Made available in DSpace on 2016-07-18T17:53:10Z (GMT). No. of bitstreams: 1 Mariana Paz Rodrigues.pdf: 560276 bytes, checksum: ef29af82731e0fa25f9dc58ae50f2640 (MD5) Previous issue date: 2012-09-28 / This study evaluates acupuncture effect in the prevention of arrhythmias induced by epinephrine crescent doses in rats. Were studied 26 Wistar rats, healthy males were divided into 2 groups: Group 1 (G1) - acupuncture for 30 minutes, points Pericardium 6 (Pc6) and Heart 7 (C7) before the intravenous administration of epinephrine, Group 2 (G2) - adrenaline, without performing acupuncture (control). In both groups, epinephrine was administered at an initial dose of 10 ug / kg by adding 5 ug / kg every 5 minutes until the final dose of 40 ug / kg. The ECG was recorded on continuous monitoring comparing the number of records changes in both groups. It was observed that the main changes produced by adrenaline were the occurrence of atrioventricular block of second degree (BAV2) (G1: 92.3% and G2: 100%) and bradycardia (G1: 69.2% and G2: 92.3%) in two groups. Less frequently, there was occurrence of nonsustained ventricular tachycardia (VT) (G1, G2 7.7% and 23.1%), extrasystoles (ES) isolated (G1: 92.3% - 14.5 ± 11.7 and G2: 100% - 24.9 ± 13.9) (p <0.5) and premature atrial complexes (PAC) (G1: 92.3% - 5.6 ± 7.2 and G2: 84.6% - 12.5 ± 9.5). During episodes of bradycardia and BAV2, we measured the time (in seconds) to restore the heart ratre to physiological levels (G1: 137.3 ± 117.4 and G2: 253.5 ± 151.1) (p <0, 5). It was concluded that acupuncture is effective in reducing occurrences of ES, and mitigate the effects of the Bezold-Jarisch reflex, being able to delay the occurrence of bradycardia and BAV2 and reduce recovery time until physiological rhythm, showing up as a promising tool in the prevention of cardiac arrhythmias. / Este estudo avalia o efeito da acupuntura na prevenção de arritmias induzidas por doses crescentes de adrenalina em ratos. Foram estudados 26 ratos Wistar, hígidos, machos, divididos em 2 grupos: Grupo 1 (G1) - acupuntura por 30 minutos, nos pontos Pericárdio 6 (Pc6) e Coração 7 (C7), antes da administração intravenosa de adrenalina; Grupo 2 (G2) administração de adrenalina, sem realização de acupuntura (controle). Em ambos os grupos, foi realizada a administração de adrenalina, na dose inicial de 10 ug/Kg, adicionando-se 5 ug/Kg, a cada 5 minutos, até a dose final de 40 ug/Kg. Realizou-se eletrocardiograma em monitorização contínua, comparando-se o número de registros de alterações em ambos os grupos. Observou-se que as principais alterações produzidas pela adrenalina foram ocorrência de bloqueio átrio-ventricular de 2º grau (BAV2) (G1: 92,3% e G2: 100%) e bradicardia (G1: 69,2% e G2: 92,3%) nos 2 grupos. Em menor frequência, verificou-se ocorrência de taquicardia ventricular (TV) não sustentada (G1: 7,7% e G2: 23,1%), extra-sístoles (ES) isoladas (G1: 92,3% - 14,5±11,7 e G2:100% - 24,9±13,9) (p<0,05) e complexos atriais prematuros (CAP) (G1: 92,3% - 5,6±7,2 e G2: 84,6% - 9,5±12,5). Durante os episódios de BAV2 e bradicardia, foi avaliado o tempo (em segundos) para restauração da frequência cardíaca a níveis fisiológicos (G1: 137,3±117,4 e G2: 253,5±151,1) (p<0,05). Conclui-se que a acupuntura é eficaz em reduzir ocorrências de ES, além de atenuar os efeitos do reflexo de Bezold-Jarisch, sendo capaz de retardar a ocorrência de BAV2 e bradicardia e reduzir o tempo de recuperação para ritmo fisiológico, mostrando-se como ferramenta promissora na prevenção de arritmias cardíacas.

