects of acupuncture: a state-of-the-art review.

The present study aims to describe state-of-the-art of preclinical studies that have investigated peripheral receptors and neuromediators involved in the antihyperalgesic effects of acupuncture. The PubMed, Scopus, and Web of Science databases were searched using the integrative review method. Preclinical articles that involved the study of peripheral receptors and neuromediators on the pain control effects of acupuncture in rats or mice were selected using a predefined search strategy. From this search, 456 articles were found, and 29 of them met the inclusion criteria of the study. The selected articles addressed the following peripheral receptors: opioid (n = 9), adenosine (n = 5), cannabinoid (n = 5), transient receptor potential vanilloid (TRPV) (n = 3), histamine (n = 2), adrenergic (n = 1), muscarinic (n = 1), corticotrophin-releasing factor (CRF) (n = 2), IL-1 (n = 1), and endothelin (n = 1) receptors. The peripheral neuromediators correlated with the peripheral pain control effect were as follows: opioid peptides (n = 4), adenosine (n = 3), histamine (n = 1), substance P (n = 1) calcitonin gene-related peptide (CGRP) (n = 1), anandamide (n = 1), nitric oxide (n = 1), and norepinephrine (n = 1). This review summarizes the methods used to investigate the peripheral effects of acupuncture and discusses the main findings on each family of receptors and neuromediators. Ten families of peripheral receptors and 8 types of neuromediators were correlated with the antihyperalgesic effects of acupuncture in preclinical studies. Considering the benefits of a better understanding of the role of peripheral receptors and neuromediators in the context pain management, the findings of the present study highlight the importance of deepening the exploration of the peripheral mechanisms of acupuncture.

Impact of Acupuncture Intervention on the Pain Intensity of Patients Treated at a Tertiary Hospital in Brazil.

BACKGROUND: Nowadays, in western societies, acupuncture is widely used over the control of pain and this analgesic approach is still the most studied aspect of acupuncture. Several studies have shown that most patients go through a significant pain decrease soon after the first sessions of acupuncture. OBJECTIVES: This research has as a goal the evaluation on the effect of acupuncture treatment regarding the relief of pain intensity of different etiologies, through the visual analog scale. METHODS: This research constitutes a retrospective, descriptive study, carried out with 449 patients attended in the Institute Hospital de Base of the Federal District, in Brasilia city- Brazil. Every data was gathered from our own form, with detailed clinical history which included age, marital status, work activity, reason for referral to acupuncture, main and secondary complaints, pain intensity evaluated by the Visual Analog Scale (VAS), number of sessions completed and drug therapy. All data was organized in the Microsoft Excel and processed in the Statistical Package for the Social Sciences (SPSS), version 20.0. RESULTS: Regarding the main complaint, the mean pain decreased from 7.3 (initial VAS) to 3.2 (final VAS), a reduction that meant more than 50% relief in pain intensity. This 50% reduction in initial pain was also observed in secondary complaints (initial VAS = 6.5 and final VAS = 3.1). CONCLUSIONS: The results of this research suggest that acupuncture treatment was effective in relieving pain intensity, providing a 50% reduction on the visual analogue scale, in relation to painful complaints of different etiologies.

Use of IMMPACT domains in clinical trials of acupuncture for chronic pain: A methodological survey.

Acupuncture is one of the therapeutic resources used for the management of chronic pain. Variability in outcome measurements in randomized clinical trials of non-oncologic chronic pain (RCT-NOCP) generates inconsistencies in determining effects of treatments. The objective of this survey was to assess the adherence to the recommendations made by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) in the measurement of RCT-NOCP of acupuncture. This methodological research made a systematic search for eligible studies from different sources of information. Eligible studies included those with number of patients ≥100, who randomized and allocated patients with chronic non-oncologic pain to be treated with acupuncture or with "sham" acupuncture, or non-acupuncture. This research included the recommendations for IMMPACT in the measurement of RCT-NOCP: presence of outcomes pain, physical function, emotional state and improvement perception of patient, the source of the outcome information pain and the tools used to measure such domains. From a total of 1,386 studies, 24 were included in this survey. Eleven studies presented low risk of bias. Pain outcome was measured in 23 studies, physical function in 22 studies, emotional state in 14 studies and improvement perception of patient in one study. As for the pain outcome, the patient was the information source in 50% of the studies. The measurement tools recommended for IMMPACT were included in eight studies (35%) that evaluated pain, one study that evaluated the emotional state (7%), and one study that evaluated the improvement perception and satisfaction of patient. It was observed that studies which did not adhere to the recommendations had more favorable results for acupuncture in the outcome pain. This study concludes that randomized clinical trials that used acupuncture to manage chronic pain failed to adhere to IMMPACT recommendations. Clinical societies and IMMPACT do not share the same recommendations. This fact reflects in the diversity of outcomes and instruments adopted in the studies, making it difficult to compare the results.

