光生物调节治疗颞下颌关节紊乱病患者疼痛效果的Meta分析  

Photobiomodulation therapy for pain in patients with temporomandibular disorders:a Meta-analysis

作　　者：刘小雅 杨春[1] 牛涛[1] 罗寒 LIU Xiao-ya;YANG Chun;NIU Tao;LUO Han(Department of Prosthodontics,Hospital of Stomatology,Kunming Medical University,Kunmning 650100,China;不详)

机构地区：[1]昆明医科大学附属口腔医院修复科,云南昆明650100 [2]昆明医科大学附属口腔医院口腔颌面外科,云南昆明650100 [3]杭州口腔医院,浙江杭州310006

出　　处：《中国实用口腔科杂志》2021年第4期475-481,共7页Chinese Journal of Practical Stomatology

基　　金：昆明医科大学研究生创新基金(2019S020)。

摘　　要：目的评价光生物调节治疗颞下颌关节紊乱病患者疼痛效果,为临床提供参考依据。方法计算机检索PubMed、Embase、Cochrane Library、中国知网、万方、维普等数据库,查找光生物调节治疗颞下颌关节紊乱病相关文献。应用Meta分析评价光生物调节(研究组)与放置激光光纤但不予激光照射(对照组)治疗颞下颌关节紊乱病患者疼痛效果,将视觉模拟评分(visual analogue scale,VAS)、压力疼痛感受阈值(pressure pain threshold,PPT)、最大自由开口度(maximum mouth opening,MMO)、左右侧侧方运动(left lateral excursion,LLE;right lateral excursion,RLE)及前伸运动范围(protrusion excursion,PE)作为评价指标。结果纳入了7篇相关文献,共8项随机对照研究。Meta分析结果发现,与对照组相比,研究组能明显改善VAS和PPT(均P <0.05)。但两组在改善患者MMO、LLE、RLE、PE方面,差异无统计学意义(均P> 0.05)。分析其中6项针对慢性颞下颌关节紊乱病疼痛效果的随机对照研究结果显示,光生物调节能显著改善VAS(P <0.05)。结论光生物调节治疗能较好地改善颞下颌关节紊乱病患者的疼痛症状,对慢性疼痛患者的疗效也较好,但对于下颌运动障碍的改善不明显。Objective To evaluate the effectiveness of photobiomodulation therapy in the treatment of pain in patients with temporomandibular disorders(TMD)and to provide a reference for clinical treatment. Methods Literatures about photobiomodulation therapy in the treatment of TMD in PubMed,EMbase,Cochrane Library,CNKI,WanFang,WeiPu and other databases were systematically searched. Meta-analysis was used to evaluate the effectiveness of photobiomodulation therapy(experimental group)versus placebo(control group)for the treatment of painful TMD. We used visual analogue scale(VAS),pressure pain threshold(PPT),maximum mouth opening(MMO),left lateral excursion(LLE),right lateral excursion(RLE),protrusion excursion(PE)as outcome indicators. Results Eight randomized controlled trials from 7 literatures were included. Statistical results found that experimental group could significantly improve VAS and PPT compared with control group(P < 0.05). However,there was no statistical difference in the improvement of MMO,LLE,RLE,PE between experimental group and control group(P > 0.05). Six trials of chronic TMD showed that photobiomodulation therapy could improve VAS(P < 0.05). Conclusion Photobiomodulation therapy can significantly improvethe pain of patients with TMD,and shows same effect on patients with chronic pain. However,there may be no difference in improving the function of the temporomandibular joint.

关 键 词：光生物调节 低能量激光 颞下颌关节紊乱病 疼痛 META分析 

分 类 号：R78[医药卫生—口腔医学]