针刺配合手法治疗颞下颌关节紊乱症临床研究  

Clinical Study on Acupuncture Combined with Manipulation for Temporomandibular Joint Disorders

作　　者：谢磊 杨曼 XIE Lei;YANG Man

机构地区：[1]河南省直第三人民医院,河南郑州450006

出　　处：《新中医》2023年第7期184-188,共5页New Chinese Medicine

基　　金：河南省医学攻关计划项目(LHGJ20220244);河南省医学攻关计划项目(LHGJ20190861)。

摘　　要：目的:观察针刺配合手法治疗对颞下颌关节紊乱症疼痛缓解及颌关节功能恢复的影响。方法:将86例颞下颌关节紊乱症患者按随机数字表法分为观察组和对照组各43例。对照组采用针刺治疗,观察组采用针刺联合手法治疗,治疗4周。比较2组疼痛评分、关节弹响度、最大张口度、颞下颌关节功能的变化情况,并评价2组临床疗效及治疗安全性。结果:观察组总有效率为93.02%,高于对照组79.07%(P<0.05)。治疗后,2组视觉模拟评分法(VAS)评分、关节弹响度较治疗前降低,最大张口度较治疗前升高(P<0.05);且观察组VAS评分、关节弹响度低于对照组,最大张口度高于对照组(P<0.05)。治疗后,2组下颌运动、关节杂音、关节压诊及功能障碍指数(DI)值较治疗前降低(P<0.05);且观察组下颌运动、关节杂音、关节压诊及DI值低于对照组(P<0.05)。结论:针刺配合手法治疗能够改善颞下颌关节紊乱症患者疼痛、关节弹响及张口受限症状,促进颞下颌关节功能恢复,提高临床治疗效果,且安全性高。Objective:To observe the effect of acupuncture combined with manipulation on pain relief of temporomandibular joint disorders and functional recovery of jaw joint.Methods:A total of 86 cases of patients with temporomandibular joint disorders were divided into the observation group and the control group according to the random number table method,with 43 cases in each group.The control group was treated with acupuncture,and the observation group was treated with acupuncture combined with manipulation.Both groups were treated for 4 weeks.The changes in pain scores,clicking of joint,maximum mouth opening,and temporomandibular joint function were compared between the two groups.The clinical effects and treatment safety in the two groups were evaluated.Results:The total effective rate was 93.02%in the observation group,higher than that of 79.07%in the control group(P<0.05).After treatment,Visual Analogue Scale(VAS)scores and clicking of joint in the two groups were decreased when compared with those before treatment,and the maximum mouth opening was increased when compared with that before treatment(P<0.05);the VAS scores and clicking of joint in the observation group were lower than those in the control group,and the maximum mouth opening was higher than that in the control group(P<0.05).After treatment,mandibular movement,joint noise,pressure palpation of joint,and dysfunction index(DI)in the two groups were decreased when compared with those before treatment(P<0.05);mandibular movement,joint noise,pressure palpation of joint,and DI in the observation group were lower than those in the control group(P<0.05).Conclusion:Acupuncture combined with manipulation can improve the symptoms of pain,clicking of joint and mouth opening limitation in patients with temporomandibular joint disorders,promote the functional recovery of temporomandibular joint,improve the clinical effect,and have high safety.

关 键 词：颞下颌关节紊乱症 疼痛 针刺 手法治疗 颞下颌关节功能 关节弹响度 最大张口度 

分 类 号：R783.5[医药卫生—口腔医学]