经皮神经电刺激治疗颞下颌关节疼痛的研究  

Effects of Transcutaneous Electrical Nerve Stimulation on Patients with Painful Temporomandibular Disorders

作　　者：陈一楠[1,2] 周薇娜[1,2] 于林凤 奚晓菁 王琛[1,2] 张静露[1,2] CHEN Yi-Nan;ZHOU Wei-Na;YU Lin Feng;XI Xiao-Jing;WANG Chen;ZHANG Jing-Lu(Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University;Department of Polyclinic, Affiliated Hospital of Stomatology , Nanjing Medical University, Nanjing 210029, China;2. Orofacial Pain ＆ TMD Research Unit, Institute of Stomatology , Nanjing Medical University, Nanjing 210029, Chin;3. Dental Depart ment , BenQ Medical Center, Nanjing 210019, China)

机构地区：[1]南京医科大学口腔疾病研究江苏省重点实验室南京医科大学附属口腔医院综合科,江苏南京210029 [2]南京医科大学口腔医学院口颌面疼痛与颞下颌关节病研究中心,江苏南京210029 [3]南京明基医院口腔科,江苏南京210019

出　　处：《口腔医学研究》2018年第3期254-257,共4页Journal of Oral Science Research

基　　金：国家自然科学基金重点项目(编号:81230022);江苏省干部保健科研项目(编号:BJ16030)

摘　　要：目的:探讨经皮神经电刺激(TENS)对颞下颌关节(TMJ)疼痛患者感觉和运动功能的影响。方法:采用随机、双盲的方法将单侧TMJ疼痛患者20名与20名正常者平均分为2组,第1组先接受真性TENS(rTENS),后接受假性TENS(sTENS),另1组则相反。测量治疗前、治疗后即刻和治疗后30min双侧TMJ机械痛阈值(MPT)、压力痛阈值(PPT),无痛最大开口度(opening range,OR)和有痛OR。采用方差分析进行统计。结果:患者PPT、无痛OR及有痛OR低于对照组(PPPT=0.034,P_(无痛)<0.001,P_(有痛)<0.001)。患者组疼痛侧MPT及PPT低于对照侧(P_(MPT)<0.001,P_(PPT)<0.001)。rTENS后MPT、PPT、无痛OR、有痛OR均有差异(P_(MPT)=0.003,P_(PPT)<0.001,P_(无痛)<0.001,P_(有痛)<0.001)。结论:TMJ疼痛患者的感觉较敏感,运动功能下降;TENS可以改善患者的疼痛阈值和开口度。Objective：To investigate the effect of transcutaneous electrical nerve stimulation（TENS）on somatosensory and jaw function in patients with unilateral temporomandibular joint（TMJ）pain.Methods：Twenty patients with unilateral TMJ pain and 20 healthy controls were assigned randomly and double-blinded into two groups to receive real and sham TENS（rTENS and sTENS）stimulation for 30 min in a randomized order.mechanical pain threshold（MPT）,pressure pain threshold（PPT）,opening range（OR）without pain and maximal OR were tested before（T1）,immediately after（T2）,and 30 min after treatment（T3）.Results：PPTs and ORs of patients were lower than normal＇s（PPPT=0.034,Pno pain〈0.001,Ppain〈0.001）.There were significant differences for MPT and PPT between painful and control sides in patients（PMPT〈0.001,PPPT〈0.001）.MPTs,PPTs and ORs were significantly different between pre-and post-treatment（rTENS）（PMPT=0.003,PPPT〈0.001,Pno pain〈0.001,Ppain〈0.001）.Conclusion：TMJ pain patients demonstrated high sensitivity and limitation of jaw motion.TENS showed significant improvement in terms of somatosensory and motor function in patients with unilateral TMJ pain.

关 键 词：颞下颌关节紊乱病 经皮神经电刺激 疼痛 定量感觉测试 

分 类 号：R782.6[医药卫生—口腔医学]