弹性带(运动带)在颞下颌关节骨关节病患者综合治疗中的作用

E. Bulycheva, M. Postnikov, D. S. Bulycheva
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引用次数: 0

摘要

介绍。颞下颌关节(TMJ)关节病是一种慢性疾病,其特征是TMJ的营养不良和退行性改变伴无菌性炎症过程。有其他TMJ疾病史的患者患TMJ关节病的比例在32- 39%之间。TMJ关节病的复杂治疗包括药物治疗、物理治疗、TMJ运动治疗和咀嚼肌按摩、手工治疗、口腔修复等,但这些治疗方法并不总是能达到预期的效果。本研究的目的是改进传统的使用弹性带(kinesiotapes)治疗TMJ关节病的方法。材料和方法。68名患者在“银河”美容研究所诊所(圣彼得堡)和FSBEI HE SamSMU MOH俄罗斯(萨马拉)进行了检查。对照组患者给予药物治疗、颞下颌关节运动治疗和咀嚼肌按摩,而主组患者给予弹力带强化治疗。采用视觉模拟疼痛量表(VAS)、张口宽度和咀嚼肌肌电图对治疗效果进行评价。治疗第21天,主组疗效显著。此时患者疼痛强度由8.77±0.8降至5.19±0.5 (Z1-4=- 5.88;P1-4 =0,0015)点,以及开口宽度从21-23增加到33-35毫米。对照组患者的类似变化仅在治疗第5周开始时才出现(Z1-6=-5,58;p1-6 = 0, 0015)。开口宽度范围由21 ~ 23 mm增加到27 ~ 29 mm。主组患者最大间歇期咀嚼肌生物电位振幅在第四周初基本接近正常结果。在对照组患者中,即使在观察结束时(研究的第42天),咀嚼肌生物电位的振幅仍然降低。因此,将弹性带应用与传统的TMJ关节治疗方法相结合,大大提高了治疗的有效性,可以在相对较短的时间内缓解疼痛,使咀嚼肌的生物电活动正常化。由于弹性带的应用简单,因此可以教患者自行应用弹性带的技术,并建议使用弹性带来预防TMJ关节病的复发。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The role of elastic bands (kinesiotapes) in complex therapy of patients with temporomandibular joint osteoarthrosis
Introduction. Temporomandibular joint (TMJ) arthrosis is a chronic disease, characterized by dystrophic and degenerative changes in TMJ with aseptic inflammatory process. The prevelence of TMJ arthrosis in patients with a history of other TMJ disorders varies between 32-39 % of cases. Complex treatment of TMJ arthrosis includes pharmacotherapy, physiotherapy, exercise therapy for TMJ and massage of the masticatory muscles, manual therapy, prosthodontics, but these treatment methods are not always lead to a desired result.The aim of the study is to improve the traditional treament method of patients suffering from TMJ arthrosis by using elastic tapes (kinesiotapes).Materials and methods. 68 patients were examined at the «Galaxy» Beauty Institute Clinic (St. Petersburg) and FSBEI HE SamSMU MOH Russia (Samara). Comparison group of patients was prescribed pharmacotherapy, exercise therapy for TMJ and massage of masticatory muscles, while for the main group of patients the same therapy was enhanced by elastic bands. The effectiveness of therapy was evaluated using a visual-analog pain scale (VAS), mouth opening width and electromyography of the masticatory muscles.Results. Noticeable positive effect in the main group of patients was observed on the 21th day of treatment. By this time patients noticed significant decrease in pain intensity from 8,77±0,8 to 5,19±0,5 (Z1-4=-5,88; p1-4=0,0015) points as well as increase in mouth opening width from 21-23 to 33-35 mm. Similar changes in the comparison group of patients were achieved only by the beginning of fifth week of treatment (Z1-6=-5,58; p1-6=0,0015). The range of mouth opening width increased from 21-23 to 27-29 mm. Amplitude of masticatory muscles biopotentials in maximum intercuspation in patients of the main group almost approached to the normal results by the beginning of the fourth week. In patients of the comparison group the amplitude of masticatory muscles biopotentials remained reduced even by the end of observations (42 day of the study).Conclusion. Thus, the combination of elastic bands applications with conventional treatment methods of TMJ arthrosis greatly increases the effectiveness of therapy and allows to relief pain and normalize bioelectric activity of masticatory muscles in a relatively short time. Due to the simplicity of elastic bands application it is possible to teach patients the technique of self-applying bands and recommend to use them as a prevention of relapse of TMJ arthrosis.
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