关节腔臭氧浴联合物理疗法治疗颞下颌关节不可复性盘前移位的效果评价

Clinical efficacy of intra-articular ozone gas bath therapy combined with physiotherapy on temporomandibular anterior disc displacement without reduction

目的:探讨关节腔内臭氧浴联合物理疗法治疗颞下颌关节不可复性盘前移位(anterior disc displacement without reduction,ADDwoR)的临床疗效。方法:将54例ADDwoR患者随机分为实验组(27例)和对照组(27例),分别行关节腔臭氧浴和透明质酸钠(sodium hyaluronate, SH)注射,每周1次,连续注射3次,同时联合包括健康教育、手法复位、被动开口训练的物理疗法。对2组治疗后1、3个月后的疼痛视觉模拟评分、下颌功能运动和有效率进行临床评价。采用SPSS 21.0软件包对数据进行统计学分析。结果:2组患者疼痛度和下颌功能运动均较治疗前显著改善(P<0.05),但组间比较无显著差异(P>0.05);2组患者治疗总有效率差异无统计学意义(P>0.05)。结论 :关节腔内臭氧浴联合物理疗法能有效改善ADDwoR症状,与SH联合疗法效果相似,价格低廉,有望成为新的临床治疗选择。

PURPOSE: To explore the clinical efficacy of intra-articular ozone gas bath therapy combined with physiotherapy on temporomandibular anterior disc displacement without reduction(ADDwoR). METHODS: Fifty-four patients diagnosed with ADDwoR were randomized into the experimental group(27 cases) and control group(27 cases). Patients in the two groups respectively underwent intra-articular ozone gas bath and sodium hyaluronate(SH) injection, once a week for 3 weeks, simultaneously combined with physical therapy modalities which included patients education, mandibular ma-nipulation technique, passive training with open mouth. The visual analogue scale(VAS) of pain, mandibular movements,and efficiency of the two groups were assessed after 1, 3 months of follow-up. SPSS 21.0 software package was used for data analysis. RESULTS: The pain intensity and mandibular movements improved significantly compared to these of pretreatment in both groups(P<0.05), with no significant intra-group difference(P>0.05). There was no significant difference in the total effective rate between the two groups(P>0.05). CONCLUSIONS: Intra-articular ozone gas bath therapy combined with physiotherapy can provide symptomatic relief on ADDwoR, similar to the efficacy of SH combination;however,it could be a cheaper clinical alternative.