针刺肌筋膜触发点联合综合康复治疗肌源性颞下颌关节紊乱病临床研究

Clinical Study on Acupuncture at Myofascial Trigger Points Combined with Compre⁃ hensive Rehabilitation for Myogenous Temporomandibular Disorders

摘要:

目的：观察针刺肌筋膜触发点联合综合康复治疗肌源性颞下颌关节紊乱病（TMD） 的临床效果。方法：选取2022年6月—2024年6月郑州大学第一附属医院康复医学科收治的肌源性TMD患者60例，采用随机数字表法分为观察组和对照组各30例。治疗过程中，观察组脱落1例，对照组脱落2例。对照组给予综合康复治疗，观察组在对照组基础上给予针刺肌筋膜触发点治疗。2组均连续治疗2周。比较2组疼痛视觉模拟评分法评分（VAS）、最大张口度（MMO）、颞下颌关节功能障碍指数（DI）、肌肉触压痛指数（PI） 以及颞下颌关节紊乱指数（CMI）。结果：治疗后，2组VAS评分较治疗前降低（P＜0.05），且观察组VAS评分低于对照组（P＜0.05）。治疗后，2组MMO较治疗前增加（P＜0.05），且观察组MMO大于对照组（P＜0.05）。治疗后，2组DI、PI、CMI评分较治疗前下降（P＜0.05），且观察组DI、PI、CMI评分低于对照组（P＜0.05）。2组均未发生严重不良反应事件。结论：针刺肌筋膜触发点联合综合康复治疗可显著改善肌源性TMD患者疼痛、张口度及颞下颌关节功能，无不良反应。

Abstract:

Abstract： Objective： To observe the clinical effect of acupuncture at myofascial trigger points combined with comprehensive rehabilitation on myogenous temporomandibular disorders （M-TMD）. Methods：Sixty M-TMD patients admitted to the Department of Rehabilitation Medicine，the First Affiliated Hospital of Zhengzhou University from June 2022 to June 2024 were selected and divided into the observation group and the control group by random number table method，with 30 cases in each group. During treatment，one case fell off in the observation group and two cases in the control group. The control group was given comprehensive rehabilitation for treatment， and the observation group was given acupuncture at myofascial trigger points on the basis of the control group. Both groups were continuously treated for two weeks. The scores of Visual Analogue Scale（ VAS） of pain，maximum mouth opening（ MMO），temporomandibular joint Dysfunction Index （DI）， muscle Palpation Index （PI）， and Craniomandibular Index （CMI） were compared between the two groups. Results：After treatment，the VAS scores in the two groups were decreased when compared with those before treatment （P＜0.05），and the VAS score in the observation group was lower than that in the control group （P＜0.05）. After treatment， MMO in the two groups was increased when compared with that before treatment （P＜0.05）， and MMO in the observation group was larger than that in the control group （P＜0.05）. After treatment， the scores of temporomandibular joint DI， muscle PI， and CMI in the two groups were decreased when compared with those before treatment （P＜0.05），and the above three scores in the observation group were lower than those in the control group （P＜0.05）. No serious adverse events occurred in either group. Conclusion： The combination use of acupuncture at myofascial trigger points and comprehensive rehabilitation treatment can significantly improve the pain， mouth opening， and temporomandibular joint function in M-TMD patients， without adverse reactions.