低强度Nd：YAG激光与传统药物治疗肌筋膜痛的疗效评价

doi:10.19439/j.sjos.2023.03.008

上海口腔医学 ›› 2023, Vol. 32 ›› Issue (3): 261-265.doi: 10.19439/j.sjos.2023.03.008

低强度Nd：YAG激光与传统药物治疗肌筋膜痛的疗效评价

李旭^1,3, 赵宁², 刘宗霖³, 张善勇⁴, 蔡圳³, 朱超³

1.锦州医科大学口腔医学院,辽宁锦州 121000;
2.潍坊医学院口腔医学院,山东潍坊 261000;
3.临沂市人民医院口腔科,山东临沂 276000;
4.上海交通大学医学院附属第九人民医院口腔外科,上海 200011

收稿日期:2022-11-29 修回日期:2023-02-20 出版日期:2023-06-25 发布日期:2023-06-28
通讯作者: 朱超,E-mail：zhuchao31400@163.com
作者简介:李旭（1986-）,男,本科,主治医师,E-mail： lixu1986106@163.com
基金资助:
山东省自然科学基金面上项目（ZR2021MH362）

Evaluation of low intensity Nd: YAG laser and traditional drugs in the treatment of myofascial pain

LI Xu^1,3, ZHAO Ning², LIU Zong-lin³, ZHANG Shan-yong⁴, CAI Zhen³, ZHU Chao³

1. Department of Stomatology,Jinzhou Medical University. Jinzhou 121000, Liaoning Province;
2. Department of Stomatology, Weifang Medical University. Weifang 261000, Shandong Province;
3. Department of Stomatology, Linyi People's Hospital. Linyi 276000, Shandong Province;
4. Department of Oral Surgery, Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China

Received:2022-11-29 Revised:2023-02-20 Online:2023-06-25 Published:2023-06-28

摘要/Abstract

摘要： 目的：评估低强度Nd：YAG激光与传统药物治疗肌筋膜痛(myofascial pain,MP)的效果。方法：将80例接受治疗的MP患者按照随机、双盲原则分为激光组（n=40）和传统药物组（n=40）。激光组采用低强度Nd ∶YAG激光（1 064 nm,8 J/cm²,250 mW）,2次治疗间隔48 h,整个疗程共10次。传统药物组采用赛来昔布胶囊,每次1粒（ 0.2 g）,每天2次,连续口服2周。肌筋膜痛患者每次接受治疗前后,测量开口度、前伸动度、患侧侧方动度和对侧侧方动度,并进行疼痛视觉模拟（VAS）评分,记录相应分值,采用SPSS 22.0 软件包对数据进行统计学分析。结果：激光组患者下颌功能运动状态（P<0.05）、疼痛症状（P<0.05）显著改善;传统药物组患者下颌功能运动状态（P<0.05）、疼痛症状（P<0.05）同样显著改善,两者总有效率无统计学差异（P>0.05）。激光组患者VAS评分低于传统药物组,但差异无统计学意义（P>0.05）。结论：低强度Nd：YAG激光与传统药物治疗均可有效缓解肌筋膜痛症状,改善其下颌功能运动状态。激光治疗具有疗程短、效率高、无痛苦和副作用少等优点,值得临床推广应用。

