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(ADDwo R)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ADDwo R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ADDWo R患者的疼痛和开口受限症状,改善下颌功能,远期疗效良好。
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（ADDWo R）.METHODS：A total of 256 patients with chronic ADDwo R（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-treatmentpost-treatment followup（P〈0.05）;the patients＇ VAS：pre-treatmentpost-treatment follow-up（P〈0.05）;the patients＇ MFIQ：pre-treatmentpost-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 ADDwo R of TMJ,and long-term efficacy was good.The causes of recurrence in some patients need further study.
作者
方仲毅
范帅
蔡斌
徐丽丽
姜鑫
刘丽琨
贺英
FANG Zhong-yi;FAN Shuai;CAI Bin;XU Li-li;JIANG Xin;LIU Li-kun;HE Ying(Department of Rehabilitation Medicine ,Shanghai Ninth People＇s Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011;Department of Rehabilitation, Group of Shanghai Ninth People ＇s Hospital. Shanghai 201411, China)
出处
《上海口腔医学》
CAS
CSCD
北大核心
2018年第3期289-292,共4页
Shanghai Journal of Stomatology
基金
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)
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
Temporomandibular joint disorders
Modality therapy
Manual therapy
Movement therapy
