Acupuntura auricular e laser de baixa frequência no tratamento da lombalgia e cefaleia em pacientes assistidos na atenção primária à saúde: novas possibilidades

Abstract

In the context of the Unified Health System, Integrative and Complementary Health Practices present themselves as an important care tool. Among Integrative and Complementary Health Practices, auricular acupuncture demonstrates effectiveness in treating various outcomes, with painful symptoms. Furthermore, another treatment for analgesia is low frequency laser, with the Intravascular Laser Irradiation of Blood technique. The present study aimed to develop and validate an auricular acupuncture protocol for the treatment of headache and evaluate the effect of auricular acupuncture associated with low-frequency laser with the Intravascular Laser Irradiation of Blood technique in the treatment of chronic low back pain in Care patients. Primary Health. The methodological study, carried out in June 2023, was structured in three stages: planning (bibliographic survey and identification of study variables), construction of instruments (characterization of experts, point protocol and treatment regimen) and validation of content by 15 experts. In data analysis, the percentage of absolute agreement equal to or greater than 80% was used. In the randomized clinical trial, conducted between July and November 2023. The volunteers underwent two assessments: an initial assessment and a final assessment 7 days after the last intervention session. Pain was identified using the numerical pain scale. Furthermore, the degree of physical disability was assessed using the Roland and Morris Disability Questionnaire; quality of life using the World Health Organization Quality of Life-Bref and the perception of self-efficacy related to chronic pain control using the Chronic Pain Self-Efficacy Scale. 104 individuals with chronic low back pain, randomized into groups: experimental (n = 52), undergoing 4 sessions of auricular acupuncture with radionic crystals, fixed to microporous tape, on the TF4 ear points (Shenmen); CO10 (Kidney); AH6 (Sympathetic Nerve); AH10 (Lumbar Vertebrae); CO12 (Liver) and AT4 (Subcortex) and low frequency laser using the Intravascular Laser Irradiation of Blood technique and control (n = 52). The data were analyzed using the non-parametric Chi-Square and Mann-Whitney tests, with 5% significance for sociodemographic and clinical variables, while the comparison of primary and secondary variables of the EG and GP were analyzed using the longitudinal model. of Generalized Estimating Equations. The study was registered in the Brazilian Clinical Trials Registry (RBR-472dvp3). The ear acupuncture protocol for the treatment of headache, validated by experts, was composed of the following points: “Door of the Mind” (93.3%), Kidney (86.7%), Sympathetic (86.7%), Anxiety (86.7%), Subcortex (86.7%), Brain Stem (86.7%), Frontal (86.7%), Occipital (86.7%), Temporal (86.7%) and Liver (80 %). In the clinical trial, auricular acupuncture associated with low frequency laser (modified ILIB technique), during four sessions, showed a significant effect in the experimental group in reducing pain intensity between the initial and final moments (p<0.0001), improvement in the degree of physical disability at the initial and final moments (p<0.0001), improvement in quality of life in the health satisfaction domains; psychological and environmental aspects between the initial and final moments (p<0.0001) and improvement in the perception of self efficacy related to the control of chronic low back pain in the initial and final moments (p<0.0001). In conclusion, the auricular acupuncture protocol for the treatment of headache was considered valid, which will allow its use in clinical practice and research and auricular acupuncture associated with low frequency laser (modified ILIB technique) showed a superior effect in the experimental group when compared to the placebo group in reducing chronic low back pain.