Analgesia quirúrgica acupuntural y técnicas bioenergéticas afines en estomatología / Surgical acupunctural analgesia and bioenergetics techniques related in stomatology

Fundamento: la analgesia quirúrgica acupuntural permite realizar el tratamiento quirúrgico sin el uso de anestésicos convencionales, pues la acupuntura y la electroterapia, logran un aumento del umbral doloroso en el paciente, y producen una disminución o pérdida de la percepción del dolor. Este proceder combinado con otras técnicas bioenergéticas afines es más efectivo. Objetivo: divulgar información actualizada sobre el uso de la analgesia quirúrgica acupuntural y las técnicas bioenergéticas afines, en profesionales dela estomatología. Método: se realizó una revisión bibliográfica desde enero hasta marzo de 2017, en las bibliotecas de la facultad de Estomatología y Medicina, de la Universidad de Ciencias Médicas de la provincia Camagüey. Se consultó la bibliografía impresa, libros clásicos revistas y la información disponible en internet, que aparece escrita en los idiomas español, inglés y portugués. La búsqueda se realizó en bases de datos como: Medline, Lilacs, Dialnet, Redalyc, Hinari, Doyma, SciELO. De los 90 artículos encontrados, se incluyen 47 en la investigación, Desarrollo: la revisión bibliográfica muestra la importancia de combinar la acupuntura con técnicas eléctricas, terapias psicológicas, la hipnosis, la homeopatía y la auriculopuntura; al realizar exodoncias. Se mencionan los antecedentes históricos, conceptos, indicaciones, precauciones, contraindicaciones, equipo e instrumental, aspectos que garantizan el éxito del tratamiento. Se señalan los puntos acupunturales más útiles, ventajas de su uso, iatrogenias y eventos adversos frecuentes.Conclusiones: la analgesia quirúrgica acupuntural es un procedimiento con bases científicas en continuo desarrollo. Su indicación para exodoncias en estomatología es favorable y su eficacia es mayor al combinarla con terapias bioenergéticas afines, por tanto es necesario potenciar y desarrollar estudios rigurosos sobre este tema, para estimular y divulgar su uso entre los profesionales de la estomatología(AU)

Background: the surgical acupunctural analgesia allows accomplishing the surgical treatment without the use of conventional anesthetics, because acupuncture and electrotherapy achieve an increase of the painful doorstep in the patient and they produce a decrease or loss of the perception of the pain. This action combined with other techniques related bioenergetics is more effective. Objective: to popularize updated information on the use of the surgical acupunctural analgesia and techniques related to bioenergetics in stomatology. Methods: a bibliographic revision was carried out from January to March 2017, at the libraries of Dentistrys and Medicine´s faculty of Medical Science's University of Camagüey´s province. It was consulted the printed bibliography, classical books, magazines and the available information in internet, which appear written in the Spanish, English and Portuguese languages. The search was carried out in databases like Medline, Lilacs, Dialnet, Redalyc, Hinari, Doyma and SciELO. Of the 90 articles found, 47 are included in the investigation; a high percentage of them were published in the last five years. Development: the bibliographical review shows the importance of combining the acupuncture with electrical techniques, psychological therapies, hypnosis, homeopathy, and auriculopuncture; when performing exodontias. There are mentioned the historic background, concepts, indications, precautions, contraindications. It is pointed out the most useful acupuncture points, advantages of its use, iatrogenic and frequent adverse events. Conclusions: the surgical acupunctural analgesia is a procedure with scientific bases in continuous development. Its indication for exodontias in dentistry is clearly favorable and its efficacy is higher when combining with bioenergetics therapies, therefore it is necessary to encourage and to develop rigorous studies on this theme to stimulate and to promote its use among the professionals of dentistry(AU)

Analgesic Effects Elicited by Neuroactive Mediators Injected into the ST 36 Acupuncture Point on Inflammatory and Neuropathic Pain in Mice.

The present study evaluates whether the injection of serotonin, acetylcholine, glutamate, bradykinin, histamine, or substance P (SP) into the Zusanli (Stomach 36, ST 36) acupoint can also produce the acupuncture-induced antinociceptive effect on inflammatory or neuropathic pain. In this in vivo experimental study, a total of 450 male Swiss mice were used. Mice were injected with saline or complete Freund's adjuvant (CFA) or subjected to sham or chronic constriction injury (CCI) surgery. After the establishment of the inflammatory (4 hours) or the neuropathic pain (3 days), the animals (n = 6) received manual acupuncture, sham acupuncture, or injection of saline, serotonin, acetylcholine, glutamate, bradykinin, histamine, or SP into the ST 36 and were evaluated for up to 24 hours. Mechanical threshold was evaluated, and the L4-L6 dorsal root ganglion was used for analysis of the transient receptor potential vanilloid type 1 overexpression. The mice from both the CFA and CCI models treated with manual acupuncture had significant increases in the thresholds for more than 24 hours. Sham acupuncture stimulation did not change the thresholds. In the mice injected with each of the mediators, the thresholds were significantly increased for all times in both the CFA and CCI models. Transient receptor potential vanilloid type 1 overexpression in CFA and CCI mice was reduced at all times by injection of serotonin, acetylcholine, or SP but not by injection of glutamate, histamine, or bradykinin. Our data suggest that the neuroactive mediators released by acupuncture-induced tissue injury may contribute to acupuncture-induced analgesia.