The effects of acupuncture on mental wellbeing in chronically ill patients Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague Student: Anna Šteflová Tutor: PharmDr. Jitka Pokladníková, Ph.D. Introduction: Demand of patients for the Traditional Chinese medicine (TCM) in Czech Republic is raising and therefore it is necessary to critically evaluate its benefit for specific diagnoses, so that it would be possible to draw conclusions about its use in clinical practice. Objective: To evaluate influence of acupuncture with other methods of TCM on wellbeing and subjective level of pain in patients with musculoskeletal disorders. Methods: Wellbeing of patients before and after TCM therapy was assessed using validated questionnaire WEMWBS (Warwick-Edinburgh Mental Well-being Scale) and subjective level of pain before and after TCM therapy was determined using VAS (Visual Analogue Scale). The changes of wellbeing and subjective level of pain were evaluated first for the whole set of patients with musculoskeletal disorders and subsequently for the subsets of patients divided by the type of musculoskeletal disorder (according to International Classification of Diseases and Related Health Problems) and by the intensity of pain at the beginning of the...

The effects of acupuncture on mental wellbeing in chronically ill patients II Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague Student: Ivana Chuová Tutor: PharmDr. JitkaPokladníková, Ph.D Introduction: Traditional Chinese Medicine (TCM), including acupuncture, is widely used in the treatment of chronically ill patients, whose numbers are increasing. This treatment is widely used either alone or as a supplementary method. Though, more attention should be given to the research of TCM effectiveness in studies. Objective: To assess the effect of selected sociodemographic and clinical variables such as age, gender, size of residence, type of musculoskeletal disorders and concomitant use of Chinese phytotherapy on the alteration in personal well-being and pain in patients with musculoskeletal disorders, who underwent the acupuncture therapy at the Czech-Chinese Centre of TCM University Hospital Hradec Králové (FNHK). Methods: The Evaluation of patients' personal well-being from the data obtained by using WEMWBS and Visual Analogue Scale (VAS) questionnaires. The patients were undergoing therapy at the Czech-Chinese TCM FNHK Centre. The process of the Data collection from questionnaires took place in the period from 7 April 2017 to 12...

Bakgrund: Muntorrhet är vanligt förekommande i den vuxna befolkningen och epidemiologiska studier visar att dess förekomst ökar med åldern vilket leder till att salivproduktionen minskar, vilket är en följd av systemiska sjukdomar, läkemedel och strålbehandling av huvud- och halscancer. Syftet: Syftet med studien var att beskriva olika åtgärder som finns för att lindra muntorrhet hos vuxna. Metod: Studien har genomförts i form av en litteraturstudie med kvantitativ metod. Vetenskapliga artiklarna söktes efter i tre olika databaser med totalt 21 artiklar som redovisades i en artikelmatris. Artiklarna publicerades mellan 2000–2021 och åldersgräns &gt;18 år. Resultat: Resultatet har visat flera olika metoder och åtgärder för att lindra och motverka muntorrhet hos vuxna individer. Bland de åtgärderna har läkemedel, salivstimulerade tugg- och sugtabletter, munspray/gel samt akupunkur, elektrisk nervstimulering och LLLT använts. Slutsats: Litteraturstudien har redovisat olika metoder som finns för att lindra muntorrhet hos vuxna människor men nya studier behövs för att förstärka resultatet samt komma fram till fler metoder för att lindra muntorrhet. / Abstract: Dry mouth is common in the adult population and epidemiological studies show that its prevalence increases with age leading to a decrease in saliva production, which is a consequence of systemic diseases, drugs and radiotherapy for head- and neck cancer. Aim: The aim of this study is to describe the various measures available to alleviate dry mouth in adults. Method: The study was conducted as a literature review using quantitative methods. The scientific articles were searched in three different databases, a total of 21 articles presented in an article matrix table. The articles were published between 2000-2021 and the age limit was &gt;18 years. Result: The results have shown several different methods and measures to alleviate and counteract dry mouth in adults. Among those measures, medications; pilocarpine and cervemelin, saliva stimulated tablets, mouth spray/gel as well as Acupuncture, TENS and LLLT have been used. Conclusion: The literature review has reported various methods available to alleviate dry mouth in adults, but new studies are needed to strengthen the results and more methods to alleviate dry mouth.

