不同方法治疗颞下颌关节滑膜炎临床疗效的观察  

Outcomes of different treatments for acute temporomandibular joint synovitis

作　　者：徐济群 柴琳 黄伟[1] 陶琳[2] XU Jiqun;CHAI Lin;HUANG Wei;TAO Lin(Department of Stomatology,The Third People′s Hospital of Hefei,Hefei 230032,China)

机构地区：[1]合肥市第三人民医院口腔科,安徽合肥230032 [2]合肥市第三人民医院针灸科,安徽合肥230032 [3]皖南医学院口腔医学院,安徽芜湖241002

出　　处：《皖南医学院学报》2022年第4期372-376,共5页Journal of Wannan Medical College

基　　金：北京航空航天大学虚拟现实技术与系统国家重点实验室开放课题(VRLAB2020D03)。

摘　　要：目的:比较不同方法在治疗颞下颌关节滑膜炎(TMJS)中的疗效。方法:收治TMJS患者40例,随机将患者分为4组:中医组(采用温针刺穴位法)、西医组(采用关节上腔注射玻璃酸钠+局部涂擦扶他林)、中西结合组、对照组(热敷),每组10例。4组均按照诊疗程序对患者进行为期2周的治疗,4组治疗后测定以下指标:患者静息状态和咬合状态下的视觉模拟评分(VAS)、张口度、颞下颌关节紊乱指数(Fricton指数)以及血清CRP值。结果:4组治疗后Frition指数均较治疗前下降(P<0.05),中西结合组治疗后MM、DI、MP、PI和CMI指标改善程度均优于对照组、中医组和西医组(P<0.05),而JN指标改善程度优于对照组,JP指标改善程度优于对照组和中医组(P<0.05);4组治疗后静息状态VAS和CRP水平均较治疗前下降(P<0.05),张口度较治疗前增大(P<0.05),中西结合组治疗后静息状态VAS、咬合状态VAS改善程度以及CRP水平改善程度均优于中医组和西医组(P<0.05),而4组治疗后张口度改善情况差异无统计学意义(P>0.05)。结论:中西医结合治疗对TMJS各项功能的恢复更加有效。Objective:To compare the outcomes of different treatments in acute temporomandibular joint synovitis(TMJS).Methods:Forty patients with acute TMJS were randomized to four groups, namely, TCM group(treated by traditional Chinese acupuncture at the point using warming needle),WM group(treated by western medicine using sodium hyaluronate injection at the upper cavity of mandibular joints plus local application of diclofenac diethylamine emulgel),combined treatment group(treated by TCM plus WM) and control group(only managed by heat compress)(n=10 for each group).Patients in the four groups underwent consecutive 2 weeks of treatment, and were observed for the clinical indexes after treatment, including scores on the visual analogue scale(VAS) at rest and occlusion state, mouth opening degree, temporomandibular joint disorder index(Fricton index) and serum CRP level.Results:Fricton index was generally decreased in the four groups of patients following treatment(P<0.05).The indexes, including MM,DI,MP,PI and CMI,were better improved after treatment in the combined treatment group compared to the control group, TCM and WM groups(all P<0.05).However, the improvement of JN index was better in the combined treatment group than in the control group, and better than that of the control group and TCM group(P<0.05).After treatment, VAS at rest and CRP levels were decreased, yet mouth opening degree was increased(all P<0.05).The improvement degree of VAS at rest and occlusion as well as CRP level was better in the integrated TCM treatment group than in simple TCM and WM groups following treatment(all P<0.05),yet there was no significant difference in the mouth opening degree among the four groups(P>0.05).Conclusion:Treatment of acute TMJS with integrated TCM and WM can lead to better and effective recovery of the temporomandibular joint functions.

关 键 词：玻璃酸钠 扶他林 颞下颌关节急性滑膜炎 颞下颌关节紊乱指数 

分 类 号：R782.6[医药卫生—口腔医学]