Acupuncture in the treatment of xerostomia – dryness of mucus membranes in mouth due to damage of salivary glands

Dryness inside mouth results from different diseases and situations. Its specific kind is related to the damage of salivary glands as an adverse event connected to the radiotherapy in the area of neck and head. The development of modern oncology leads to constant enlargement of the group of people suffering from xerostomia.

Acupuncture is an effective method of treatment of this condition. In 2008 a preliminary report was published by a group of Brazilian scientists describing beneficial effect of acupuncture on production of saliva in patients with xerostomia after radiotherapy(source)1. This team continued researching this indication and published another article, this time proving that acupuncture effectively prevented xerostomia(source)2.

A team of American researchers, working in China, independently reported similar results.  In their well design, placebo controlled experiment, acupuncture significantly improved the quality of life of patients measured by XQ and MDASI-HN(source)3 questionnaires. Another randomised trial, called ARIX, was performed in Great Britain proving that acupuncture was better than oral care education(source)4.

The mechanism of the influence of acupuncture on the production of saliva by salivary glands damaged by radiotherapy is not well known. It was shown that acupuncture significantly increases the blood flow in the skin above salivary glands(source)5. Other experiments proved that acupuncture results in the increased excretion of Vasoactive Intestinal Peptide(source)6 and Calcitonin Gene Related Peptide to the saliva(source)7.

STRENGTH OF EVIDENCE
Power of arguments
BIBLIOGRAPHY

1 Braga FP1, Sugaya NN, Hirota SK, Weinfeld I, Magalhães MH, Migliari DA. „The effect of acupuncture on salivary flow rates in patients with radiation-induced xerostomia.” Minerva Stomatol. 2008 Jul-Aug;57(7-8):343-8.

2 Braga FP1, Lemos Junior CA, Alves FA, Migliari DA. „Acupuncture for the prevention of radiation-induced xerostomia in patients with head and neck cancer.” Braz Oral Res. 2011 Mar-Apr;25(2):180-5.

3 Meng Z1, Kay Garcia M, Hu C, Chiang J, Chambers M, Rosenthal DI, Peng H, Wu C, Zhao Q, Zhao G, Liu L, Spelman A, Lynn Palmer J, Wei Q, Cohen L. „Sham-controlled, randomised, feasibility trial of acupuncture for prevention of radiation-induced xerostomia among patients with nasopharyngeal carcinoma.” Eur J Cancer. 2012 Jul;48(11):1692-9. doi: 10.1016/j.ejca.2011.12.030. Epub 2012 Jan 28

4 Simcock R1, Fallowfield L, Monson K, Solis-Trapala I, Parlour L, Langridge C, Jenkins V; ARIX Steering Committee. „ARIX: a randomised trial of acupuncture v oral care sessions in patients with chronic xerostomia following treatment of head and neck cancer.” Ann Oncol. 2013 Mar;24(3):776-83. doi: 10.1093/annonc/mds515. Epub 2012 Oct 25

5 Blom M, Lundeberg T, Dawidson I, Angmar-Mansson B. „Effects on local blood flux of acupuncture stimulation used to treat xerostomia in patients suffering from Sjogren’s syndrome”. J Oral Rehabil. 1993; 20(5):541–548

6 Dawidson I, Angmar-Mansson B, Blom M, Theodorsson E, Lundeberg T. „Sensory stimulation (acupuncture) increases the release of vasoactive intestinal polypeptide in the saliva of xerostomia sufferers”. Neuropeptides. 1998; 32(6):543–548

7 Dawidson I, Angmar-Mansson B, Blom M, Theodorsson E, Lundeberg T. „Sensory stimulation (acupuncture) increases the release of calcitonin gene-related peptide in the saliva of xerostomia sufferers”. Neuropeptides. 1999; 33(3):244–250.

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