Användandet av alternativa behandlingsmetoder, däribland akupunktur, ökar i många länder. Enligt WHO ska varje medlemsland verka för en ökad integration mellan skolmedicin och komplementär- och alternativmedicin. Enligt Socialstyrelsen bör sjuksköterskor söka information och implementera ny kunskap i den skolmedicinska sjukvården. Syftet var att undersöka patienters upplevelser av att ha valt och erhållit alternativ behandling med akupunktur för sina besvär. Ansatsen är en kvalitativ intervjustudie med narrativ metod där manifest innehållsanalys användes för analysen. Resultatet utmynnade i sju kategorier; 1)”otillräcklig vård och behandling” där informanterna uppgav att akupunkturen hjälpt mot besvär där sjukvården inte räckt till, 2) ”patientcentrerad holistisk syn” där informanterna upplevde sig satta i centrum först när de valt alternativ behandling med akupunktur, 3) ”önskan om integrerad vård” där samtliga informanter uttryckte önskan av integrering av akupunktur enligt traditionell kinesisk medicin i den skolmedicinska sjukvården, 4) ”känsla av trygghet” där informanterna uttryckte större trygghet i akupunktur utförd enligt traditionell kinesisk medicin med en utbildning och kunskap som ansågs djupare jämfört med akupunkturen inom sjukvården som kändes ytlig, 5) ”känsla av ökat välbefinnande” där samtliga informanter upplevde ökat fysiskt och psykiskt välbefinnande efter att ha erhållit akupunktur enligt traditionell kinesisk medicin, 6) ”ekonomisk fråga” där alternativ behandlingsmetod med akupunktur ansågs dyr och 7) ” attityder” där informanterna upplevde blandade attityder angående val av behandling. Sammanfattningsvis tyder resultatet på att det kan finnas ett behov av ökad integration mellan skolmedicin och komplementär- och alternativmedicin med fokus på akupunktur som ett komplement för att öka den enskilda individens valfrihet av behandlingsmetod. Fortsatt forskning om effekten av akupunktur enligt traditionell kinesisk medicin för olika besvär behövs för tyngre evidens inom ämnesområdet och erkännande inom skolmedicinen. / Use of alternative treatment, including acupuncture, has increased in many countries. According to WHO, each member country should work for an increased integration of complementary- and alternative medicine into school medicine. According to The National Board of Health and Welfare nurses should seek information and implement new knowledge within school medicine. The aim was to explore why people choose alternative treatment such as acupuncture and their experiences of it. The approach was an interview with narrative method and manifest content analysis was used for the analysis. The result generated into seven categories; 1) ”insufficient care and treatment” where the informants stated that acupuncture had helped them with their troubles when school medicine was insufficient, 2) “patient-centered holistic approach” where the informants experienced the feeling of being put in the centre first when they chose an alternative treatment with acupuncture, 3) “desire for integrated care” where all informants expressed a wish for integration of acupuncture according to Traditional Chinese Medicine within school medicine, 4) “sense of security” where the informants expressed a larger sense of security for acupuncture in accordance with Traditional Chinese Medicine due to the education and knowledge that was regarded as more profound than the acupuncture within school medicine which felt more superficial, 5) “feeling of increased wellbeing” where all informants experienced an increased sense of wellbeing, both physical and mental, after having received acupuncture in accordance with Traditional Chinese Medicine, 6) “financial matters” where alternative treatment of acupuncture was considered expensive, 7) “attitudes” where informants experienced mixed attitudes regarding their choice of treatment. In conclusion, the result shows that there may be a need for an increased integration between school medicine and the complementary- and alternative medicine, focusing on acupuncture, as a complement to increase individual freedom in choosing treatment. Continuous research regarding the effect of acupuncture according to Traditional Chinese Medicine for different troubles is needed for a greater evidence within in the subject area and recognition in school medicine.