关键词: 低强度Nd：YAG激光, 赛来昔布胶囊, 肌筋膜痛, 颞下颌关节紊乱病

Abstract: PURPOSE: To evaluate the efficacy of low intensity Nd: YAG laser and traditional drugs in the treatment of myofascial pain (MP). METHODS: Eighty patients with MP were divided into laser group(n=40) and traditional medicine group(n=40) according to the principle of randomization and double-blindness. The patients in the laser group were treated with low intensity Nd :YAG laser(1 064 nm, 8 J/cm², 250 mW) , with an interval of 48 h between the two laser treatments. The whole course of treatment was 10 times. Patients in the traditional medicine group uesd celecoxib capsules, 1 capsulet each time(0.2 g), twice a day for 2 weeks. Before and after each treatment, mouth opening, protrusion excursion, lateral movement of the affected side and lateral movement of the contralateral side were measured, and pain visual analogue scores (VAS) were measured and recorded. The data were statistically analyzed with SPSS 22.0 software package. RESULTS: Patients in laser group had significantly improved mandibular function and movement status(P<0.05) and pain symptoms(P<0.05); patients in traditional medicine group had the same significant improvement on mandibular functional movement status(P<0.05) and pain symptoms (P<0.05). The total effective rate of the two groups had no significant difference(P>0.05). The VAS score of patients in laser group was lower than that of traditional medicine group, but the difference was not significant(P>0.05). CONCLUSIONS: Low intensity Nd: YAG laser and traditional medicine can effectively relieve the symptoms of myofascial pain and improve mandibular function and movement. Laser treatment has the advantages of short course of treatment, high efficiency, no pain and fewer side effects, which is worthy of clinical application.

Key words: Low intensity Nd: YAG laser, Celecoxib capsules, Myofascial pain, Temporomandibular joint disorder

中图分类号:

R782

李旭, 赵宁, 刘宗霖, 张善勇, 蔡圳, 朱超. 低强度Nd：YAG激光与传统药物治疗肌筋膜痛的疗效评价[J]. 上海口腔医学, 2023, 32(3): 261-265.

LI Xu, ZHAO Ning, LIU Zong-lin, ZHANG Shan-yong, CAI Zhen, ZHU Chao. Evaluation of low intensity Nd: YAG laser and traditional drugs in the treatment of myofascial pain[J]. Shanghai Journal of Stomatology, 2023, 32(3): 261-265.

