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

doi:10.19439/j.sjos.2018.03.015

上海口腔医学 ›› 2018, Vol. 27 ›› Issue (3): 289-292.doi: 10.19439/j.sjos.2018.03.015

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

方仲毅¹，²，范帅¹，²，蔡斌¹，²，徐丽丽¹，姜鑫¹，²，刘丽琨¹，贺英²

1.上海交通大学医学院附属第九人民医院康复医学科，上海 200011；
2.上海第九人民医院集团奉城医院康复科，上海 201411

收稿日期:2018-01-12 修回日期:2018-03-27 出版日期:2018-07-20 发布日期:2018-07-20
通讯作者: 范帅， E-mail: shuaifantasy@163.com
作者简介:方仲毅(1983-)，男，学士，E-mail: tony33tony@163.com
基金资助:
上海市卫生计生系统重要薄弱学科建设计划（2015ZB0404）；上海交通大学医学院附属第九人民医院院级课题（2013B10）；奉贤区临床诊疗中心建设计划（fclczlzx-a-201706）

A long-term clinical evaluation of comprehensive physiotherapy for patients with chronic anterior disc displacement of the temporomandibular joint without reduction

FANG Zhong-yi¹,², FAN Shuai¹,², CAI Bin¹,², XU Li-li¹, JIANG Xin¹,², LIU Li-kun¹, HE Ying².

1.Department of Rehabilitation Medicine，Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011；
2.Department of Rehabilitation, Group of Shanghai Ninth People's Hospital. Shanghai 201411, China

Received:2018-01-12 Revised:2018-03-27 Online:2018-07-20 Published:2018-07-20

摘要/Abstract

摘要： 目的： 观察综合物理治疗改善慢性颞下颌关节盘不可复性前移位（ADDwoR）患者症状及功能的远期临床疗效。方法： 随访2014年1月—2015年12月在我院康复科完成治疗的慢性ADDwoR患者256例（病程为8.4±9.6个月），比较治疗前、治疗后、随访时的症状和功能，包括最大主动开口度、视觉模拟评分法（VAS）疼痛评分、下颌功能损害问卷（MFIQ）分值。随访复发频率及复发时的症状。采用SPSS17.0软件包对数据进行重复测量方差分析。结果： 平均随访时间为30.5±4.6个月，患者最大主动开口度随访时>治疗后>治疗前（P<0.05）；VAS疼痛评分随访时<治疗后<治疗前（P<0.05）；MFIQ分值随访时<治疗后<治疗前（P<0.05）。治疗后直到随访时，82.8%的患者未出现症状复发，14.5%复发，2.7%症状未见好转。37例有症状的复发患者中，70.3%为疼痛，13.5%为开口受限，13.6%为疼痛伴开口受限。结论： 综合物理治疗可显著改善ADDWoR患者的疼痛和开口受限症状，改善下颌功能，远期疗效良好。

关键词: 颞下颌关节紊乱病, 物理因子治疗, 手法治疗, 运动疗法

Abstract: PURPOSE: To observe the long-term clinical efficacy of comprehensive physiotherapy for patients with chronic anterior disc displacement of the temporomandibular joint (TMJ) without reduction (ADDWoR). METHODS: A total of 256 patients with chronic ADDwoR (the course of disease was 8.4±9.6 months) who completed the treatment in our hospital from January 2014 to December 2015 were followed up. Symptoms and function pre-treatment, post-treatment and during follow-up including the maximum active mouth opening (mm), visual analog scale(VAS), mandibular function impairment questionnaire (MFIQ) score were recorded and compared; recurrent frequency and symptoms were recorded and compared, too. SPSS 17.0 software package was used for analysis of variance of repeated measurement. RESULTS: The follow-up period was 30.5±4.6 months, the patients' maximum mouth opening: pre-treatment post-treatment> follow-up (P<0.05); the patients' MFIQ: pre-treatment>post-treatment> follow-up (P<0.05). 82.8% patients didn't have recurrent symptoms, 14.5% had recurrence and the symptoms were not improved in 2.7% of patients. Among 37 patients with symptomatic recurrent disease, 70.3% had pain, 13.5% had mouth opening limitation, and 13.6% had pain with mouth opening limitation. CONCLUSIONS: Comprehensive physical therapy can significantly relieve pain and improve mouth limitation in patients with chronic ADDwoR of TMJ, and long-term efficacy was good. The causes of recurrence in some patients need further study.

Key words: Temporomandibular joint disorders, Modality therapy, Manual therapy, Movement therapy

中图分类号:

R782.6

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.

FANG Zhong-yi, FAN Shuai, CAI Bin, XU Li-li, JIANG Xin, LIU Li-kun, HE Ying.. A long-term clinical evaluation of comprehensive physiotherapy for patients with chronic anterior disc displacement of the temporomandibular joint without reduction[J]. Shanghai Journal of Stomatology, 2018, 27(3): 289-292.

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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

A long-term clinical evaluation of comprehensive physiotherapy for patients with chronic anterior disc displacement of the temporomandibular joint without reduction

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