Si l’alternative est de nos jours et dans nos sociétés occidentales un concept de plus en plus en vogue, son caractère lui, en demeure pas moins ambigu. En effet, et alors même que nombre de pratiques dites alternatives émergent de part et d’autre de la société, en faire allusion dans certains domaines équivaut à s’affliger soi-même d’une étiquette sur laquelle serait inscrite « New-Age » en caractère gras. Pourtant, son caractère loin d’évoquer cette seule dimension, semble par ailleurs être conséquente d un déséquilibre de plus en plus prégnant au sein même des prérogatives de l’État. Ce mémoire tente donc de rendre compte de ce phénomène tout en investiguant les répercussions de cette asymétrie sur l’intégration de pratiques médicales alternatives au Québec. Ceci dans l’intention non seulement d’explorer davantage la nature de la relation entre médecine alternative et biomédecine, mais aussi afin de poser un nouveau regard sur son expansion. Un regard, lequel permettrait potentiellement de poser les jalons nécessaires à un espace de conciliation entre les médecines, lequel découlerait alors d’un nouvel équilibre au cœur des prérogatives mêmes de l’État. / If the alternative is to our days and in our western societies a concept more and more in vogue, its character remains ambiguous. In effect, and even that number of practices called “alternatives” emerge on both sides of the society, in referring to in some areas is equivalent to plague itself-even a label on which would be marked “New-Age” in bold. Yet, its character far from referring to this single dimension, seems also be consistent to a more and more significant unbalance within the prerogatives of the State. This dissertation therefore attempts to account for this phenomenon while inquiry into the repercussions of this asymmetry on the integration of alternative medical practices in Quebec. This with the intention not only to further explore the nature of the relationship between alternative medicine and biomedicine, but also in order to install a new look on its expansion. A look, which would potentially lay the groundwork necessary to a space of conciliation between the medicines and which would lead to a new balance in the heart of the prerogatives of the State.

Title: Manual techniques based on the theory of fascial chains Objectives: The aim of this thesis is to summerize academic findings and information about anatomy, histology, neurophysiology and biomechanical properties of fascial tissue from the latest research and studies in the theoretical part. Analytical and descriptive part is firstly focused on principles of tissue remodeling, mechanism of myofascial therapy effects and on diagnostic methods which are available for evaluation of structure, properties and function of fascia. The main goal is to describe and compare different diagnostic and therapeutic approaches of most known authors based on various theories of fascial chains. Another important purpose of this work is to demonstrate the objective effect of particular fascial techniques and manual therapies. Methods: This thesis is theoretical work with the purpose of summerizing, organizing and analyzing relevant studies related to the topic through the literary research in available academic databases. Results: The key information concerning structure and properties of fascial tissue have been collected and analyzed according to the latest fascial researches. This thesis describes three best known and widely used approaches which concern the theory of fascial chains and practical outfall...

A presente tese tem por objetivos: identificar concepções sobre Medicina Convencional e Acupuntura que contribuem para o entendimento dos motivos que levam médicos a procurarem conhecer ou se especializar em medicina chinesa, identificar expectativas dos médicos investigados com relação ao exercício da Acupuntura e desvelar o significado dos discursos sobre prática médica e sobre mudança de especialidade médica. Com a hipótese de que os médicos que buscam especialização em Medicina Chinesa - Acupuntura objetivam exercer Acupuntura de forma integrada à Medicina Convencional, o que se dá a partir de uma nova visão de mundo, tendo por referência o contexto de uma prática médica mais abrangente e com relação médico-paciente mais humanista. O tema estudado é de relevância, visto que atualmente é crescente a procura de médicos por especialização em práticas médicas não convencionais, mais freqüentemente, Acupuntura. Também porque tem aumentado o afluxo de pacientes para estas especialidades e, finalmente, porque a discussão do humanismo na medicina é bastante presente na atualidade. Neste contexto, interessa-nos estudar o médico que tem formação na medicina convencional e busca se especializar-se em Acupuntura. Dada a natureza do problema, a pesquisa realizada é quanti-qualitativa. Foram pesquisados 175 médicos do 'Curso de Desenvolvimento em Medicina Chinesa-Acupuntura' do Center-AO - Centro de Pesquisa e Estudo da Medicina