Tratamiento acupuntural de la neuralgia del trigémino resistente a la farmacoterapia convencional. Estudio retrospectivo
Revista Internacional de Acupuntura, ISSN: 1887-8369, Vol: 14, Issue: 2, Page: 46-52
2020
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Article Description
Aunque la farmacoterapia ha mostrado ser eficaz en el tratamiento de la neuralgia del trigémino (NT), hay pacientes sin buena respuesta, o con efectos adversos no tolerables. La neurocirugía, también efectiva, tiene contraindicaciones, riesgos y recidivas. Aunque la acupuntura ha estado asociada con el alivio del dolor, esta respuesta necesita ser más documentada en pacientes con pobre respuesta a la farmacoterapia convencional. Nos propusimos describir la evolución clínica de pacientes con NT con escasa respuesta a los medicamentos, tratados con estimulación de puntos acupunturales, y se determinaron sus efectos sobre la intensidad del dolor. Estudio retrospectivo con revisión de historias clínicas, en un solo centro, de pacientes con NT resistente a la farmacoterapia convencional, que recibieron estimulación de puntos acupunturales con agujas y láser puntual, selección individualizada según la medicina tradicional china, y 3 sesiones semanales durante 4-12 semanas. La medida principal fue la intensidad del dolor. De 7 pacientes, con 5 meses o más de dolor con respuesta desfavorable, 5 fueron mujeres. La edad promedio fue de 59,0 años (rango, 34 a 87 años). Todos toleraron bien el tratamiento. La intensidad del dolor disminuyó significativamente en la escala numérica de dolor: de 9,8 ± 0,4 inicial a 2,3 ± 2,5 en la décima sesión (cuarta semana) y a 1,3 ± 2,0 a las 12 semanas (p < 0,001). A la cuarta semana, la intensidad del dolor disminuyó en 5 pacientes (más de un 50%), de los cuales 3 estaban sin dolor. Los pacientes con NT y pobre respuesta a la farmacoterapia convencional, tratados con estimulación de puntos acupunturales mediante agujas y láser puntual, tuvieron una evolución clínica favorable, con buena tolerancia al tratamiento y alivio significativo de la intensidad del dolor. Although pharmacotherapy has been shown to be effective in the treatment of trigeminal neuralgia (NT), there are patients who do not achieve a good response, or who have intolerable adverse effects. Neurosurgery, also effective, has contraindications, risks and recurrences. Although acupuncture has been associated with pain relief, this response needs to be more documented in patients with poor response to conventional pharmacotherapy. We set out to describe the clinical outcome of patients with trigeminal neuralgia with poor response to medications, treated with stimulation of acupuncture points, determining their effects on pain intensity. We conducted a retrospective study reviewing clinical charts, in one centre, including patients diagnosed with trigeminal neuralgia with poor response to conventional pharmacotherapy, who were treated with laser and needle acupoint stimulation, 3 sessions weekly, 4 to 12 weeks. Pain intensity was the principal measurement. Seven patients, with 5 months or more with trigeminal neuralgia without response to conventional pharmacotherapy were analysed. Five were women. The mean age of the patient was 59.0 years (range 34–87 years). All tolerated the treatment well. Pain intensity decreased significantly (from a mean [SD] 9.8 [.4] at the beginning, to 2.3 [2.5] in session 10 (week 4), and to 1.3 [2,0] at week 12; p <.001). At week 4, in 5 patients, pain intensity had decreased by 50%, and 3 were without pain. Patients with trigeminal neuralgia and poor response to conventional pharmacotherapy, treated with stimulation of acupunctural points using needles and laser puncture, with individualized selection according to diagnosis by traditional Chinese medicine, had a satisfactory clinical outcome with good treatment tolerance and significant relief of pain intensity.
Bibliographic Details
http://www.sciencedirect.com/science/article/pii/S1887836920300387; http://dx.doi.org/10.1016/j.acu.2020.03.004; http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85087011005&origin=inward; https://linkinghub.elsevier.com/retrieve/pii/S1887836920300387; https://api.elsevier.com/content/article/PII:S1887836920300387?httpAccept=text/xml; https://api.elsevier.com/content/article/PII:S1887836920300387?httpAccept=text/plain; https://dul.usage.elsevier.com/doi/; https://dx.doi.org/10.1016/j.acu.2020.03.004
Elsevier BV
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