手法整复颈椎配合铍针松解治疗颞颌关节功能紊乱60例
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摘要
目的:评价手法整复颈椎配合铍针松解治疗颞颌关节功能紊乱的临床疗效。方法:自2012年3月至2017年5月,应用手法整复颈椎配合铍针松解治疗颞颌关节功能紊乱60例,男26例,女34例;年龄18~60岁,平均32.5岁;病程1周~5年,平均3个月。对患者颞颌关节最大主动张口度、弹响程度、VAS疼痛评分,进行治疗前和治疗后随访评估。结果:60例均获随访,时间6~24个月,平均12个月。末次随访时,颞颌关节最大主动张口度从治疗前的(1.99±0.47)cm提高至治疗后的(3.17±0.19)cm,关节弹响度从治疗前100%降至治疗后的(27.33±13.51)%,VAS评分从治疗前的4.73±0.67降至治疗后的1.80±0.53。结论:采用手法整复颈椎配合铍针松解治疗颞颌关节功能紊乱,具有操作简便、疗效确切、疗程短等优点,是治疗颞颌关节功能紊乱的有效方法。
Objective:To evaluate the clinical effects of manipulative reduction of cervical vertebrae combined with Pi needle release for the treatment of temporomandibular joint dysfunction. Methods:From March 2012 to May 2017,60 patients with temporomandibular joint dysfunction were treated by manipulative reduction of cervical vertebrae with Pi needle release,including 26 males and 34 females,ranging in age from 18 to 60 years old,with an average of 32.5 years old. The courses of the disease ranged from 1 week to 5 years,with a mean duration of 3 months. The patients were followed up before and after treatment by maximum active opening of temporomandibular joint,joint clicking and comparison of visual analogue scale(VAS) pain scores. Results:All 60 patients were followed up,and the duration ranged from 6 to 24 months,with an average of 12 months. The maximum active opening of temporomandibular joint increased from(1.99±0.47) cm before treatment to(3.17±0.19) cm. The joint clicking decreased from 100% before treatment to(27.33 ±13.51)% after treatment. The VAS score decreased from 4.73 ±0.67 before treatment to 1.80±0.53 after treatment. Conclusion:Treatment of temporomandibular joint dysfunction by manipulative reduction of cervical vertebrae combined with Pi needle release has such advantages as easy operation,obvious curative effect,short course of treatment,which is an effective method for the treatment of temporomandibular joint dysfunction.
Objective:To evaluate the clinical effects of manipulative reduction of cervical vertebrae combined with Pi needle release for the treatment of temporomandibular joint dysfunction. Methods:From March 2012 to May 2017,60 patients with temporomandibular joint dysfunction were treated by manipulative reduction of cervical vertebrae with Pi needle release,including 26 males and 34 females,ranging in age from 18 to 60 years old,with an average of 32.5 years old. The courses of the disease ranged from 1 week to 5 years,with a mean duration of 3 months. The patients were followed up before and after treatment by maximum active opening of temporomandibular joint,joint clicking and comparison of visual analogue scale(VAS) pain scores. Results:All 60 patients were followed up,and the duration ranged from 6 to 24 months,with an average of 12 months. The maximum active opening of temporomandibular joint increased from(1.99±0.47) cm before treatment to(3.17±0.19) cm. The joint clicking decreased from 100% before treatment to(27.33 ±13.51)% after treatment. The VAS score decreased from 4.73 ±0.67 before treatment to 1.80±0.53 after treatment. Conclusion:Treatment of temporomandibular joint dysfunction by manipulative reduction of cervical vertebrae combined with Pi needle release has such advantages as easy operation,obvious curative effect,short course of treatment,which is an effective method for the treatment of temporomandibular joint dysfunction.
引文
[1]王启才.针灸治疗学[M].北京:中国中医药出版社,200:221.WANG QC.Acupuncture and Moxibustion Therapy[M].Beijing:Chin Press of Traditional Chinese Medicine,200:221.Chinese.
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[6]赵勇,方维,闫安,等.铍针治疗肩胛肌筋膜炎的病例对照研究[J].中国骨伤,2014,27(4):291-294.ZHAO Y,FANG W,YAN A,et al.Case control study on the treatment of patients with scapular muscle fasciitis by Pizhen[J].Zhongguo Gu Shang/China J Orthop Trauma,2014,27(4):291.Chinese with abstract in English.
[7]董福慧,郭振芳,张春美,等.皮神经卡压综合症[M].北京:北京科学技术出版社,2002:37.DONG FH,GUO ZF,ZHANG CM,et al.Cutaneous Nerve Entrapment Syndrome[M].Beijing:Beijing Science and Technology Press,2002:37.Chinese.
[8]马绪臣,张震康.颞下颌关紊乱病的命名、诊断分类及治疗原则[J].中华口腔医学杂志,2002,37(4):241.MA SC,ZHANG ZK.Naming,diagnostic classification and treatment principles of temporomandibular disorders[J].Zhonghua Kou Qiang Yi Xue Za Zhi,2002,37(4):241.Chinese.