Chinesa e UNIFESP - EPM, com questionários composto por perguntas abertas e fechadas. Os dados obtidos foram analisados estatisticamente com metodologia que se aplicou no caso específico do presente estudo, bem como, com técnica de coleta de material denominada do tipo temática, baseada nas respostas dos médicos. As respostas foram analisadas com a técnica de análise de conteúdo, buscando desvelar unidades de significado, e a partir daí, estabelecemos categorias gerais e específicas, que passaram a dar significado aos discursos. Dessa forma obtivemos três grupos categoriais: "Aprimoramento profissional", "Ampliar seu próprio horizonte de vida" e "Compreender o paciente em uma dimensão mais abrangente". Nossos dados revelaram que médicos de especialidades médicas cognitivas e intermediárias são mais atraídos para a especialização em Acupuntura. Também revelaram que os médicos de nosso estudo pretendem exercer Acupuntura em diversos espaços de prática como consultório e outros espaços da medicina privada, SUS, hospitais, pesquisa e docência, entre outros, de forma integrada à Medicina Convencional, no bojo da qual a Acupuntura se firma como especialidade médica. / The main goal of the thesis is to identify conceptions relating to Conventional Medicine and Acupuncture that contributes to the understanding of reasons why doctors search for or specialize in Chinese medicine, identify expectations of the doctors researched in connection with the practice of Acupuncture and reveal the meaning of speeches about medical practice and changes of medical specialization. Assuming as a hypothesis that doctors specialize in Chinese medicine aims to practice Acupuncture integrated with Conventional Medicine, which comes from a new view of the world, having as base a more broaden medical practice in view of a more humanistic doctor-patient relationship. The subject is relevant in view of the current growth in number of doctors searching for specialization in unconventional medical practices, most frequently, Acupuncture. In addition to that, the number of patients of such practices is increasing and, finally, since the discussion of humanistic values in medicine is a current matter. In view of the above, it is important to study the doctor who has as a base the conventional medicine and who searches for specialization in Acupuncture. Due to the nature of the problematic a quantitative-qualitative research was carried on. 175 doctors from 'Curso de Desenvolvimento em Medicina Chinesa-Acupuntura' of Center-AO - Centro de Pesquisa e Estudo da Medicina Chinesa e UNIFESP - EPM- São Paulo, was researched and subjected to a questionnaire of open and closed questions. The obtained data was statistically analyzed with the methodology applicable to the concrete case of the present study, in addition to the applicable collection of material denominated thematic, based on the doctor's answers. Such answers were analyzed in face of the "content analysis" method, seeking to reveal significance units, and from than on, establishing general and specific categories, which leads to the meaning of speeches. In face of that, 3 categories were established: "Professional Improvement", "Broaden self life horizon" and "Understand patients in a more broaden dimension". The data collected reveals that doctors who specialize in cognitive and intermediary medical practices are more drawn to Acupuncture specialization. The data also revealed that doctors subject to the present study aim to practice Acupuncture in several environments, such as private offices and clinics, public hospitals (SUS), academic research, among others, in an integrated way with Conventional Medicine, which establishes Acupuncture as a medical specialization.

Extrações de terceiros molares inferiores e colocações de implantes são cirurgias comuns na prática clínica Odontológica que podem proporcionar, mesmo com as devidas precauções, a parestesia. A terapia de fotobiomodulação com laser de baixa potência estimula a reparação tecidual a partir da absorção dessa luz pelo tecido irradiado. Essa terapia pode ser realizada com a aplicação do laser sobre trajetória do nervo comprometido (laserterapia) ou, sobre pontos de acupuntura da face (laseracupuntura). Este ensaio clínico randomizado, cego, controlado, em paralelo, avaliou o retorno sensitivo do nervo alveolar inferior quando utilizadas uma das duas técnicas de fotobiomodulação em pacientes com parestesia, pós-extração de terceiros molares inferiores ou cirurgia de implantes. Foram selecionados 60 participantes que tiveram a deficiência sensitiva, após o procedimento cirúrgico, acometendo o nervo alveolar inferior. Os participantes da pesquisa foram aleatoriamente divididos em três grupos (n=20): Grupo 1 - medicação sistêmica - composto de ribonucleotídeos pirimidínicos, uridina trifosfato trissódio, citidina monofosfato dissódio (ETNA®, 01 cápsula de 8/8 hrs, 30 dias); Grupo 2 - laserterapia - 808 nm, 100 mW, 40s/ponto, 4 J de energia/ponto, distância de 