低能量钕激光治疗飞行员咀嚼肌功能紊乱临床研究

Clinical study on the treatment of pilots with masticatory muscle dysfunction by low energy Nd∶YAG laser

目的:探讨Nd∶YAG激光低能量疗法(LLLT)治疗飞行员咀嚼肌功能紊乱的临床疗效。方法:将84例研究对象分为3组(n=28),应用Nd∶YAG激光频率分别为5、10和20 Hz治疗咀嚼肌群,每周3次,连续2周。采用TMJ紊乱指数(CMI)和表面肌电图(sEMG)比较激光干预前、后咀嚼肌功能紊乱改善变化。结果:5、10、20 Hz组Nd∶YAG激光总有效率分别为67.86%、89.29%和75%,10和20 Hz组较5 Hz组有效率显著提高(P<0.01和P<0.05),治疗后20 Hz组颞下颌关节功能障碍指数(DI)评分降低(P<0.05),10 Hz组DI、肌肉压痛指数(PI)和CMI总分均明显下降(P<0.01)。下颌姿势位(MPP)时,10 Hz组右侧颞肌前束(RTA)和左侧咬肌(LMM)平均肌电幅值均减少明显(P<0.01),左侧颞肌前束(LTA)和右侧咬肌(RMM)亦减少(P<0.05);RTA、LTA和RMM的变化值10 Hz组均大于20 Hz组(P<0.05和P<0.01);牙尖交错位(ICP)时,10 Hz组RTA、LTA和RMM均明显增加(P<0.01),LDA亦增加(P<0.05),20 Hz组RTA和RMM增加(P<0.05),LTA、RMM和LDA的变化值10 Hz组均大于20 Hz组(P<0.01和P<0.05)。结论:频率为10 Hz的Nd∶YAG激光LLLT治疗飞行员咀嚼肌功能紊乱疗效显著。

Objective:To investigate the clinical efficacy of Nd∶YAG laser low energy therapy(LLLT)for pilots with masticatory muscle dysfunction.Methods:84 patients were divided into 3 groups(n=28)and treated by Nd∶YAG laser LLLT with the frequence of 5,10 and 20 Hz respectively,3 times a week for 2 weeks.TMJ disorder index(DI)and surface electromyography(sEMG)were used to compare the changes of masticatory muscle dysfunction before and after laser intervention.Results:The total effective rates of Nd∶YAG laser in 5,10 and 20 Hz groups were 67.86%,89.29%and 75%respectively(5 Hz vs 10 Hz,P<0.01;5 Hz vs 20 Hz,P<0.05).After treatment DI score of 20 Hz group was decreased(P<0.05),the total scores of DI,palpation index(PI)and craniomandibular index(CMI)in 10 Hz group were significantly decreased(P<0.01).At mandibular postural position(MPP),the mean EMG amplitude of right anterior temporal muscle(RTA)and left masseter muscle(LMM)in 10 Hz group were significantly reduced(P<0.01),and the left anterior temporal muscle(LTA)and right masseter muscle(RMM)were also reduced(P<0.05);RTA,LTA and RMM in 10 Hz group changed more than in 20 Hz group(P<0.05 and P<0.01).At intercuspal position(ICP),RTA,LTA,RMM and LDA were increased after treatment(P<0.01 and P<0.05),RTA and RMM in 20 Hz group increased(P<0.05);LTA,RMM and LDA changed more in 10 Hz group than in 20 Hz group(P<0.01 and P<0.05).Conclusion:Nd∶YAG laser LLLT with the frenquence of 10 Hz is effective in the treatment of masticatory muscle dysfunction in pilots.