颞下颌关节弹响与咀嚼肌功能紊乱相关性研究

发布时间：2018-03-09 19:14

本文选题：颞下颌关节　切入点：弹响　出处：《青岛大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:肌功能锻炼是一种临床常用的治疗方式,但常见于躯干四肢的肌功能锻炼,然而咀嚼肌进行肌功能锻炼的疗效研究较少。超短波理疗是一种临床广泛应用的理疗方式,有一定的临床疗效。为了比较咀嚼肌功能锻炼和超短波理疗治疗颞下颌关节弹响的效果,指导临床颞下颌关节弹响治疗方式的选择设计了该实验,并且结合中医的经筋理论对颞下颌关节弹响发生的可能机制进一步探讨。方法:选择2012年6月至2014年6月因颞下颌关节弹响来我院就诊的128例患者,年龄在14~65岁之间,病史为3天~2年,同时患者牙列完整未见异常,无明显咬合干扰和错合畸形,曲面体层片或CT检查未发现髁突骨质破坏,且无颌面部创伤史,既往无精神、心理疾患史。将128例患者随机分为实验组和对照组,每组64例。实验组和对照组在治疗之前均进行详细的健康教育,以破除患者之前不良的生活或工作习惯。并且咀嚼肌功能锻炼要求患者具有较好的依从性,通过健康教育可以让患者对发病原因有一定的了解,积极主动地进行肌功能锻炼。实验组指导患者进行咀嚼肌功能锻炼,并仔细反复确认患者已正确掌握咀嚼肌功能锻炼的方式。对照组采用上海产50型五官超短波治疗机对患者进行超短波理疗。实验组和对照组疗程均为两周,3个月后进行随访。并详细记录2周后复诊和3个月后随访的结果,采集记录患者在一定时间内关节弹响出现的次数及时间,与初诊时记录数据比较,将弹响消失和弹响次数减少定义为治疗有效,将弹响次数无变化定义为治疗无效。采用SPSS17.0对两组数据进行卡方检验,比较两种方法的近远期治疗效果。结果:治疗2周后复诊,实验组的64例患者弹响全部消失,总有效率100%;对照组的64例患者33例弹响消失,20例弹响次数减少,11例弹响次数无改变,总有效率82.81%,两组结果有显著性差异(P0.05)。治疗3个月后回访,治疗组随访率95.31%,对照组随访率93.75%,治疗组总有效率100%,对照组总有效率66.67%,两组疗效差异明显(χ2=22.004,P0.05),3月后对照组治疗总有效率下降(χ2=4.306,P0.05)。经统计学分析比较,实验组的近远期疗效均优于对照组。结论:临床实验表明,咀嚼肌功能锻炼和超短波理疗治疗颞下颌关节弹响均有效,但咀嚼肌功能锻炼治疗颞下颌关节弹响的效果优于超短波理疗。且咀嚼肌功能锻炼让患者形成了良好的咀嚼肌运动习惯,以彻底破除不健康的运动方式造成的不良影响,所以咀嚼肌功能锻炼治疗颞下颌关节弹响较超短波理疗治疗颞下颌关节弹响的疗效更为显著,并且咀嚼肌功能锻炼治疗颞下颌关节弹响的远期效果也更加稳定。
[Abstract]:Objective: muscle function exercise is a commonly used clinical treatment method, but it is usually used in trunk and extremities, but the curative effect of masticatory muscle exercise is less. Ultrashort wave physiotherapy is a widely used physiotherapy method in clinic. In order to compare the effect of masticatory muscle exercise and ultrashort wave physiotherapy on temporomandibular joint bounce, the experiment was designed to guide the choice of clinical temporomandibular joint elastic response. The possible mechanism of temporomandibular joint (TMJ) bouncing was further explored with the meridian theory of traditional Chinese medicine. Methods: 128 patients with temporomandibular joint bounce from June 2012 to June 2014, aged between 14 and 65 years, were selected. The history ranged from 3 days to 2 years. At the same time, there was no abnormal dentition, no obvious occlusal interference and malocclusion, no condylar bone destruction, no maxillofacial trauma and no previous mental state. The history of psychological disorders. 128 patients were randomly divided into experimental group and control group, 64 cases in each group. The experimental group and control group were given detailed health education before treatment. In order to break the bad life or work habits of the patients before, and the masticatory muscle function exercise requires the patients to have good compliance, through health education, we can let the patients have a certain understanding of the causes of the disease. The patients in the experimental group were instructed to exercise the masticatory muscles. The patients in the control group were given ultrashort wave therapy with Shanghai 50 type ultrashort wave therapy machine. The course of treatment in both the experimental group and the control group was two weeks and three months. The results of follow-up after 2 weeks and 3 months were recorded in detail. The frequency and time of the joint bounce in a certain time were collected and recorded. Compared with the data recorded during the first visit, the reduction of the number of the bounce and the number of the bounce was defined as the effective treatment. SPSS17.0 was used to carry out chi-square test on the two groups of data to compare the short-term and long-term therapeutic effects of the two methods. Results: after 2 weeks of treatment, 64 patients in the experimental group all disappeared. The total effective rate was 100%, in the control group, 33 cases (33 cases) with missing bounce sound and 20 cases (20 cases) with the reduction of the number of bounce sounds were not changed, and the total effective rate was 82.81%. There was a significant difference between the two groups (P 0.05). After 3 months of treatment, the results of the two groups were returned. The follow-up rate of the treatment group was 95.31, the follow-up rate of the control group was 93.755.The total effective rate of the treatment group was 100, and the total effective rate of the control group was 66.67. The difference between the two groups was significant (蠂 ~ 2, 22.004, P 0.05, 蠂 ~ (2)), and the total effective rate of the control group was decreased after March (蠂 ~ 2, P = 4.306, P 0.05). Conclusion: the clinical experiment shows that the masticatory muscle function exercise and ultrashort wave physiotherapy are effective in the treatment of temporomandibular joint elastic response. But the effect of masticatory muscle exercise on temporomandibular joint bounce was better than that of ultrashort wave physiotherapy. Therefore, masticatory muscle function exercise in the treatment of temporomandibular joint bounce is more effective than ultrashort wave physiotherapy in the treatment of temporomandibular joint bounce, and the long-term effect of masticatory muscle exercise in the treatment of temporomandibular joint bounce is more stable.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R782.6

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