Extracción dentaria con analgesia acupuntural / Dental extraction acupuntural analgesia

Se realizó un estudio de intervención terapéutica durante el periodo comprendido de junio de 2015 a junio de 2016 en 29 pacientes que presentaron necesidad de extracción dentaria en la Clínica Estomatológica "Ramón Guevara Montano" de Baracoa, Guantánamo, con la finalidad de evaluar la evolución clínica de dichos pacientes con esta técnica de tratamiento. Los pacientes fueron incluidos en la muestra según el orden de recepción luego de su consentimiento informado. Se utilizaron las variables: dolor, limpieza del campo operatorio, complicaciones post extracción dentaria y reparación tisular. La evolución clínica de los pacientes fue satisfactoria(AU)

A study of therapeutic intervention was conducted during the period from June 2015 to June 2016 in 29 patients who presented a need for tooth extraction at the "Ramón Guevara Montano" Stomatology Clinic in Baracoa, Guantanamo, The patients were included in the sample according to the reception order after their informed consent. The variables were used: pain, cleaning of the operative field, complications after tooth extraction and tissue repair. The clinical evolution of the patients was satisfactory(AU)

Yamamoto New Scalp Acupuncture for postoperative pain management in cats undergoing ovariohysterectomy.

OBJECTIVE: To evaluate the analgesic efficacy of Yamamoto New Scalp Acupuncture (YNSA) as an adjuvant for postoperative pain management in cats. STUDY DESIGN: Prospective, randomized, blinded, clinical study. ANIMALS: Twenty cats aged (mean ± standard deviation) 25 ± 9 months and weighing 2.7 ± 0.6 kg undergoing ovariohysterectomy. METHODS: The cats were sedated with intramuscular (IM) ketamine (5 mg kg-1), midazolam (0.5 mg kg-1) and tramadol (2 mg kg-1). The cats were randomly distributed before induction of anesthesia into two groups of 10 cats each: group YNSA, in which bilateral basic D points were stimulated with a dry needle from 20 minutes prior to anesthetic induction to the end of the surgery; group Control, in which no acupuncture was applied. Postoperative analgesia was assessed at 1, 2, 4, 8, 12, 18 and 24 hours postextubation using an Interactive Visual Analog Scale and Universidade Estadual Paulista-Botucatu Multidimensional Composite Pain Scale (UNESP-Botucatu MCPS). Rescue analgesia was provided with IM tramadol (2 mg kg-1), and the pain scores were reassessed 30 minutes after rescue intervention. If the analgesia remained insufficient, meloxicam (0.2 mg kg-1 as a single dose) was administered IM. Data were analyzed using Student t-test, Fisher exact test, Mann-Whitney U test and Friedman test (p < 0.05). RESULTS: Significantly lower pain scores were observed in YNSA when compared with Control at 1-4 hours based on the UNESP-Botucatu MCPS scores. Although significant differences were not identified between groups requiring rescue analgesia, additional postoperative analgesia was administered to four of 10 cats in Control and no cats in YNSA. CONCLUSION AND CLINICAL RELEVANCE: Perioperative YNSA resulted in decreased pain scores and a reduction in postoperative requirement for rescue analgesia in cats. This method should be considered a viable option as an adjuvant analgesic therapy for cats undergoing ovariohysterectomy.

Golpe del espolón calcáneo complementado con electroacupuntura / Calcaneal spur shockwave complemented with electroacupuncture

El síntoma más importante del espolón calcáneo es el dolor, que se agrava con la carga estando el paciente parado o caminando; localizado en la zona del talón y de rara irra­diación. Se hace presentación de caso: mujer de 47 años de edad, sobrepeso, larga estancia de pie laborando en una cafetería, con espolón calcáneo y la descripción técnica de un único golpe en región plantar, complementado con electroacupuntura por su efecto analgésico y antiinflamatorio. La técnica se aplica por personal calificado y especializado de salud pública(AU)

The most important symptom of the calcaneal spur is pain, which worsening with the weight charge as the patients is standing up or walking; located in the heel area and of rare irradiation. Case presentation: women of 47 years of age, overweight, long time standing up as she works in a cafeteria, with a calcaneal spur and the technical description of an only plantar region shockwave, complemented with electroacupuncture for its analgesic and anti-inflammatory effect. The technique was applied by the qualified and specialized public health personal(AU)

