自体富血小板纤维蛋白关节腔注射对颞下颌关节骨关节炎的疗效研究  

Therapeutic Effects of Autologous Platelet Rich Fibrin Intra-Articular Injection on Temporomandibular Joint Osteoarthritis:A Comparative Study

作　　者：韩新生 薛博元 张兴安[1] 贾佳欣 贾超 谭小尧[1] Han Xinsheng;Xue Boyuan;Zhang Xing'an(Department of Oral and Maxillofacial Surgery,the Second Clinical Medical College of North Sichuan Medical College,Nanchong,Sichuan 637000,China)

机构地区：[1]川北医学院第二临床医学院口腔颌面外科,四川南充637000

出　　处：《四川医学》2023年第12期1256-1261,共6页Sichuan Medical Journal

基　　金：南充市科技局市校合作项目基金(编号:20SXQT0096)。

摘　　要：目的比较可注射自体富血小板纤维蛋白血浆与透明质酸钠关节腔注射治疗颞下颌骨关节炎的临床疗效。方法回顾性分析2020年6月至2021年12月就诊我科的190例颞下颌关节骨关节炎患者,可注射自体富血小板纤维蛋白血浆注射治疗组(iPRF组)90例;透明质酸钠关节注射治疗组(HA组)100例。两组均每两周注射一次,注射3次为一疗程。于注射治疗开始前(T0)和治疗结束后3个月(T1)、6个月(T2)进行颞下颌关节紊乱病(TMD)的规范检查,记录结局指标最大开口度(MMO)、视觉模拟评分值(VAS)、颞下颌关节紊乱指数(CMI)。收集数据资料进行统计学分析,做出临床疗效的客观评价。结果术后3、6个月平均MMO值组间比较差异均无统计学意义(P>0.05),两组较治疗前比较张口度明显改善,差异均有统计学意义(P<0.05);术后6个月和3个月的MMO值组间比较,差异无统计学意义(P>0.05)。术后3、6个月VAS值和术前比较差异有统计学意义(P<0.05),组间比较差异有统计学意义(P<0.05);术后6个月和术后3个月的VAS值组间比较,差异有统计学意义(P<0.05)。术后3、6个月CMI值和术前比较差异有统计学意义(P<0.05),组间比较差异无统计学意义(P>0.05);术后6个月和3个月的CMI值组间比较,差异无统计学意义(P>0.05)。结论自体富血小板纤维蛋白关节腔注射对长时间减轻颞下颌骨关节炎患者疼痛症状更具优势,是一种新型的生物补充治疗,值得在临床推广应用。Objective To compare clinical efficacy of injectable autologous platelet rich fibrin and hyaluronic acid in the treatment of temporomandibular joint osteoarthritis with articular injection.Methods From June 2020 to December 2021,a retrospective analysis was performed on 190 patients with temporomandibular joint osteoarthritis who visited our department.Injectable autologous platelet rich fibrin plasma group(iPRF group,n=90)and hyaluronic acid injection treatment group(HA group,n=100)were set up.Injections were given every 2 weeks,3 injections as a course of treatment.Standard temporomandibular disorders(TMD)examination was performed before injection therapy(T0),at 3 months after treatment(T1)and 6 months after treatment(T2),and outcome indexes were recorded as maximum opening degree(MMO),visual analog scale(VAS)and craniomandibular index(CMI).Statistical analysis of receipt data was conducted to make objective evaluation of clinical efficacy.Results At T1 and T2,there was no significant difference of MMO(P>0.05).Degree of mouth opening changed more than T0 with statistically significant difference(P<0.05).MMO difference was not statistically significant between T2 and T1(P>0.05).For VAS,there were statistically significant difference among T0,T1 and T2(P<0.05),difference between T1 and T2 was also statistically significant(P<0.05).For CMI,differences were statistically significant among T0,T1 and T2(P<0.05),there was no significant difference between T1 and T2(P>0.05).Conclusion Injectable autologous Platelet-rich fibrin,a new biologic complementary therapy of temporomandibular joint osteoarthritis,could reduce pain symptoms,which is worthy of clinical application.

关 键 词：颞下颌关节骨关节炎 可注射自体富血小板纤维蛋白血浆 关节腔注射 

分 类 号：R782.6[医药卫生—口腔医学]