上海口腔医学

上海口腔医学 ›› 2016, Vol. 25 ›› Issue (6): 758-761.

• 临床总结 • 上一篇    下一篇

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

江美媛1, 游清玲2   

  1. 1.江西省抚州市第一人民医院 口腔科,江西 抚州 344000;
    2.上海交通大学医学院附属第九人民医院·口腔医学院 口腔正畸科,上海 200011;
  • 收稿日期:2016-07-19 出版日期:2016-12-25 发布日期:2016-12-29
  • 通讯作者: 游清玲,E-mail:youql@126.com
  • 作者简介:江美媛（1975-）,女,硕士,主治医师,E-mail:2544782603@qq.com

Efficacy of semiconductor laser therapy combined with botulinum toxin A type injection in treatment of temporomandibular disorders

JIANG Mei-yuan, YOU Qing-ling   

  1. 1. Department of Stomatology, The First People's Hospital of Fuzhou City. Fuzhou 344000, Jiangxi Province;
    2.Department of Orthodontic, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China
  • Received:2016-07-19 Online:2016-12-25 Published:2016-12-29

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摘要： 目的研究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疗效及对血清白细胞介素1（IL-1）和肿瘤坏死因子α（TNF-α）水平的影响。方法选择颞下颌关节紊乱病患者90例,随机分为对照组和治疗组（各45例）。对照组采取半导体激光理疗法,1次/d,1周为1个疗程。治疗组在对照组基础上采取A型肉毒毒素治疗,每侧嚼肌和颞肌分别按5个注射点肌注A 型肉毒毒素50 U。2组均连续治疗2周。比较2组Fricton 量表指数、疼痛指数和临床疗效。检测2组IL-1和TNF-α水平。采用SPSS 19.0软件包对数据进行统计学分析。结果治疗后,治疗组患者的肌肉压痛指数（PI）、功能障碍指数（DI）和颞下颌关节紊乱指数（CMI）显著低于对照组（P<0.01）。治疗后1周和2周,治疗组患者的VAS评分显著低于对照组（P<0.01）。治疗组患者的总有效率为93.33%,显著高于对照组（66.67%,P<0.05）。治疗后,治疗组患者血清中IL-1和TNF-α水平显著低于对照组（P<0.01）。结论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疗效显著,患者血清IL-1和TNF-α水平降低可能与疗效有关。

关键词: 半导体激光理疗, A型肉毒毒素, 颞下颌关节紊乱病, 白细胞介素1, 肿瘤坏死因子α

Abstract: PURPOSE: To observe the efficacy of semiconductor laser therapy in combination with botulinum toxin A type injection in treating temporomandibular disorders and the influence on serum levels of interleukin(IL)-1 and tumor necrosis factor(TNF)-α. METHODS: Ninety patients with temporomandibular disorders were selected and randomly divided into control group and treatment group with 45 cases in each group. Patients in the control group received semiconductor laser therapy,once per day and 1 course for 1 week. Patients in the treatment group was given semiconductor laser therapy in combination with botulinum toxin A type. 50 U botulinum toxin A type were injected into the masseteric and temporal muscles with 5 injections at different sites in each side. The treatment course of patients was 2 weeks. Fricton scale indexes, pain index, and efficacy were compared between the two groups. Serum levels of IL-1 and TNF-α were detected in both groups. SPSS19.0 software package was used for data analysis. RESULTS: After treatment, PI, DI and CMI in the treatment group were significantly lower than the control group (P<0.01). After 1 and 2 weeks of treatment, VAS score of the treatment group was significantly lower than the control group (P<0.01). The total efficacy rate of the treatment group was 93.33%,which was significantly higher than control group (66.67%, P<0.05). Serum levels of IL-1 and TNF-α of the treatment group were significantly lower than the control group (P<0.01). CONCLUSIONS: The efficacy of semiconductor laser therapy in combination with botulinum toxin A type injection in treating temporomandibular disorders is significant,and may be related to decreased serum levels of IL-1 and TNF-α.

Key words: Semiconductor laser therapy, Botulinum toxin A type, Temporomandibular disorders, Interleukin-1, Tumor

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