Golpe del espolón calcáneo complementado con electroacupuntura / Calcaneal spur shockwave complemented with electroacupuncture

El síntoma más importante del espolón calcáneo es el dolor, que se agrava con la carga estando el paciente parado o caminando; localizado en la zona del talón y de rara irra­diación. Se hace presentación de caso: mujer de 47 años de edad, sobrepeso, larga estancia de pie laborando en una cafetería, con espolón calcáneo y la descripción técnica de un único golpe en región plantar, complementado con electroacupuntura por su efecto analgésico y antiinflamatorio. La técnica se aplica por personal calificado y especializado de salud pública(AU)

The most important symptom of the calcaneal spur is pain, which worsening with the weight charge as the patients is standing up or walking; located in the heel area and of rare irradiation. Case presentation: women of 47 years of age, overweight, long time standing up as she works in a cafeteria, with a calcaneal spur and the technical description of an only plantar region shockwave, complemented with electroacupuncture for its analgesic and anti-inflammatory effect. The technique was applied by the qualified and specialized public health personal(AU)

Efetividade da eletroacupuntura versus acupuntura manual em pacientes com dor lombar crônica não específica: um ensaio clínico randomizado / Effectiveness of electroacupuncture versus manual acupuncture in patients with chronic nonspecific low back pain: a randomized controlled trial

Introdução: A dor lombar crônica inespecífica é um importante problema de saúde e de ordem socioeconômica responsável por alto índice de absenteísmo no trabalho e redução do desempenho funcional. A utilização da acupuntura manual como terapia alternativa no tratamento de dor lombar e a eletroacupuntura para potencializar o tratamento, tem se mostrado eficaz, entretanto, com poucas evidências sobre sua efetividade. Objetivo: Comparar a efetividade da eletroacupuntura versus acupuntura manual no tratamento da dor e incapacidade funcional em pacientes com dor lombar crônica inespecífica Método: Sessenta e seis pacientes com dor lombar crônica inespecífica foram distribuídos aleatoriamente em dois grupos: Grupo eletroacupuntura (GE n=33) e grupo acupuntura (GA n=33). Os desfechos clínicos primários foram dor, avaliada com a escala numérica de dor e incapacidade funcional pelo questionário de Incapacidade Roland Morris e os desfechos secundários foram: qualidade da dor medida com o questionário McGill de dor, percepção global com escala da percepção do efeito global, qualidade de vida por meio do Short-Form Health Survey questionnaire (SF-36), depressão com o inventário Beck de Depressão, e cinesiofobia com a Escala Tampa de Cinesiofobia. Os grupos foram tratados duas vezes por semana com duração de 40 minutos, durante seis semanas, totalizando 12 sessões. Foram realizadas três avaliações: inicial, final e follow-up de três meses. O nível de significância foi de alfa < 0,05. Resultados: Ambos os grupos relataram melhora na intensidade da dor e incapacidade funcional, sem diferença entre os grupos. Na intensidade e incapacidade escores de dor entre os grupos foram -0,4 (95% intervalo de confiança [IC] = -1,7 a -0,8) e -2,5 pontos (IC 95% = -5,6 a 0,6), respectivamente. Nos desfechos secundários, observamos uma diferença entre grupos apenas para cinesiofobia (diferença = -4.1 pontos, IC95% = -7,0 a -1,1) no grupo acupuntura manual. Conclusão: A eletroacupuntura e a acupuntura manual são eficazes na melhora da dor e incapacidade funcional em pacientes com dor lombar crônica inespecífica.(AU)

Introduction: Chronic nonspecific low back pain is significant problem of health and socioeconomic order responsible for high rate of absenteeism at work and reduced functional performance. The use of manual acupuncture as an alternative therapy in the treatment of low back pain and electroacupuncture to enhance the treatment has been proven effective, however, with little evidence of effectiveness. Objective: Compare the effectiveness of electroacupuncture versus manual acupuncture in patients with chronic nonspecific low back pain. Methods: Sixty-six patients with chronic nonspecific low back pain were divided into: electroacupuncture (n=33) and acupuncture group (n=33). The primary clinical outcomes were pain, assessed with the numerical Scale of Pain and functional disability by questionnaire Disability Roland Morris and secondary outcomes were quality of pain measure with the McGill Pain Questionnaire, global perception with the perception of the Global Scale Effect, quality of life through the Short-Form Health Survey questionnaire (SF- 36), depression with the Beck depression inventory, and kinesiophobia with Tampa Scale kinesiophobia. The groups were treated twice a week lasting 40 minutes for six weeks, 12 sessions. Were three evaluations: baseline, post treatment and follow-up of three months. The level of significance was alfa < 0.05. Results: Both groups reported improvements in pain intensity and disability with no difference between groups. Differences in intensity and disability scores of pain between groups were -0.4 (95% confidence interval [CI] = -1.7 to - 0.8) and -2.5 points (95% CI = -5 6 to 0.6), respectively. Regarding secondary outcomes, we observed a difference between-groups for kinesiophobia (difference= -4.1 points, 95% CI - 7.0 -1.1) in acupuncture group. Conclusion: Electroacupuncture and manual acupuncture have similar efficacy in reducing pain and disability in patients with chronic nonspecific low back pain.(AU)

