体外冲击波治疗颞下颌关节紊乱病的疗效观察

Extracorporeal shock wave therapy for temporomandibular disorders

关键词:  颞下颌关节紊乱病  冲击波  Fricton指数  最大开口度  疼痛

Key words:  temporomandibular disorders  extracorporeal shock wave therapy  Fricton index  maximum opening degree  pain

摘要:

目的　观察体外冲击波治疗颞下颌关节紊乱病(TMD)的临床效果。方法　选取首发TMD患者80例，随机分为两组。冲击波组40例，采用体外冲击波治疗，1次/周，共2周；联合治疗组40例，采用超短波结合超声波治疗，6次/周，共2周。采用Fricton指数法、视觉疼痛模拟评分法（VAS）、最大开口度对患者的疗效进行评估。结果　治疗后两组治疗有效率：冲击波组97.5%，联合治疗组80.0%；VAS评分：冲击波组（0.56±0.37)，联合治疗组(1.32±0.54）；最大开口度冲击波组（3.44±1.08）mm，联合治疗组(2.92±0.83）mm；颞下颌关节紊乱指数(CMI)：冲击波组（0.24±0.06），联合治疗组（0.11±0.03），上述指标组内、组间比较差异有显著性意义（P<0.05），其中治疗有效率、VAS、最大开口度两组组间比较差异具有极显著性意义（P<0.01）。结论　在缓解TMD的疼痛、肌肉压痛指数、最大开口度效果方面，体外冲击波、超短波结合超声波均有疗效，但体外冲击波效果更好，值得在临床上推广。

Abstract:

Objective To analyze the clinical effects of extracorporeal shock wave therapy (ESWT) on temporomandibular joint disorders (TMD). Methods Eighty patients with first-diagnosed TMD were randomly divided into 2 groups. Forty patients were in the shock wave group and were treated with ESWT for 2 weeks, once a week. Forty patients were in the combined treatment group and were treated with both ulthrashort wave and ultrasound therapy for 2 weeks, 6 times a week. The therapeutic efficacy was evaluated by Fricton index, VAS and maximum opening degree. Results The therapeutic efficiencies were 97.5% in the shock wave group and 80.0% in the combined treatment group with Fricton indexes 0.24±0.06 in the shock wave group and 0.11±0.03 in the combined treatment group, VAS 0.56±0.37 in the shock wave group and 1.32±0.54 in the combined treatment group, and maximum opening degree (3.44±1.08)mm in the shock wave group and (2.92±0.83)mm in the combined treatment group. The above factors showed significant difference between the groups (P<0.05). Among them, the therapeutic efficiency, VAS and maximum opening degree had the most significant difference (P<0.01). Conclusion ESWT is more effective than ultrashort wave combined with ultrasound, in alleviating the pain, muscle tenderness index and maximum opening degree of temporomandibular joint disorders, and therefore is worth promoting in the clinic.