正畸扩弓治疗中疼痛与昼夜节律相关性的研究

The study on the relationship between circadian rhythm and the pain of rapid palatal expansion therapy

目的:研究按照昼夜节律进行正畸加力控制,获得昼夜节律对正畸扩弓治疗中疼痛的影响和作用,为临床上更有效地进行正畸加力治疗后的疼痛控制。方法:34例连续正畸扩弓治疗病例,男18例,女16例,年龄10.8～12.8岁,腕骨片示均处于生长发育高峰期,采用相同固定快速扩弓装置,每日加力时间按照人体昼夜节律规律分为0点、3点、6点、9点、12点、15点、18点、21点8个时段组,每组加力方式相同,利用MPQ疼痛量表进行疼痛程度的观察,通过统计学软件进行余弦拟合及多样本t检验。结果:不同性别对于疼痛的耐受力有区别,女性对于正畸扩弓治疗疼痛的耐受力低于相同情况下男性。正畸加力后疼痛量化结果显示正畸加力后疼痛基本符合昼夜节律规律。峰值出现在0点,而谷值出现在12点的时间节点。结论:人体昼夜节律可以影响正畸扩弓治疗后的疼痛程度。按照昼夜节律进行正畸扩弓矫治可以获得更好的疼痛控制效果。提示正畸扩弓加力较合适在午间进行,这样有利于控制正畸患者的疼痛。

Objective：The aim of this study was to enrich the theory of circadian rhythm,and guide pain control of rapid palatal expansion therapy with circadian rhythm.Method：Thirty-four patients with growing spurt were randomly divided into 2 groups by gender.All patients are used the same RPE therapy.Each inspection was implemented every 3 hours,from 12：00 in the first morning to 12：00 in the next morning,totally 8 times during 24 hour.And the quantification of the pain were counted by the way of MPQ.Then all the values of each RPE patients were analyzed by Halberg methods for cosinor-rhythmometry and t test.Result：Based on the findings of this study,it was concluded that the pain of RPE therapy according to circadian rhythm,fitting to a cosine curve.The acrophase and bathyphase appear at 24：00 and 12：00 separately.Also in the same condition the sensitivity of pain about female are much sensitive than the male.Conclusion：This study demonstrated strong cohesive trends in the pain of the RPE therapy using with different time,and for controlling pain,the best time using RPE therapy was 12：00.