稳定型咬合板联合关节灌洗术治疗颞下颌关节紊乱病的疗效评价

Clinical efficacy of stable occlusal plate combined with joint lavage in the treatment of temporomandibular joint disorders

目的:评价稳定型咬合板联合关节灌洗术治疗颞下颌关节紊乱病的临床效果。方法:选取2020年1月—2021年1月在台州市第一人民医院因颞下颌关节紊乱病就诊的患者104例,随机分为对照组和试验组(每组各52例),对照组给予单纯关节灌洗术,试验组配戴稳定型咬合板联合关节灌洗术,均治疗6个月。比较2组患者最大开口度、疼痛、颞下颌关节紊乱指数、生活质量量表(SF-36)和心理健康评分及关节液内肿瘤坏死因子α(TNF-α)、基质金属蛋白酶2(MMP-2)水平。采用SPSS 19.0软件包对数据进行统计学分析。结果:治疗后,2组最大开口度、SF-36评分升高;疼痛、颞下颌关节紊乱指数、心理健康评分降低。试验组最大开口度、SF-36评分显著高于对照组(P<0.01);疼痛、颞下颌关节紊乱指数、心理健康评分显著低于对照组(P<0.01)。治疗后,2组关节液内TNF-α、MMP-2水平显著降低,且试验组显著低于对照组(P<0.01)。试验组治疗总有效率为96.15%,显著高于对照组的82.69%(P<0.01)。结论:稳定型咬合板联合关节灌洗术可有效提升疗颞下颌关节紊乱病临床疗效,抑制炎性反应,有效缓解颌面部疼痛,改善生活质量及心理状况。

PURPOSE:To analyze the clinical effect of stable occlusal plate combined with joint lavage in the treatment of temporomandibular joint disorder(TMD).METHODS:A total of 104 patients with TMD in Taizhou First People’s Hospital from January 2020 to January 2021 were selected and randomly divided into the control group and the experimental group,with 52 cases in each group.The control group was given gangliolar lavage,while the experimental group wore sta-ble occlusal plate combined with gangliolar lavage,both treated for 6 months.Clinical efficacy was analyzed by comparing the maximum mouth opening,pain,craniomandibular index(CMI),SF-36 and mental health score,tumor necrosis factor(TNF-α)and matrix metallo proteinase 2(MMP-2)levels in 2 groups of patients.SPSS 19.0 software package was used for data analysis.RESULTS:After treatment,the maximum mouth opening and SF-36 score increased,and the scores of pain,CMI,mental health decreased in the two groups.The maximum mouth opening,TOI index and SF-36 score of the experimental group were significantly higher than those of the control group(P<0.01).The scores of pain,CMI,mental health in the experimental were significantly lower than those of the control group(P<0.01).After treatment,the levels of TNF-αand MMP-2 in the joint fluid of the two groups were significantly decreased,and the experimental group was significantly lower than the control group(P<0.01).The total effective rate of the experimental group(96.15%)was significantly higher than that of the control group(82.69%,P<0.01).CONCLUSIONS:Stable occlusal plate combined with ganglionic lavage can effectively improve the clinical efficacy of TMD,inhibit inflammatory response,effectively relieve maxillofacial pain,improve the quality of life and psychological clearance.