[9]林友,邹宇聪,李义凯.上颈椎手法治疗对颞下颌关节紊乱症患者咬肌压痛阈值及最大张口限度的影响[J].中国康复医学杂志,2014,29(1):53.LIN Y,ZOU YC,LI YK,et al.Effects of upper cervical manipulation on the tenderness thresholds and maximizing mouth opening degree in temporomandibular joint disturbance patients[J].Zhongguo Kang Fu Yi Xue Za Zhi,2014,29(1):53.Chinese.
[10]周贤华.手法治疗颈源性颞合关节紊乱综合症17例[J].中国骨伤,2004,17(10):629.ZHOU XH.Manipulative treatment for cervical derangement of temporomandibular joint:a report of 17 cases[J].Zhongguo Gu Shang/China J Orthop Trauma,2004,17(10):629.Chinese.
[11]Sjaastad O,Saunte C,Hovdahl H,et al.“Cervicogenic”headache.An hypothesis[J].Cephalalgia,1983,3(4):249-256.
[12]张明才,石印玉,黄仕荣,等.“骨错缝筯出槽”与颈椎病发病关系的临床研究[J].中国骨伤,2013,26(7):557-560.ZHANG MC,SHI YY,HUANG SR,et al.Study on the correlation between“Gucuofeng and Jinchucao”and cervical spondylosis[J].Zhongguo Gu Shang/China J Orthop Trauma,2013,26(7):557-560.Chinese with abstract in English.
[13]周贤华.手法治疗儿童寰枢关节半脱位21例[J].中国骨伤,2012,25(2):108-109.ZHOU XH.Manipulative treatment for atlantoaxial subluxation in21 children[J].Zhongguo Gu Shang/China J Orthop Trauma,2012,25(2):108-109.Chinese.
[2]邱蔚六.口腔颌面外科学[M].北京:人民卫生出版社,2008:318.QIU WL.Oral and Maxillofacial Surgery[M].Beijing:People's Medical Publishing House,2008:318.Chinese.
[3]Walker N,Bohannon RW,Cameron D.Discriminant validity of temporomandibular joint range of motion measurements obtained with a ruler[J].J Orthop Sports Phys Ther,2000,30(8):484-492.
[4]Makofsky HW.Spinal Manual Therapy:An Introduction to Soft Tissue Mobilization,Spinal Manipulation,Therapeutic and Home Exercises[M].New Jersey:SLACK Inc.,2010:124-136.
[5]Katsoulis J,Richter M.Efficacy of specific physiotherapy for temporomandibular joint dysfunction of muscular origin[J].Rev Stomatol Chir Maxillofac,2008,109(1):9-14.
[6]赵勇,方维,闫安,等.铍针治疗肩胛肌筋膜炎的病例对照研究[J].中国骨伤,2014,27(4):291-294.ZHAO Y,FANG W,YAN A,et al.Case control study on the treatment of patients with scapular muscle fasciitis by Pizhen[J].Zhongguo Gu Shang/China J Orthop Trauma,2014,27(4):291.Chinese with abstract in English.
[7]董福慧,郭振芳,张春美,等.皮神经卡压综合症[M].北京:北京科学技术出版社,2002:37.DONG FH,GUO ZF,ZHANG CM,et al.Cutaneous Nerve Entrapment Syndrome[M].Beijing:Beijing Science and Technology Press,2002:37.Chinese.
[8]马绪臣,张震康.颞下颌关紊乱病的命名、诊断分类及治疗原则[J].中华口腔医学杂志,2002,37(4):241.MA SC,ZHANG ZK.Naming,diagnostic classification and treatment principles of temporomandibular disorders[J].Zhonghua Kou Qiang Yi Xue Za Zhi,2002,37(4):241.Chinese.
[9]林友,邹宇聪,李义凯.上颈椎手法治疗对颞下颌关节紊乱症患者咬肌压痛阈值及最大张口限度的影响[J].中国康复医学杂志,2014,29(1):53.LIN Y,ZOU YC,LI YK,et al.Effects of upper cervical manipulation on the tenderness thresholds and maximizing mouth opening degree in temporomandibular joint disturbance patients[J].Zhongguo Kang Fu Yi Xue Za Zhi,2014,29(1):53.Chinese.
[10]周贤华.手法治疗颈源性颞合关节紊乱综合症17例[J].中国骨伤,2004,17(10):629.ZHOU XH.Manipulative treatment for cervical derangement of temporomandibular joint:a report of 17 cases[J].Zhongguo Gu Shang/China J Orthop Trauma,2004,17(10):629.Chinese.
[11]Sjaastad O,Saunte C,Hovdahl H,et al.“Cervicogenic”headache.An hypothesis[J].Cephalalgia,1983,3(4):249-256.
[12]张明才,石印玉,黄仕荣,等.“骨错缝筯出槽”与颈椎病发病关系的临床研究[J].中国骨伤,2013,26(7):557-560.ZHANG MC,SHI YY,HUANG SR,et al.Study on the correlation between“Gucuofeng and Jinchucao”and cervical spondylosis[J].Zhongguo Gu Shang/China J Orthop Trauma,2013,26(7):557-560.Chinese with abstract in English.
[13]周贤华.手法治疗儿童寰枢关节半脱位21例[J].中国骨伤,2012,25(2):108-109.ZHOU XH.Manipulative treatment for atlantoaxial subluxation in21 children[J].Zhongguo Gu Shang/China J Orthop Trauma,2012,25(2):108-109.Chinese.