针刺治疗混合型磨牙症经验撷要并附验案1则

Experience of Acupuncture for Mixed-Type Bruxism and a Case Report

摘要: 磨牙症是口颌系统功能紊乱的一种常见病，而混合型磨牙症既有日间磨牙又有夜间磨牙，治疗较为困难。本文通过对病例进行分析以及查阅文献的方式，总结了针灸治疗混合型磨牙症的经验。选取一位典型的混合型磨牙症患者进行研究，该患者为50岁女性，自述日间无意识咬牙、夜间磨牙伴颞下颌关节疼痛3年余。采用中医辨证论治的方法，结合现代针灸技术，以疏肝解郁、宁心安神为治疗原则，选取百会、四神聪、神门、三阴交、太冲、合谷等主要穴位，配合头部特定区域的针灸刺激。治疗周期为8周，每周3次，每次留针30分钟。通过磨牙症状评分量表、睡眠质量指数、颞下颌关节功能评估等指标进行疗效观察。结果显示，患者日间磨牙症状明显减轻，夜间磨牙频次显著下降，颞下颌关节疼痛基本消失，睡眠质量明显改善。结合相关文献分析发现，针灸治疗混合型磨牙症的作用机制可能与调节神经递质平衡、改善脑血流循环、缓解肌肉紧张等因素有关。针灸疗法具有操作方便、副作用小、效果持久等优点，对混合型磨牙症的治疗有很好的指导意义。本研究为临床针灸治疗磨牙症提供了一定的借鉴作用，但是还需要更多的大样本随机对照试验来进一步证实其有效性。

Abstract: Bruxism is a common disorder of the stomatognathic system, and mixed-type bruxism—characterized by both diurnal and nocturnal bruxism—is particularly challenging to treat. This article summarizes the experience of acupuncture therapy for mixed-type bruxism through case analysis and literature review. A representative patient with mixed-type bruxism was enrolled: a 50-year-old female who had experienced diurnal unconscious teeth clenching, nocturnal bruxism, and temporomandibular joint (TMJ) pain for over three years. Guided by traditional Chinese medicine syndrome differentiation and modern acupuncture techniques, the treatment principle was to soothe the liver and relieve stagnation, as well as calm the heart and stabilize the mind. The main acupoints selected included Baihui (GV20), Sishencong (EX-HN1), Shenmen (HT7), Sanyinjiao (SP6), Taichong (LR3), and Hegu (LI4), combined with acupuncture stimulation in specific cranial regions. The treatment course lasted eight weeks, with three sessions per week, each session with needle retention for 30 minutes. Therapeutic outcomes were evaluated using the Bruxism Symptom Rating Scale, the Sleep Quality Index, and TMJ function assessment. Results showed that diurnal clenching was significantly alleviated, nocturnal bruxism frequency markedly decreased, TMJ pain nearly resolved, and sleep quality substantially improved. Literature analysis suggests that the therapeutic mechanisms of acupuncture for mixed-type bruxism may involve regulating neurotransmitter balance, improving cerebral blood circulation, and relieving muscle tension. Acupuncture offers advantages including convenient operation, low side effects, and durable effects, providing valuable guidance for treating mixed-type bruxism. This study provides a reference for the clinical application of acupuncture for bruxism; however, further large-scale randomized controlled trials are needed to confirm its efficacy.