Acupuncture and pharmacopuncture are as effective as morphine or carprofen for postoperative analgesia in bitches undergoing ovariohysterectomy

ABSTRACT PURPOSE : To investigate the analgesic effect of acupuncture (AP) or micro-dose pharmacopuncture (PA), using carprofen or morphine, in bitches undergoing ovariohysterectomy (OHE). METHODS: Thirty five dogs were randomly assigned to five groups after sedation with acepromazine IM: AP, 0.5 mg.kg-1 of morphine subcutaneously (SC), 4 mg.kg-1 of carprofen SC, and PA with 0.05 mg.kg-1 of morphine or 0.4 mg.kg-1 of carprofen. Anaesthesia was induced with propofol and maintained with isoflurane. Pain was assessed after OHE by a blind observer for 24h, by dynamic visual analogue scale (DIVAS), Glasgow (CMPS-SF), Melbourne (UMPS) and Colorado University pain scale (CSU). Animals reaching 33% of the UMPS score received rescue analgesia with morphine IM. Non parametric data were analysed by Kruskal-Wallis or Friedman tests where applicable, followed by Dunn´s test. Parametric data were analysed by two way ANOVA, followed by Tukey test. RESULTS: There were no differences among groups in number of rescue analgesia. Except for the DIVAS score where animals treated with morphine had the lowest score compared with AP and carprofen, at 1h after surgery, there were no other differences among groups. CONCLUSION: Acupuncture or pharmacopuncture were equally effective as morphine or carprofen to control postoperative pain in bitches undergoing ovariohysterectomy.

Acupuncture and pharmacopuncture are as effective as morphine or carprofen for postoperative analgesia in bitches undergoing ovariohysterectomy.

PURPOSE: To investigate the analgesic effect of acupuncture (AP) or micro-dose pharmacopuncture (PA), using carprofen or morphine, in bitches undergoing ovariohysterectomy (OHE). METHODS: Thirty five dogs were randomly assigned to five groups after sedation with acepromazine IM: AP, 0.5 mg.kg(-1) of morphine subcutaneously (SC), 4 mg.kg(-1) of carprofen SC, and PA with 0.05 mg.kg(-1) of morphine or 0.4 mg.kg(-1) of carprofen. Anaesthesia was induced with propofol and maintained with isoflurane. Pain was assessed after OHE by a blind observer for 24h, by dynamic visual analogue scale (DIVAS), Glasgow (CMPS-SF), Melbourne (UMPS) and Colorado University pain scale (CSU). Animals reaching 33% of the UMPS score received rescue analgesia with morphine IM. Non parametric data were analysed by Kruskal-Wallis or Friedman tests where applicable, followed by Dunn's test. Parametric data were analysed by two way ANOVA, followed by Tukey test. RESULTS: There were no differences among groups in number of rescue analgesia. Except for the DIVAS score where animals treated with morphine had the lowest score compared with AP and carprofen, at 1h after surgery, there were no other differences among groups. CONCLUSION: Acupuncture or pharmacopuncture were equally effective as morphine or carprofen to control postoperative pain in bitches undergoing ovariohysterectomy.

Orthodontic post-adjustment pain control with acupuncture.

OBJECTIVE: This study aimed to evaluate the analgesic efficacy of systemic acupuncture therapy on the pain caused after orthodontic adjustments. METHODS: An initial sample of 30 orthodontic patients with fixed appliances monthly adjusted was selected; however, only 11 participants completed the study. For this reason, final sample comprised these patients' data only. Initially, average pain levels were assessed at different periods by means of an analogue visual scale (VAS) for three months without acupuncture. In the following three months, the volunteers were submitted to systemic acupuncture sessions on Hegu (LI4) and Jiache (St6) points, before orthodontic adjustments were carried out. RESULTS: Results revealed statistically significant reduction in pain level indexes both for men (P = 0.030) and women (P = 0.028) when acupuncture therapy was performed prior to orthodontic adjustment. Patients did not present any side effects. CONCLUSION: Acupuncture is a safe and effective method in reducing orthodontic post-adjustment pain.

