偏侧咀嚼去诱因治疗后的表面肌电图变化

Surface electromyography changes after removal of inducing factors of unilateral mastication

目的:针对诱发因素去除后的偏侧咀嚼患者进行咀嚼肌肌电活动的测定,从咀嚼肌功能恢复情况探讨常规去诱因治疗的有效性。方法:采用咀嚼肌表面肌电图检测技术分别测定偏侧咀嚼组(30例)和对照组(30例)在下颌姿势位、最大张闭口运动和随意咀嚼运动时的咬肌(MM)、二腹肌前腹(DA)的肌电情况,进行相关参数的统计学分析。偏侧咀嚼组已在试验前6个月进行了完善的去诱因治疗。结果:偏侧咀嚼组最大张闭口运动中右二腹肌前腹(RDA)、随意咀嚼运动中右咬肌(RMM)的平均肌电值均低于对照组(P<0.05)。偏侧咀嚼组最大张闭口运动中双侧DA、随意咀嚼运动中双侧MM的平均肌电峰值均低于对照组(P<0.05)。除DA在下颌姿势位,偏侧咀嚼组MM、DA活动不对称指数测定值均高于对照组(P<0.01)。结论:单纯去诱因治疗不能彻底解决偏侧咀嚼者咀嚼肌功能受损情况,提出了去诱因治疗后需要加以干预,以及为何要干预的理论基础。

Objective:To determine the electromyography(EMG)activity of masticatory muscles in patients with unilateral chewing after eliminating the inducing factors,and to discuss the effectiveness of this treatment from the recovery of masticatory muscles.Methods:The surface electromyography(s EMG)of masseter muscle(MM)and anterovent of digastric muscle(DA)was separately measured for unilateral mastication group(n=30)and control group(n=30)in the mandibular posture position,maximum opening and closing movement and random chewing.The parameters were analyzed statistically.The conventional inducing factors of unilateral chewing had been removed 6 months before the experiment.Results:The average EMG value of the right anteriovent of digastric muscle(RDA)in maximum opening and closing movement and the right masseter muscle(RMM)in the random chewing in unilateral mastication group were lower than those in control group(P<0.05).The average peak value of EMG of bilateral DA during maximum opening and closing movement and bilateral MM during random chewing in unilateral mastication group were lower than those in control group(P<0.05).Except for DA in mandibular posture,the measured values of asymmetry index of MM and DA activity in unilateral mastication group were higher than those in control group(P<0.01).Conclusions:The therapy by removal of inducing factors can not completely recover the impairment of masticatory muscle function in unilateral chewing.After removal of inducing factors,intervention should still be required.