Temporomandibular Joint Disorder

Kudzu is a commonly known plant that grows all over the countryside, empty lots, and backyards of homes in the southern states.  It is a starch, and depending on what country you come from, there are a wide range of uses for it in all sorts of kitchen recipes.

Below is an interesting article from the Chinese medical journal,  Zhongyi Zazhi.  I translated it into English in order to understand the effects of the herb Puerariae Radix  (gé gën) when used for TMJ disorder.  It goes without saying that this article is geared for TCM clinicians and not for the dilettante.  However, for those of you who have never read a case study based on a traditional Chinese medical perspective, this article may give you some insight into how a primary herb acts as the centerpiece in a treatment plan in accordance with pattern differentiation.  For my fellow TCM herbalists, I hope that the article provides you with some new approaches to benefit your patients.

Ge Gen Is Good at Treating Temporomandibular Joint Disorder Syndrome

Shandong province Liao city nursing school (Shangdong 252060) By Zhū Shù Kuān

For nearly 10 years I have used Puerariae Radix (gé gën) as the primary herb in pattern differentiation and treatment of 30 cases of temporomandibular joint [TMJ] disorder, with rather good results. Case presentations are as follows.

These 30 cases, all of which are outpatient cases, conform to the diagnostic criteria for TMJ disorder. Among these cases are 19 males and 11 females, with the youngest patient being 23 years old and the oldest being 40 years old; the longest term of the disorder was 11 years, and the shortest three months. Treatment results: Among these 30 cases, the treatment was curative for 26 cases and there was improvement in the other four cases. Treatment in all cases was considered to be efficacious. The greatest amount of herbs used in treatment was 26 packs, and the least amount was six packs; the average being 16 packs of herbs.

One example is the treatment of Ms. Li, a 23 year-old female teacher. Her first visit was on February 3, 1994. Three months earlier the patient had contracted a wind-cold. Afterwards, she had a nasal congestion with clear runny mucus. Overall her body and joints were inflexible, tense, and painful. After taking aspirin the wind-cold resolved, and all the symptoms diminished. However, three days later she had pain and a loud clicking sound that came from the temporomandibular joint with mastication, and at the same time she had difficulty opening her mouth. She went immediately to the local hospital for treatment, where she was diagnosed with TMJ syndrome. She was treated for half a month with Oryzanol, vitamin B1, and oxytetracycline; results were less than effective.  I saw that the patient still had generalized body tightness and discomfort, as well as thirst and vexation. The tongue body was red with a thin coat, the pulse sunken and wiry, the diagnosis is wind-cold binding the exterior, with suppression of the defensive qi, leading to heat being generated constraint. She was given a modification of Cinnamon Twig, Peony, and Anemarrhena Decoction (guì zhï sháo yào zhï mû täng):  Cinnamomi Ramulus (guì zhï) 10g,  Paeoniae Radix (sháo yào) 15g,  Anemarrhenae Rhizoma (zhï mû) 15g, Ephedrae Herba (má huáng) 6g,  Aconiti Radix lateralis preparata (zhì fù zî) 6g,  Saposhnikoviae Radix (fáng fëng) 6g, Angelicae dahuricae Radix (bái zhî) 15g, Gentianae Macrophyllae Radix (qín jiäo) 15g, Puerariae Radix (gé gën) 30g, Glycyrrhizae Radix (gän câo) 3g. Formula was decocted in water and taken warm, 1 packet a day. After taking five packs she was able to open her mouth. The remaining symptom was that she lacked strength when she chewing. She continued with five more packs of the same formula to strengthen and consolidate the treatment. No recurrences of the problem were noted at a one-year checkup.

Note: TMJ disorder is chiefly due to invading wind, cold, and damp pathogens. This results in stasis and obstruction of the channels and collaterals. The defensive and constructive qi become disharmonized, leading to the tendon-channels losing moistening nourishment. Consider that Puerariae Radix (gé gën) is good at releasing spasms and helps to moisten the sinews. In the clinic it is frequently used to treat cervical spine symptoms like those, which lead to extreme stiffness in the nape and neck, Puerariae Radix (gé gën) is used to treat TMJ disorder and spasms of the masseter muscles while chewing by helping to guide [the effects of the formula] to this area. As mentioned above it requires 30 or more grams of Puerariae Radix (gé gën) to be used; only then is the treatment remarkable.

葛根善治颞颌关节功能紊乱综合征           山东省聊城卫生学校(山东252060)            朱树宽

近10年来,笔者用葛根为主辨证治疗颞颌关节功能紊乱综合征30例, 取得较好疗效,兹 介绍如下。

30例均为门诊病例,均符合颞颌关节功能 紊乱综合征的诊断标准。其中,男19例,女11 例;年龄最小23岁,最大40岁;病程最长11 年,最短3个月。治疗结果: 30例中,治愈26 例,好转4例,全部有效。服药最多26剂,最少 6剂,平均16剂。

如治李某,女.23岁,教师。1994年2月3 日初诊。患者3个月前触冒风寒后,出现鼻塞流 清涕,周身关节拘急作痛,经服阿斯匹林、感冒 通后,诸症减轻。但3天后下颌关节咀嚼时出现 弹响和疼痛,并感张口困难,急赴当地医院治疗,诊为颞颌关节功能紊乱综合征,予服谷维素、维生素B1、土霉素等治疗半月,效果不著。 余见患者尚有周身拘急不舒,口渴心烦。察舌质 红、苔薄,按脉沉而弦,诊为风寒外束,卫气被遏,郁而化热,予桂枝苟药知母汤化裁:桂枝 10g, 白苟15g,   知母15g,  麻黄6g,附子6g,防风 6g,白术15g,  秦艽15g,  葛根30g, 甘草3g,            水煎 温服, 日1剂。服药5剂,口能张开,唯感咀嚼无力.  上方继服5剂,以资巩固。随访1年,未见复发.

按:颞颌关节功能紊乱综合征,主要是由于 风寒湿邪入侵,导致经络痕阻,营卫失和,筋脉 失于濡养。考葛根善于解痊濡筋,临床善治颈椎 病等所引起的”项背强几几”,乃援引于此,用治咬肌、咀嚼肌痉挛所致的颞颌关节功能紊乱综合征, 其理亦然. 唯葛根用量,需在30g 以上, 疗效才显著.

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One Response to Temporomandibular Joint Disorder

  1. Ben Brodhead L.Ac., M.Ac.O.M. says:

    Great translation Kathryn and on one of my favorite herbs too! I am so happy to see you using the translation skills we gained from SIOM. The site looks great to. All the best!

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