Orthodontic post-adjustment pain control with acupuncture

OBJECTIVE: This study aimed to evaluate the analgesic efficacy of systemic acupuncture therapy on the pain caused after orthodontic adjustments. METHODS: An initial sample of 30 orthodontic patients with fixed appliances monthly adjusted was selected; however, only 11 participants completed the study. For this reason, final sample comprised these patients' data only. Initially, average pain levels were assessed at different periods by means of an analogue visual scale (VAS) for three months without acupuncture. In the following three months, the volunteers were submitted to systemic acupuncture sessions on Hegu (LI4) and Jiache (St6) points,before orthodontic adjustments were carried out. RESULTS: Results revealed statistically significant reduction in pain level indexes both for men (P = 0.030) and women (P = 0.028) when acupuncture therapy was performed prior to orthodontic adjustment. Patients did not present any side effects. CONCLUSION: Acupuncture is a safe and effective method in reducing orthodontic post-adjustment pain. .

OBJETIVO: o presente trabalho objetivou avaliar a eficácia analgésica da acupuntura sistêmica, realizada previamente, sob a dor oriunda pós-ajuste ortodôntico. MÉTODOS: uma amostra de 30 indivíduos usuários de aparelhos fixos foi selecionada, os quais tinham de ser ajustados mensalmente. Contudo, somente 11 participantes completaram o estudo, e somente os seus dados foram coletados e analisados. A princípio, foi realizada uma média do índice de dor, em diferentes períodos, por meio de uma escala analógica visual (EAV), por três meses, sem a utilização da acupuntura. Nos três meses seguintes, os voluntários foram submetidos a sessões de acupuntura sistêmica nos pontos Hegu (IG4) e Jiache (E6), previamente ao ajuste ortodôntico. A média dos resultados do índice de dor com e sem acupuntura foram comparados. RESULTADOS: os resultados demonstraram que houve redução estatisticamente significativa no índice geral de dor, tanto para os homens (p = 0,030) quanto para as mulheres (p = 0,028), após a utilização da acupuntura previamente ao ajuste, e nenhum voluntário apresentou efeitos adversos. CONCLUSÃO: conclui-se que os pontos de acupuntura utilizados são eficientes e seguros na redução da dor pós-ajuste ortodôntico. .

Acupuncture in the management of acute dental pain.

Acute dental pain is the main reason for seeking dental services to provide urgent dental care; there is consensus about the use of alternative therapies, such as acupuncture, to control dental pain in pre-dental care. This study aimed to evaluate the use of acupuncture in reducing the intensity of acute dental pain in pre-dental care in patients waiting for emergency dental care, and was conducted at the After-Hours Emergency Dental Clinic of Piracicaba Dental School, and at the Emergency Center Dental Specialties I in Piracicaba, São Paulo, Brazil. The sample consisted of 120 patients. The Visual Analog Scale (VAS) was used to measure pain intensity. All patients underwent one session of acupuncture; the points LI4, ST44 and CV23 were selected and were used alone or in combinations. Reduction in pain was observed in 120 patients (mean initial VAS=6.558±1.886, p<0; mean final VAS=0.962±2.163, p<0.00001). The results of this study indicate that acupuncture analgesia could be a technical adjunct to pain control in patients with acute dental pain, contributing to the restoration of health with social benefit.

Sedative and clinical effects of the pharmacopuncture with xylazine in dogs.

PURPOSE: To investigate the sedative and clinical effects of the pharmacopuncture with xylazine, compared to the conventional dose of a intramuscular injection in dogs. METHODS: Twelve dogs were randomly distributed in two groups of six animals and treated as follows: control group (X-IM): 1mg kg(-1) of xylazine given intramuscularly (IM); pharmacopuncture group (X-Yintang): 0.1mg kg(-1) of xylazine diluted to 0.5 mL of saline injected into the Yin Tang acupoint. Heart rate, cardiac rhythm (ECG), systolic arterial blood pressure (SABP), respiratory rate (RR), rectal temperature (RT), blood glucose concentration, degree of sedation and adverse effects were evaluated. RESULTS: Sedative effect was observed in both groups. The degree of sedation was greater in X-IM only at 15 min when compared with X-Yintang group. Cardiovascular established was observed in X-Yintang group, while marked reduction in the HR and increased incidence of ECG abnormalities were detected in X-IM. In both treatment groups, minimal changes were observed in relation to SABP, RR, RT and blood glucose. High incidence (66%) of vomiting was observed in X-IM, while this adverse effect was absent in X-Yintang. CONCLUSION: Pharmacopuncture with xylazine induced clinically relevant sedative effects in dogs, with the advantage of reduction of undesirable side effects associated with α2-agonists, including bradycardia, cardiac arrhythmias, and emesis.

