小针刀联合运动疗法治疗颞下颌关节盘不可复性前移位的效果评价  

Clinical application of small needle knife therapy combined with exercise therapy in the treatment of displacement of temporomandibular joint disc without reduction

作　　者：胡阿特·哈德尔 周伟[2] 帕尔哈提·艾买提 胡娟[3] 王珊 买买提吐逊·吐尔地[3] HUATE·Hadeer;ZHOU Wei;PALAHATI·Aimaiti;HU Juan;WANG Shan;MAIMAITITUXUN·Tuerdi(Department of Stomatology,Karamay Central Hospital. Karamayi 834000;Department of Acupuncture and Massage,The First Affiliated Hospital of Xinjiang Medical University. Urumqi 830054,Xinjiang Uygur Autonomous Region,China;Department of Oral and Maxillofacial Surgery,The First Affiliated Hospital of Xinjiang Medical University. Urumqi 830054,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]克拉玛依市中心医院口腔科,新疆克拉玛依834000 [2]新疆医科大学第一附属医院针灸推拿科,新疆乌鲁木齐830054 [3]新疆医科大学第一附属医院口腔颌面外科,新疆乌鲁木齐830054

出　　处：《中国口腔颌面外科杂志》2019年第4期327-331,共5页China Journal of Oral and Maxillofacial Surgery

基　　金：新疆维吾尔自治区自然科学基金(2016D01C249)

摘　　要：目的:评价小针刀联合运动疗法治疗颞下颌关节盘不可复性前移位的临床疗效。方法:选取32例颞下颌关节盘不可复性前移位患者,随机分为实验组(16例)和对照组(16例),2组患者均接受健康指导、手法复位、运动训练,实验组同时给予小针刀治疗。治疗前和治疗后3、6个月,比较分析2组患者疼痛视觉模拟评分(VAS)、最大开口度(maximum mouth opening,MMO)、Fricton颞下颌关节紊乱指数;MRI检查治疗后3、6个月时2组患者的颞下颌关节盘-髁关系。采用SPSS 19.0软件包对数据进行统计学分析。结果:对照组治疗前平均MMO为25.95 mm,治疗结束后增大到38.71 mm,3个月和6个月复诊时平均MMO分别为38.94和38.94 mm;实验组治疗前平均MMO为26.3 mm,联合治疗结束后增大到41.06 mm,3个月和6个月复诊时分别为41.04和41.19 mm。对照组16例患者治疗前VAS为3.93,治疗后降为1.60,3个月、6个月复诊时分别降为1.18、0.62;实验组联合治疗前VAS为4.063,治疗后降为0.80,3个月、6个月复诊时分别降为0.375、0.25。治疗后3个月和6个月比较,2组患者Fricton颞下颌关节紊乱指数明显改善,治疗前、后及2组间治疗效果有显著差异(P<0.05)。MRI检查提示,2组患者治疗前均诊断为不可复性关节盘前移位。3个月时,对照组16例患者中,6例为可复性关节盘前移位;6个月时,3例患者复发为不可复性关节盘前移位。实验组患者复位后3个月复查时有5例为可复性关节盘前移位,6个月时不可复性关节盘前移位患者为2例。经统计学分析,2组患者颞下颌关节盘-髁关系比治疗前均显著改善(P<0.05),治疗后2组间治疗效果无显著差异(P>0.05)。结论:小针刀联合运动疗法较单纯运动疗法治疗颞下颌关节盘不可复性前移位效果更理想。PURPOSE:To evaluate the clinical efficacy of small needle knife therapy combined with exercise therapy in the treatment of anterior disk displacement without reduction of temporomandibular joint(TMJ).METHODS:Thirty-two patients with anterior disk displacement without reduction of TMJ were randomly divided into the experimental group(n=16)and the control group(n=16).Patients in both groups received health guidance,manual reduction,exercise training.Patients in the experimental group were given small needle knife treatment at the same time.Visual analogue score(VAS),maximum mouth opening(MMO),Fricton TMJ index of the two groups were compared and analyzed before treatment,3 months and 6 months after treatment.MRI examination was performed to observe the reduction of TMJ of the two groups.The measurement data were analyzed with SPSS 19.0 software package.RESULTS:The average MMO of the control group was 25.95 mm before treatment,increased to 38.71 mm after treatment,and the average MMO was 38.94 mm and38.94 mm at 3 and 6 months of follow-up,respectively.The MMO of the experimental group was 26.3 mm before treatment,increased to 41.06 mm after treatment,41.04 mm and 41.19 mm at 3 and 6 months of follow-up,respectively.VAS scores in the control group were 3.93 before treatment,1.60 after treatment,3 and 6 months after treatment decreased to 1.18 and 0.62,respectively;while in the control group were 4.063 before treatment,0.80 after treatment,3 months and 6 months after treatment decreased to 0.375 and 0.25,respectively.Fricton TMJ index significantly improved 3 months and 6 months after treatment,and the treatment effect was significantly different before,after treatment and between the two groups(P<0.05).MRI examination suggested both groups were diagnosed as anterior disc displacement without reduction before treatment.In the control group,3 months after treatment,6 of the 16 patients were diagnosed as reducible anterior disc displacement;6 months after treatment,3 patients relapsed into anterior disc displacement wit

关 键 词：小针刀 运动疗法 颞下颌关节盘 手法复位 关节盘不可复性前移位 

分 类 号：R782.6[医药卫生—口腔医学]