颞下颌关节紊乱病患者与健康人群颌面部机械疼痛敏感性的比较  

The comparison of mechanical sensitivity mapping in the orofacial regions of the temporomandibular disorder patients and healthy individuals

作　　者：阿迪拉·艾赛提 王琛[1,2,3] 周薇娜[1,2,3] 赵晶[1,2,3] 于林凤[2] 张静露 ADILA Aisaiti;WANG Chen;ZHOU Weina;ZHAO Jing;YU Linfeng;ZHANG Jinglu(Department of Orofacial Pain&TMD,AJjllidted Hospital of Stomatology,Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]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 [2]南京医科大学口腔疾病研究江苏省重点实验室,江苏南京210029 [3]南京医科大学附属口腔医院颞颌关节与口颌面疼痛科,江苏南京210029

出　　处：《口腔医学》2021年第4期303-308,共6页Stomatology

基　　金：江苏省干部保健科研课题(BJ16030);西尔欧横向合作项目(WZ22016001)。

摘　　要：目的利用定量触诊仪对受试者双侧咬肌区及关节区进行触诊,比较和分析疼痛性颞下颌关节紊乱病(TMD)患者与健康人群口颌面部机械疼痛敏感性的差异。方法选取患有单侧咬肌区或关节区疼痛的TMD患者各40例作为试验患者组,40例健康人作为对照组。利用定量触诊仪在受试者双侧咬肌区或关节区进行触诊,通过口述疼痛模拟评分法(NRS)获得受试者不同检测位点的机械疼痛感觉,绘制机械疼痛敏感性地图,并计算熵值和重心坐标。利用两因素方差分析法分析性别和检查侧(患者组:健患侧;对照组:左右侧)对各组熵值和重心坐标的影响;利用三因素方差分析法分析性别、检查侧和检测位点对各组NRS评分的影响。结果 TMD患者咬肌区及关节区健患侧熵值均有统计学差异(咬肌:P<0.001,关节:P=0.006),且患侧NRS指数显著高于健侧(咬肌:P<0.001,关节:P<0.001);但对照组咬肌区及关节区双侧熵值及NRS指数无明显统计学差异(P≥0.071)。结论机械疼痛敏感性地图技术在提供标准化触诊的基础上可以作为区分疼痛性TMD患者及正常人的有效辅助工具,并为该技术应用于TMD患者治疗效果评估的可行性提供了依据。Objective To compare and evaluate the difference of mechanical sensitivity mapping in the orofacial regions of the painful temporomandibular disorders(TMD) patients and healthy individuals with a quantitative palpometer. Methods Forty TMD patients with pain in the unilateral masseter muscle or temporomandibular joint(TMJ) regions and 40 healthy control subjects were involved into this study. Both groups were palpated by quantitative palpometer on their bilateral masseter muscle and TMJ regions. Numerical rating scale(NRS)(0-50-100)was used to evaluate the pressure pain sensitivity of TMD patients and healthy control subjects in test points. Shannon entropy and center of gravity(COG) were also calculated to compare the difference of mechanical sensitivity mapping in TMD patients and healthy control subjects. Data were analyzed with two-way analysis of variance(ANOVA) to find the difference of entropy and COG coordinates values over gender and test sides. Three-way ANOVA was used to analyze the difference of NRS score over gender, test site and test point within groups. Results The difference of entropy in TMD patients were statistically significant on their pain side and healthy side(masseter muscle: P<0.001;TMJ:P=0.006). TMD patients tended to have significant higher NRS scores in their painful side compared with their healthy side(masseter muscle: P<0.001,TMJ:P<0.001), but no significant difference of entropy and NRS scores were found in control subjects(P≥0.071). Conclusion Significant differences of NRS scores and entropy value of TMD patients’ pain side and healthy side indicate that mechanical sensitivity mapping with a simple quantitative palpometer can be used as an auxiliary tool to help professionals distinguish TMD patients from normal person, and it can also be used as an indicator to evaluate the effectiveness of treatment in TMD patients.

关 键 词：颞下颌关节紊乱病 机械疼痛敏感性地图 定量触诊仪 

分 类 号：K782.6[历史地理—历史学]