Avaliação de pontos-gatilho miofasciais por imagens de ultrassom e elastografia ultrassonográfica em mulheres tratadas pela acupuntura, eletroacupuntura e acupuntura sham: estudo piloto / Two-dimensional ultrasound and ultrasound elastography imaging of myofascial trigger points in women treated by acupuncture, electroacupuncture and sham acupuncture: pilot study

O presente estudo, de caráter experimental, teve como objetivo a avaliação de pontos-gatilho miofasciais (PG) do músculo trapézio descendente (TPz) por imagens de ultrassonografia bidimensional em escala de cinza (US 2D) e elastografia ultrassonográfica (ELASTO), bem como avaliar a eficácia das técnicas de acupuntura (AC) e eletroacupuntura (EA) na diminuição da dor em mulheres com síndrome da dor miofascial (SDM) associada a queixas de dor nas regiões de cabeça, pescoço e parte superior do tronco. Uma amostra de conveniência de 24 voluntárias, com idades entre 20 e 40 anos (27,33±5,05), IMC entre 18,03 e 27,09 Kg/m² (22,59±3,11), ciclo menstrual regular, presença de ao menos um PG ativo em ambos os TPz, queixa de dor local e/ ou referida há pelo menos seis meses foi selecionada para o estudo. Após a assinatura do Termo de Consentimento Livre e Esclarecido (TCLE), as voluntárias foram randomizadas em três grupos, sendo: dois grupos de tratamento (AC e EA) e um grupo controle (SHAM). Oito sessões de tratamento foram então realizadas, duas vezes por semana, durante aproximadamente um mês, levando em consideração o ciclo menstrual das voluntárias. Imagens do músculo trapézio foram adquiridas pelas técnicas de US 2D e ELASTO para avaliação e diagnóstico das propriedades mecânicas e viscoelásticas do tecido miofascial e a comparação dessas características pré e pós-tratamento. Nas imagens de US 2D, as áreas dos PG foram mensuradas. Nos elastogramas adquiridos pela ELASTO, o índice de resistência (IR) foi calculado. Tanto as voluntárias quanto o examinador eram cegos em relação aos grupos. A intensidade de dor geral e localizada nos TPz direito e esquerdo (TPzD e TPzE, respectivamente) pré e pós-tratamento foi mensurada com o auxílio da escala visual analógica (EVA). A ocorrência de fatores influenciadores e as fases do ciclo menstrual foram monitoradas. Os dados foram analisados quanto à normalidade e simetria. Na avaliação intragrupo todos os dados apresentaram distribuição normal, sendo analisados pelo teste t student para dados pareados. Observou-se diminuição da intensidade de dor geral para o grupo AC (P<0,001) e de dor geral e local para a EA (geral, P=0,027; TPzD, P<0,001; TPzE, P=0,005); sem resultados estatisticamente significantes para o grupo SHAM (geral, P=0,296; TPzD, P=0,052; TPzE, P=0,198). Quanto à avaliação de PG nas imagens de US 2D , observou-se diminuição da área do PG para ambos os TPzD e TPzE nos grupos AC (TPzD e TPzE, P<0,001) e EA (TPzD, P=0,003; TPzE, P=0,005); e não para o grupo SHAM (TPzD, P=0,117; TPzE, P=0,093). Em relação à ELASTO, os dados não apresentaram significância estatística para a amostra analisada, contudo, o IR de ambos os lados apresentou-se menor após o tratamento para a EA e AC, e maior para a SHAM. Na comparação entre grupos, diferenças estatisticamente significantes não foram observadas para as variáveis testadas. Os resultados do presente trabalho sugerem a possibilidade de utilização da US 2D e ELASTO na caracterização do tecido miofascial e de PG, apontando para a possibilidade de confirmação objetiva de efeitos subjetivos de tratamentos propostos para a SDM. Ainda, as técnicas de AC e EA demonstraram eficácia no alívio da dor geral, sendo a efetividade da EA observada também na diminuição da intensidade de dor local. O nível de significância adotado foi ?=0,05.(AU)

The aim of this study was to evaluate upper trapezius (TPz) myofascial trigger points (MTrP) through two-dimensional ultrasonography (2D US) and ultrasound elastography (ELASTO) images, as well as, to evaluate the effectiveness of acupuncture (AC) and electroacupuncuture (EA) in decreasing pain in women with myofascial pain syndrome (MPS) associated with head, neck and upper back complaints. A convenience sample of 24 volunteer aged between 20 and 40 years (27.33±5.05 years), body mass index (BMI) from 18.03 to 27.09Kg/m² (22.59±3.11), presenting regular menstrual cycle, at least one active MTrP at both right and left TPz (RTPz and LTPz, respectively) and local or referred pain for up to six months were selected. After signing the Informed Consent Form (ICF), subjects were randomized into three groups, being: two treatment groups (AC and EA) and one control group (SHAM). Eight treatment sessions were than performed, two times per week, for nearly one month, considering each volunteer menstrual cycle. Pre, post-treatment Intensity of pain was assessed by visual analogue scale (VAS) as well as MTrP mean area and strain ratio (SR) by 2D US and ELASTO, respectively, in way to myofascial tissue mechanical and viscoelastic properties assessment and diagnosis. Both, volunteers and examiner were blinded for the three groups. Influencing factors and menstrual cycle phases were monitored. Data were analyzed for normality and symmetry. All intragroup data were normally distributed, so, were analyzed by Student¿s t test for paired data. Decrease in pain intensity was observed for AC (general, P<0.001) and EA (general, P=0.027; RTPz, P<0.001; LTPz, P=0.005); without any significant result for SHAM (general, P=0.296; RTPz, P=0.052; LTPz, P=0.198). Decreased MTrPs area occurred for both sides in AC (RTPz and LTPz, P<0.001) and EA (RTPz, P=0.003; LTPz, P=0.005); on the other hand, SHAM results were not significant (RTPz, P=0.117; LTPz, P=0.093). Concerning ultrasound elastography, although not statistically significant, post-treatment SR in both sides were lower than the beginning for EA and AC, and higher for SHAM group. Regarding within group comparison, no statistically significant difference were observed for the tested variables. 2D US and ELASTO presented the possibility of MTrPs and surrounding tissue diagnosis and characterization, pointing to the possibility of objective confirmation of subjective MPS treatment effects. Also, EA and AC were effective in decreasing general pain intensity, being EA also effective in local pain intensity relief. The level of significance was ?=0.05.(AU)