1 cm entre cada ponto de irradiação, intra e extra-oral, modo contínuo, diâmetro do feixe de 0,0434 cm2 no trajeto do laser alveolar inferior lado comprometido; Grupo 3 - laseracupuntura - irradiação nas mesmas condições que grupo 2, porém apenas na região extra-oral, nos pontos de acupuntura do lado comprometido: E-4 (dicang), M-CP-18 (Jiachengjiang), VC-24 (chengjiang), E-5 (daying), E-6 (jiache) e ponto A1 (YNSA). Em seguida, foram submetidos a um protocolo padronizado de avaliação, que consistiu em 6 testes de limiares de: percepção de parestesia; térmica ao quente/frio; percepção mecânica vibratória; discriminação de dois pontos; percepção de superfície de dor e tatil. A avaliação do grupo 1 foi realizada na primeira sessão clínica (pré-intervenção terapêutica), imediatamente após a finalização da intervenção da medicação sistêmica (após 4 semanas) e 1 mês após o término das intervenção (após 8 semanas da primeira avaliação). Os Grupo 2 e 3 foram avaliados na primeira sessão clínica (pré-intervenção terapêutica), após 10 sessões de tratamento (5 semanas) e após 20 sessões de tratamento (10 semanas da primeira avaliação). Os dados coletados nas avaliações foram transcritos para fichas específicas e considerados para análise estatística. O único limiar que apresentou efeito de interação entre grupo e tempo (primeira, segunda e terceira avaliação) foi o limiar de percepção de parestesia, p=0,002. A partir de Tukey foi constatada diferença estatistica significante entre os grupos nos testes de limiares de percepção: térmica ao frio (grupo 1=3; 1 ?2; 2=3), p=0,04; de superfície de dor na mucosa anterior (grupo 1=2=3), p=0,04; corpo mandibular posterior (grupo 1=2; 1?3,2=3), p=0,01; lábio (grupo 1=2;1?3; 2?3), p=0,04; e mento (grupo 1=2;1?3;2?3), p=0,05. Não foram encontradas outras diferenças significativas nos outros testes de comparação de grupo. Tais resultados apontam que ambas as terapias de fotobiomodulação foram benéficas no tratamento de parestesia. / Mandibular third molar extractions and implant surgeries are common in the dental clinical practice and can promote, even with precautions, paresthesia. Photobiomodulation Therapy (PBMT) using low power laser stimulates tissue repair due to the absorption of light. The PBMT can be performed with the laser application over the entire trajectory on the compromised nerve (laser therapy) or only in acupuncture\'s face points (laser acupuncture). This randomized, blinded, parallel, controlled trial study aimed to evaluate the sensitive return when one of the two PBM techniques were used in patients with paresthesia caused by mandibular third molar extraction or implant surgery. Sixty volunteers reporting sensory deficiency on the inferior alveolar nerve were selected. Volunteers were randomly divided into three groups (n=20): Group 1 - systemic medication: pyrimidine ribonucleotides, uridine triphosphate trisodium, dissodium cytidine monophosphate (ETNA®, 01 capsules, 8/8 hrs, 30 days); Group 2 - laser therapy: 808 nm, 100 mw, 40s /point, 4 J energy /point, 1 cm distance between each irradiation point, intra- and extra-oral, continuous mode, beam diameter of 0.0434 cm2, following the injured alveolar laser pathway; Group 3 - laseracupuncture: irradiated in the same conditions as group 2, but only at the extra-oral region, in acupuncture points of the compromised side: E-4 (dicang), M-CP-18 (Jiachengjiang), VC-24 (chengjiang), E-5 (daying), E-6 (jiache) e ponto A1 (YNSA). Then, volunteers underwent a standardized protocol of evaluation, which consisted of 6 tests: test of perception of paresthesia; thermal perception (hot/cold); mechanical vibration perception; two-point discrimination test; and threshold of pain and tatil surface perceptions. Group 1 was evaluated at the first clinical session (pre-intervention), immediately after the end of the intervention (after 4 weeks) and 1 month after the end of the intervention (after 8 weeks of the first evaluation). Groups 2 and 3 were evaluated at the first clinical session (pre-intervention), after 10 treatment sessions (5 weeks) and after 20 treatment sessions (10 weeks of the first evaluation). The data collected in the evaluations were transcribed for specific records and considered for statistical analysis. The only threshold that presented interaction effect between group and evaluation (first, second and third) was the perception threshold of paresthesia, p = 0.002. From Tukey statistically significant difference was found between the groups in the tests of perception thresholds : thermal to cold (group 1 = 3; 1 ? 2; 2 = 3), p = 0.04; of surface of anterior mucosal pain (group 1 = 2 = 3), p = 0.04; posterior mandibular body (group 1 = 2; 1 ? 3,2 = 3), p = 0.01; lip (group 1 = 2; 1 ? 3; 2 ? 3), p = 0.04; (group 1 = 2; 1 ? 3; 2 ? 3), p = 0.05. No other significant differences were found between the groups in other tests. These results indicate that both photobiomodulation therapies have been beneficial in the treatment of paresthesia.

