关节松动术配合理疗治疗颞下颌关节紊乱综合征的疗效评估

关键词：颞下颌关节紊乱  关节松动术  理疗

Keywords:temporomandibular disorder  joint mobilization  physiotherapy

摘要：

      摘要 目的:观察关节松动术手法配合理疗治疗颞下颌关节紊乱综合征（TMD）的疗效。 方法:筛选TMDⅡb类患者40例，随机分为关节松动术配合理疗组（A组，n=20）、针灸配合理疗组（B组，n=20）。治疗前及治疗4周后采用疼痛视觉模拟评分(Visual Analogue Scale，VAS)、最大张口度、下颌功能障碍问卷（Mandibular Function Impairment Questionnaire，MFIQ）、MRI评定患者的疼痛程度、最大张口度、下颌功能及盘髁活动度。 结果:治疗后，两组疼痛（A组1.10±1.59，B组1.25±1.37）较治疗前差异均具有显著性意义（P<0.001），两组组间比较差异无显著性意义（P>0.05）；A、B组最大张口度（A组36.50±4.68mm，B组26.15±4.49mm）、下颌功能障碍（A组0.50±0.76，B组0.75±0.55）、盘髁活动度（A组6.54±1.22mm，B组4.43±1.36mm）较治疗前差异均具有显著性意义（P<0.001），两组组间比较差异有显著性意义（P<0.05）。 结论:关节松动术配合理疗的治疗方法可有效改善TMDⅡb类患者的关节疼痛。与针灸配合理疗治疗相比较，关节松动术配合理疗对张口受限、下颌功能障碍、盘髁活动度等症状的改善更加明显。

Abstract:

      Abstract Objective: To observe effects of joint mobilization combined with physiotherapy on temporomandibular disorders(TMD). Method: Forty subjects with Ⅱb classes TMD were randomly divided into the joint mobilization combined with physiotherapy group (group A, n=20) and the acupuncture combined with physiotherapy group (group B, n=20). The pain, maximum active mouth opening, mandibular function and degree of joint activities were assessed using Visual Analogue Scale(VAS)of pain, maximum active mouth opening and Mandibular Function Impairment Questionnaire (MFIQ) and MRI before and 4 weeks after treatment. Result: All the patients got significant improvement in the pain (group A 1.10±1.59,group B 1.25±1.37)after treatment（P<0.001）, while no significant difference between two groups（P>0.05）. Group A and group B both got obviously improved maximum active mouth opening(group A 36.50±4.68mm,group B26.15±4.49mm), Mandibular Function Impairment Questionnaire(MFIQ)（group A 0.50±0.76,group B 0.75±0.55）and degree of joint activities（group A 6.54±1.22mm, group B 4.43±1.36mm）(P<0.001), and at the same time group A had more significant improvement than group B (P<0.05). Conclusion: The joint mobilization combined with physiotherapy can improve the pain of Ⅱb TMD, and improve limited mouth opening, mandibular function impairment more obviously than the acupuncture combined with physiotherapy.