Acupuntura: efecto analgésico agudo en pacientes con dolor osteoarticular / Acupuncture: acute analgesic effect in patients with osteoarticular pain

Objetivos: Se realizó un estudio longitudinal descriptivo con el objetivo de evidenciar los efectos analgésicos inmediatos de la acupuntura en el dolor crónico osteoarticular. Material y métodos: Pacientes con discopatías lumbares y cervicales, tratados mediante acupunturaen CUDAM durante el año 2012, fueron evaluados mediante la Escala Numérica Verbal(ENV) antes y luego de 45 a 60 minutos de tratamiento. Agujas de 30 x 3 mm fueron aplicadas por técnica intradérmica en puntos tradicionales de acupuntura y en Trigger Points localizados por palpación. Resultados: Treinta y ocho (38) pacientes entre 21 y 71 años fueron tratados mensualmente con acupuntura entre enero y noviembre, con un total de 791 procedimientos. Conclusiones: La acupuntura mostró un efecto analgésico agudo, aplicada al dolor crónico osteoarticular, con un descenso significativo del EVN

Acupuntura: efecto analgésico agudo en pacientes con dolor osteoarticular / Acupuncture: acute analgesic effect in patients with osteoarticular pain

Se realizó un estudio longitudinal descriptivo con el objetivo de evidenciar los efectos analgésicos inmediatos de la acupuntura en el dolor crónico osteoarticular. Material y métodos: Pacientes con discopatías lumbares y cervicales, tratados mediante acupunturaen CUDAM durante el año 2012, fueron evaluados mediante la Escala Numérica Verbal(ENV) antes y luego de 45 a 60 minutos de tratamiento. Agujas de 30 x 3 mm fueron aplicadas por técnica intradérmica en puntos tradicionales de acupuntura y en Trigger Points localizados por palpación. Resultados: Treinta y ocho (38) pacientes entre 21 y 71 años fueron tratados mensualmente con acupuntura entre enero y noviembre, con un total de 791 procedimientos. Conclusiones: La acupuntura mostró un efecto analgésico agudo, aplicada al dolor crónico osteoarticular, con un descenso significativo del EVN...

ST36 laser acupuncture reduces pain-related behavior in rats: involvement of the opioidergic and serotonergic systems.

Laser acupuncture is a modality of low-level light therapy used as an alternative to needling for the past three decades. Although it has proved effective for the treatment of various conditions, the mechanisms underlying its effects are not fully understood. To contribute to this understanding, this study was designed to (1) evaluate the antinociceptive effect of ST36 laser acupuncture (830 nm, 3 J/cm(2)) in rat models of acute nociception and (2) to investigate the opioidergic and serotonergic systems involvement in this effect. Our results demonstrate that ST36 laser acupuncture inhibited (36 ± 2 %) acetic acid-induced abdominal constrictions and both neurogenic (48 ± 7 %) and inflammatory (phase IIA 42 ± 8 % and phase IIB 83 ± 6 %) phases of formalin-induced nociceptive behavior. Moreover, the antinociceptive activity of laser irradiation in the acetic acid test was significantly reversed by preadministration of naloxone (1 mg/kg, nonselective opioid receptor antagonist), pindolol (1 mg/kg, subcutaneous; nonselective 5-HT 1A/B receptor antagonist), and ketanserin (1 mg/kg; selective 5-HT2A receptor antagonist) but not by ondansetron (1 mg/kg, selective 5-HT3 receptor antagonist). Taken together, our data demonstrate, for the first time, that (1) ST36 laser acupuncture elicited significant antinociceptive effect against acetic acid- and formalin-induced behavior in rats and that (2) this effect is mediated by activation of the opioidergic and serotonergic (5-HT1 and 5-HT2A receptors) systems.