参考文献

[1] Manfredini D, Guarda-Nardini L, Winocur E, et al.Research diagnostic criteria for temporomandibular disorders: a systematic review of axis Ⅰ epidemiologic findings[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2011, 112(4): 453-462.
[2] 陈静,朱敏. 稳定型咬合板联合关节灌洗术治疗颞下颌关节紊乱病的疗效评价[J]. 中国口腔颌面外科杂志, 2022, 20(6): 565-570.
[3] Desiderá AC, Nascimento GC, Gerlach RF, et al.Laser therapy reduces gelatinolytic activity in the rat trigeminal ganglion during temporomandibular joint inflammation[J]. Oral Dis, 2015, 21(5): 652-658.
[4] Xu GZ, Jia J, Jin L, et al.Low-level laser therapy for temporomandibular disorders: a systematic review with meta-analysis[J]. Pain Res Manag, 2018: 20184230583.
[5] Gil-Martínez A, Paris-Alemany A, López-de-Uralde-Villanueva I, et al. Management of pain in patients with temporomandibular disorder (TMD): challenges and solutions[J]. J Pain Res, 2018, 11: 571-587.
[6] Chisnoiu AM, Picos AM, Popa S, et al.Factors involved in the etiology of temporomandibular disorders-a literature review[J]. Clujul Med, 2015, 88(4): 473-478.
[7] López-Ramírez M, Vílchez-Pérez MA, Gargallo-Albiol J, et al.Efficacy of low-level laser therapy in the management of pain, facial swelling, and postoperative trismus after a lower third molar extraction. a preliminary study[J]. Lasers Med Sci, 2012, 27(3): 559-566.
[8] Tesch RS, Macedo LCDSP, Fernandes FS, et al.Effectiveness of dry needling on the local pressure pain threshold in patients with masticatory myofascial pain. Systematic review and preliminary clinical trial[J]. Cranio, 2021, 39(2): 171-179.
[9] Tunér J, Hosseinpour S, Fekrazad R.Photobiomodulation in temporomandibular disorders[J]. Photobiomodul Photomed Laser Surg, 2019, 37(12): 826-836.
[10] 王晓冬,杨征, 张伟华, 等. 低强度激光治疗颞下颌关节紊乱病的疗效评价[J]. 华西口腔医学杂志, 2011, 29(4): 393-395.
[11] 张宁,张敏,崔北芸,等. Nd:YAG激光和咀嚼肌神经封闭治疗颞下颌关节痛的临床观察[J]. 临床和实验医学杂志, 2018, 17(4): 431-433.
[12] Azizi A, Sahebjamee M, Lawaf S, et al.Effects of low-level laser in the treatment of myofascial pain dysfunction syndrome[J]. J Dent Res Dent Clin Dent Prospects, 2007, 1(2): 53-58.
[13] Hersh EV, Balasubramaniam R, Pinto A.Pharmacologic management of temporomandibular disorders[J]. Oral Maxillofac Surg Clin North Am, 2008, 20(2): 197-210.
[14] Melchior MO, Venezian GC, Machado BC, et al.Does low intensity laser therapy reduce pain and change orofacial myofunctional conditions?[J]. Cranio, 2013, 31(2): 133-139.
[15] Mazzetto MO, Hotta TH, Pizzo RC.Measurements of jaw movements and TMJ pain intensity in patients treated with GaAlAs laser[J]. Braz Dent J, 2010, 21(4): 356-360.
[16] 于林凤, 阿迪拉·艾赛提, 王琛, 等. 低能量镓铝砷半导体激光对颞下颌关节疼痛的疗效评价[J]. 口腔医学, 2020, 40(9): 800-803.
[17] Azangoo KH, Ebrahimi H, Najafi S, et al.Efficacy of low-level laser, hard occlusal appliance and conventional pharmacotherapy in the management of myofascial pain dysfunction syndrome:a preliminary study[J]. J Lasers Med Sci, 2020, 11(1): 37-44.
[18] Butts R, Dunning J, Pavkovich R, et al.Conservative management of temporomandibular dysfunction: a literature review with implications for clinical practice guidelines (narrative review part 2)[J]. J Bodyw Mov Ther, 2017, 21(3): 541-548.
[19] Magri LV, Bataglion C, Leite-Panissi CRA.Follow-up results of a randomized clinical trial for low-level laser therapy in painful TMD of muscular origins[J]. Cranio, 2021, 39(6): 502-509.
[20] Khalighi HR, Mortazavi H, Mojahedi SM, et al.Low level laser therapy versus pharmacotherapy in improving myofascial pain disorder syndrome[J]. J Lasers Med Sci, 2016, 7(1): 45-50.
[21] Basili M, Barlattani A Jr, Venditti A, et al.Low-level laser therapy in the treatment of muscle-skelet pain in patients affected by temporo-mandibular disorders[J]. Oral Implantol (Rome), 2017, 10(4): 406-411.
[22] Zhang C, Wu JY, Deng DL, et al.Efficacy of splint therapy for the management of temporomandibular disorders: a meta-analysis[J]. Oncotarget, 2016, 7(51): 84043-84053.
[23] Amin A, Roseline M, Lekha K.Comparative evaluation of clinical performance of different kind of occlusal splint in management of myofascial pain[J]. J Indian Prosthodont Soc, 2016, 16(2): 176-181.
[24] Joannis K, Ausfeld-Hafter B, Windecker-Gétaz I, et al.Laser acupuncture for myofascial pain of the masticatory muscles: a controlled pilot study[J]. Schweiz Monatsschr Zahnmed, 2010, 120(3): 213-225.
[25] Balik A, Peker K, Ozdemir-Karatas M.Comparisons of measures that evaluate oral and general health quality of life in patients with temporomandibular disorder and chronic pain[J]. Cranio, 2021, 39(4): 310-320.
[26] Mussttaf RA, Jenkins DFL, Jha AN.Assessing the impact of low level laser therapy (LLLT) on biological systems: a review[J]. Int J Radiat Biol, 2019, 95(2): 120-143.
[27] 刘璐, 任媛媛, 邓琪, 等. 半导体激光理疗对颞下颌关节疼痛治疗效果的影响因素[J]. 实用口腔医学杂志, 2015, 31(6): 852-854.
[28] 王慧丽, 李玲. 超激光在颞下颌关节紊乱病治疗中的疗效观察[J]. 中国医学创新, 2011, 8(21): 146-147.
[29] Madani A, Ahrari F, Fallahrastegar A, et al.A randomized clinical trial comparing the efficacy of low-level laser therapy (LLLT) and laser acupuncture therapy (LAT) in patients with temporomandibular disorders[J]. Lasers Med Sci, 2020, 35(1): 181-192.
[30] Demirkol N, Usumez A, Demirkol M, et al.Efficacy of low-level laser therapy in subjective tinnitus patients with temporomandibular disorders[J]. Photomed Laser Surg, 2017, 35(8): 427-431.
[31] Sunjay S.Design features and simple methods of incorporating nasal stents in presurgical nasoalveolar molding appliances[J]. J Craniofac Surg, 2009, 20(Suppl 2): 1889-1894.

