Clinical Observation Of Acupuncture On Dysfunction And Anxiety And Depression Of Temporomandibular Disorders

Objective:To observe the effect of acupuncture on dysfunction and anxiety and depression of Temporomandibular Disorders(TMD),and to preliminarily explore the correlation between them.Methods:The 63 TMD cases who met the inclusion criteria were included in this study and randomly divided into treatment group(n=32)and control group(n=31).The control group was treated with routine treatment(health education + physical factors + three-step rehabilitation),and the treatment group was treated with acupuncture on the basis of the control group.The two groups were treated once every other day,3 times per week,3 weeks as a course of treatment,1 course of treatment.Visual analogue scale(VAS),Fricton temporomandibular disorder index(dysfunction index DI,palpation index PI,craniomandibular index CMI),Self-rating anxiety scale(SAS)and Self-rating depression scale(SDS)were used as observation indexes to evaluate the patients’ s TMD dysfunction and anxiety and depression before and after treatment.The curative effect was judged by the standard of curative effect evaluation after one course of treatment.Results:(1)Clinical efficacy:in terms of TMD dysfunction,after treatment,the two groups had curative effect,and the treatment group was better than the control group(P<0.05).In terms of anxiety and depression,after treatment,the two groups had curative effect,and the curative effect of the treatment group was better than that of the control group(P<0.05).(2)VAS score: after treatment,the VAS score of both groups decreased,and the decrease of VAS score in the treatment group was better than that in the control group(P<0.05).(3)Fricton index: after treatment,the scores of DI,PI and CMI in both groups were lower than those before treatment,and the decrease in the treatment group was better than that in the control group(P<0.05).In DI score,Mandibular Movement(MM),Joint Noise(JN)and Joint Palpation(JP)were all decreased after treatment,and the decrease of MM and JP in the treatment group was better than that in the control group(P<0.05),but the two group have no significant difference in the decrease of JN(P>0.05).(4)SAS,SDS scores: after treatment,the scores of SAS and SDS in both groups were lower than those before treatment,and the decrease in the treatment group was better than that in the control group(P<0.05).The scores of emotional experience,motor restlessness,functional decline,psychomotor symptoms and somatic symptoms in the SAS and SDS scores of the two groups decreased after treatment,and the decrease in the treatment group was better than that in the control group(P<0.05),but there was no significant difference in autonomic nervous dysfunction between the two groups before and after treatment(P>0.05).(5)Correlation: after treatment,there was a linear correlation between the decreasing degree of SAS and SDS scores and the decreasing degree of CMI in the two groups(r>0,P<0.05).Conclusions:(1)Both acupuncture and routine treatment can improve the TMD dysfunction,such as mandibular movement and joint muscle pain.The curative effect of acupuncture plus routine treatment is better than that of routine treatment alone,but acupuncture has no obvious advantage in improving joint bounce and noise.(2)Both acupuncture and routine treatment can improve TMD patient’s anxiety and depression,such as the emotional experience,motor restlessness and somatic symptoms.The curative effect of acupuncture plus routine treatment is better than that of routine treatment alone,but acupuncture has no obvious effect in improving autonomic nervous dysfunction.This may be related to the mild and moderate anxiety and depression of the patients included in this study.(3)For TMD patients with anxiety and depression,there is a correlation between anxiety and depression and dysfunction.Anxiety and depression and other related symptoms can be alleviated with the improvement of TMD dysfunction.It is suggested that for the TMD patients with mild or moderate anxiety and depression,it is not necessary to choose other acupoints or methods for anti-anxiety and depression.