A acupuntura, uma importante modalidade terapêutica da Medicina Tradicional Chinesa, é utilizada em mais de 130 países, e o panorama atual evidencia que o desenvolvimento mundial da acupuntura necessita incluí-la nos sistemas nacionais de saúde e no suporte governamental e acadêmico para sua legalização, normatização e inserção nas políticas públicas. No Brasil, a acupuntura é contemplada pela Política Nacional de Práticas Integrativas e Complementares (PNPIC) no Sistema Único de Saúde (SUS) que inseriu o país na vanguarda das práticas integrativas no sistema oficial de saúde, no âmbito das Américas. A PNPIC, publicada na forma da Portaria Ministerial nº 971 de maio de 2006, por meio de seus objetivos, diretrizes e ações, tem possibilitado conhecer, apoiar, incorporar e implementar experiências que já vêm sendo desenvolvidas na rede pública de saúde, em municípios de praticamente todos os Estados. Embora a acupuntura já estivesse inserida nos serviços públicos de saúde de alguns municípios, antes da publicação da PNPIC, sua incorporação na rede pública estadual e municipal mostra que experiências têm ocorrido de modo desigual, descontinuado e, muitas vezes, sem o devido registro, com fornecimento inadequado de insumos ou ações de acompanhamento e avaliação. Nesse sentido, a presente investigação constitui-se em um estudo de natureza analítica, com abordagem qualitativa, cujo objetivo foi analisar o processo de implantação da acupuntura nos serviços públicos de saúde dos municípios integrantes do Departamento Regional de Saúde XIII (DRS XIII) do Estado de São Paulo, no período de 2001 a 2011. Os dados foram obtidos por meio de análise documental, onde nesse recorte temporal foram analisados instrumentos de gestão, entre eles os Planos Municipais de Saúde (PMS), Relatórios Anuais de Gestão (RAG) e as bases do Sistema de Informação do Departamento de Informação e Informática do Sistema Único de Saúde (DATASUS), como o Cadastro Nacional dos Estabelecimentos de Saúde (CNES) e o Sistema de Informação Ambulatorial do SUS (SIA/SUS) e, também, por meio de entrevista semiestruturada com 11 sujeitos dos municípios onde a oferta da acupuntura no sistema público municipal da saúde foi identificada. Os dados da entrevista semiestruturada foram analisados a partir da matriz analítica formulada por Araújo e Maciel (2001), por meio das categorias: atores, conteúdo, contexto e processo. A análise do macro contexto possibilitou identificar semelhanças, guardando as devidas proporções, entre a PNPIC e o SUS, tanto no processo de criação quanto na implementação. A análise do micro contexto assinala que as PIC tiveram avanços, valendo-se das oportunidades do contexto político-social da saúde pública no Brasil, um exemplo é a própria elaboração e publicação da PNPIC. No entanto, seus princípios e diretrizes ainda estão distantes de serem considerados e valorizados como recursos tecnológicos em ascendência na conformação das práticas de saúde do SUS. Essas considerações sinalizam um cenário de fragilidades, contradições e contrassensos que podem comprometer a construção e a consolidação de espaços de ampliação da prática da acupuntura, nos serviços integrantes do SUS, incluindo os da Atenção Básica. Nesse sentido, destacamos a necessidade de se investir na definição do financiamento para a implantação e implementação das PIC, investir em estratégias de políticas indutoras, bem como envidar esforços na área de formação de saúde, contemplando desde a graduação até essas outras racionalidades. Também ressaltamos a importância de priorizar a acupuntura e as PIC na agenda política dos formuladores e implementadores, pautar a discussão sobre a acupuntura nos diferentes espaços de discussão e decisão, fomentar uma mobilização maciça com a participação de diversos atores e sujeitos sociais no desenvolvimento desse processo político. Nessa perspectiva, é fundamental induzir processos de implantação, implementação e avaliação, institucionalizar uma estratégia periódica de avaliação da incorporação ou não de ações das PIC/RM, assumindo publicamente, inclusive, por meio dos diferentes instrumentos de gestão, o compromisso político com a institucionalização das PIC/RM, no SUS. Esse processo de buscar fortalecer a acupuntura e demais PIC/RM no SUS pode se constituir em uma estratégia de fortalecimento de diversas políticas de saúde e, consequentemente, de fortalecimento e consolidação do Sistema Único de