电针联合稳定型咬合板对咀嚼肌功能紊乱患者疼痛及咀嚼肌肌电的影响OA
The Effect of Electroacupuncture combined with Stable Occlusal Splint on Pain and Electromyography of the Masticatory Muscles in Patients with Masticatory Muscle Dysfunction
目的:观察电针联合稳定型咬合板对咀嚼肌功能紊乱(masticatory muscle disorders,MMD)患者疼痛及咀嚼肌肌电的影响.方法:选取2021年9月至2022年11月期间在广州市番禺区第二人民医院口腔科就诊治疗62例MMD患者,按照随机数字表法分为对照组和观察组各31例.两组患者均给予健康教育,对照组辅以稳定型咬合板治疗,观察组则辅以稳定型咬合板联合合电针治疗.于治疗前、治疗结束后,检测患者疼痛(VAS评分)、最大张口度、咬肌和颞肌表面肌电均方根(RMS)值、Fricton指数、关节液内TNF-α、IL-1含量等改变情况及临床疗效.结果:治疗后,两组患者的VAS评分、最大张口度均较治疗前改善(P<0.05),且观察组组治疗后的VAS评分显著低于对照组(P<0.05),最大张口度显著大于对照组(P<0.05).治疗后,两组患者的颞肌RMS、咬肌RMS均较治疗前增高(P<0.05),且观察组组治疗后的颞肌RMS、咬肌RMS显著高于对照组(P<0.05).治疗后,两组患者的CMI、PI、DI等评分均较治疗前降低(P<0.05),且观察组组治疗后的CMI、PI、DI等评分显著低于对照组(P<0.05).治疗后,两组患者的关节液内TNF-α、IL-1含量均较治疗前降低(P<0.05),且观察组组治疗后的关节液内TNF-α、IL-1含量显著低于对照组(P<0.05).观察组总有效率为94.5%明显高于对照组的81.1%(P<0.05).结论:电针联合稳定型咬合板治疗MMD患者疗效确切,可有效抑制炎性反应缓解疼痛,增强咬肌、颞肌的咬合力,改善颞颌关节功能.
Objective:To observe the effect of electroacupuncture combined with stable occlusal splint on pain and electromyography of masticatory muscles in patients with masticatory muscle dysfunction(MMD).Methods:The 62 patients with MMD were divided into the observation group and the control group with 31 patients in each group by using the random number table method.Both groups of patients were given health education,while the control group was treated with stable occlusal splint,while the observation group was treated with stable occlusal splint combined with elec-troacupuncture.Before and after treatment,measure the changes in root mean square(RMS)values of the surface electromyography of the patient's masseter and temporal muscles;Simultaneously compare pain(VAS score),maximum mouth opening,Fricton index,TNF-α and IL-1 contents in two groups.Results:After treatment,the VAS score and maximum mouth opening degree of patients in both groups improved compared with that before treatment(P<0.05),and the VAS score of the observation group group was significantly lower than that of the control group after treatment(P<0.05),and the maximum mouth opening degree was significantly greater than that of the control group(P<0.05).After treatment,the temporal muscle RMS and biting muscle RMS of patients in both groups were higher than before treatment(P<0.05),and the temporal muscle RMS and biting muscle RMS of the observation group group were significantly higher than those of the control group after treatment(P<0.05).After treatment,the CMI,PI and DI scores of patients in both groups were lower than before treatment(P<0.05),and the CMI,PI and DI scores of the observation group were signifi-cantly lower than those of the control group after treatment(P<0.05).After treatment,the levels of TNF-α and IL-1 in the joint fluid of both groups were lower than before treatment(P<0.05),and the levels of TNF-α and IL-1 in the joint fluid of the observation group were significantly lower than those of the control group after treatment(P<0.05).The total effective rate of 94.5%in the observation group was significantly higher than that of 81.1%in the control group(P<0.05).Conclusion:The combination of electroacupuncture and stable occlusal splint has a definite therapeutic effect on MMD patients,which can effectively inhibit inflammatory reactions,alleviate pain,enhance the bite force of the masseter and temporal muscles,and improve temporomandibular joint function.
韩佩洁;郭凯锋;谢景夏;卢钜勇
广州市番禺区第二人民医院,广东广州 511430广州市番禺区中心医院,广东广州 511400
中医学
电针稳定型咬合板颞下颌关节紊乱咀嚼肌功能紊乱
ElectroacupunctureStable bite plateTemporomandibular joint disorderMasticatory muscle dysfunction
《中医康复》 2024 (004)
30-34 / 5
广州市中医药和中西医结合科技项目(20232A011027);广东省中医药管理局项目(20221299);番禺区科技计划一般医疗卫生项目(2022-Z04-060)
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