低强度Nd：YAG激光与传统药物治疗肌筋膜痛的疗效评价

Evaluation of low intensity Nd: YAG laser and traditional drugs in the treatment of myofascial pain

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 11

编辑推荐

Metrics

本文评价

[1]	唐军, 郁春华, 程蕙娟, 钱海馨, 蔡翠萍, 聂溶冰. DC/TMD推荐心理量表在颞下颌关节紊乱病诊疗中的应用[J]. 上海口腔医学, 2023, 32(1): 109-112.
[2]	张春香, 王天齐, 刘冬巧, 段小妮, 智铖, 王静, 林晨. 伴颞下颌关节紊乱病安氏Ⅱ类1分类错患者咀嚼运动中髁突轨迹分析[J]. 上海口腔医学, 2022, 31(4): 429-434.
[3]	程洁, 张栋, 谢丽丽, 王璞, 李娟, 郝玮. 双颌前突患者正畸治疗后颞下颌关节紊乱病发生状况及危险因素分析[J]. 上海口腔医学, 2021, 30(4): 439-443.
[4]	姚远, 徐丽丽, 范帅. 颞下颌关节紊乱病患者与健康人头前伸姿势的对照分析[J]. 上海口腔医学, 2021, 30(2): 173-176.
[5]	贾梦莹, 胡露露, 许颖捷, 辜文妍, 曾雪敏, 宋志强, 龚忠诚. 新疆医科大学大学生颞下颌关节紊乱病相关因素分析[J]. 上海口腔医学, 2018, 27(5): 482-485.
[6]	方仲毅，范帅，蔡斌，徐丽丽，姜鑫，刘丽琨，贺英. 256例慢性颞下颌关节盘不可复性前移位综合物理治疗远期疗效评价[J]. 上海口腔医学, 2018, 27(3): 289-292.
[7]	胡欣欣, 朱耀旻, 何柳婷, 顾颖, 梁志刚, 郑苍尚. 109例颞下颌关节紊乱病相关因素分析[J]. 上海口腔医学, 2017, 26(2): 213-216.
[8]	江美媛, 游清玲. 半导体激光理疗联合A型肉毒毒素治疗颞下颌关节紊乱病的效果评价[J]. 上海口腔医学, 2016, 25(6): 758-761.
[9]	姜鑫, 范帅, 蔡斌, 方仲毅, 徐丽丽, 刘丽琨. 手法复位配合运动与垫治疗急性颞下颌关节盘不可复性前移位的近期疗效评价[J]. 上海口腔医学, 2016, 25(5): 570-573.
[10]	杨娴睿, 宋颖, 张希, 徐浩, 史宗道, 潘剑. 心理因素与颞下颌关节紊乱病症状表现的相关性研究[J]. 上海口腔医学, 2014, 23(4): 460-464.
[11]	陈婷, 廖天安, 詹若军, 吴丽娜. 2种咬合板治疗颞下颌关节紊乱病的临床疗效分析[J]. 上海口腔医学, 2013, 22(5): 547-550.