Saúde. / Acupuncture, an important therapeutic modality of traditional Chinese medicine, is used in over 130 countries, and the current situation shows that the global development of acupuncture needs to include it in the national health systems and government and academic support for its legalization, standardization and integration in public policy. In Brazil, acupuncture is covered by the National Policy on Integrative and Complementary Practices (PNPIC) in the Unified Health System (SUS), which entered the country at the forefront of integrative practices in the public health system in the context of the Americas. The PNPIC, published in the form of Ministerial Decree No. 971 of May 2006, through its objectives, guidelines and actions, has allowed to know, support, incorporate and implement experiences that have been developed in the public health system in the municipalities of almost all states. Although acupuncture has been inserted in the public health services of some municipalities, before the publication of PNPIC, their incorporation into state and municipal public network shows that experiments have been uneven, discontinued, and so often with poor or lack of registration, with inadequate supply of inputs or actions of monitoring and evaluation. In this sense, this research consists in a study of analytical nature, with a qualitative approach whose objective was to analyze the process of deployment of acupuncture in public health services of member municipalities of the Regional Department of Health XIII (DRS XIII) of the State of São Paulo, in the period 2001-2011. Data were collected through documentary analysis, and at this time frame, management instruments were analyzed, including the Municipal Health Plans (PMS), Management Annual Reports (RAG) and the databases of the Information System of the Department of Information and Informatics of the Unified Health System (DATASUS), as the National Register of Health Service Establishments (CNES) and the SUS Ambulatory info System of SUS (SIA/SUS), and also through semi-structured interviews with 11 individuals of the municipalities where the offer of acupuncture in the municipal public health system was identified. Data from semi-structured interviews were analyzed using the analytical framework formulated by Araújo and Maciel (2001), through the following categories: actors, content, context and process. The analysis of the macro- context enabled us to identify similarities, keeping the proper proportions, between PNPIC and the SUS, both in the creation process and the implementation. The analysis of the micro- context notes that the PIC had advances, taking advantage of the opportunities of the political and social context of public health in Brazil, one example is the actual preparation and publication of PNPIC. However, its principles and guidelines are still far from being considered and valued as technological resources in ascension in order to shape health practices of SUS. These considerations point to a scenario of weaknesses, contradictions and nonsense that can compromise the construction and consolidation of spaces of expansion of the practice of acupuncture, in those integrating services of SUS, including Primary Care. In this regard, we highlight the need to invest in setting funding for the deployment and implementation of PIC, invest in strategies of inducing policies as well as efforts in the area of health education, contemplating since undergraduation until these other rationalities. We note the importance of prioritizing acupuncture and PIC on the political agenda of policymakers and implementers, include the theme about acupuncture in different spaces for discussion and decision, promote a massive mobilization to encourage the participation of various actors and social individuals in the development of this political process. From this perspective, it is essential to induce processes of deployment, implementation and evaluation, institutionalize a strategy of periodic reviewing and evaluating of the incorporation or not of actions of PIC/RM, assuming publicly, including by means of different management tools, the political commitment to the institutionalization of the PIC / RM, in the SUS. This process of seeking to strengthen acupuncture and other PIC/RM in the SUS can serve as a strategy for strengthening various health policies and, consequently, strengthen and consolidate of the Unified Health System