咀嚼肌疼痛患者的定量感觉功能研究
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摘要
目的采用定量感觉测试分析咀嚼肌疼痛患者咬肌区的感觉功能特征。方法选择初次就诊的单侧咬肌疼痛患者以及健康志愿者各20名,测量双侧咬肌区及患侧手背部的冷感觉阈值(cold detection thresholds,CDT)、热感觉阈值(warm detection thresholds,WDT)、冷痛觉阈值(cold pain thresholds,CPT)、热痛觉阈值(hot pain thresholds,HPT)和压力疼痛阈值(pressure pain threshold,PPT),采用独立样本t检验进行统计分析。结果两组受试者手背部的CDT/WDT/CPT/HPT/PPT均无明显差异。两组受试者咬肌区温度感觉阈值CDT及WDT无明显统计学差异。患者双侧温度痛觉阈值HPT及CPT较正常人敏感。患者患侧咬肌区PPT显著低于正常人对应侧(P=0.001),患者患侧咬肌区PPT低于健侧咬肌区。结论咀嚼肌疼痛患者对温度痛觉和机械疼痛较为敏感。
Objective To explore the characteristics of somatosensory function of patients with unilateral masseter pain and normal subjects by quantitative sensory test. Methods 20 patients suffering from unilateral masseter pain and 20 healthy controls were enrolled. The cold/warm detection threshold(CDT, WDT), cold/hot pain threshold(CPT, HPT), pressure pain threshold(PPT) were measured at three sites: the center of bilateral masseter muscles and the surface overlying the dorsum of the homolateral hand. Data were statistically analyzed with independent sample t test. Results There was no significant difference in CDT, WDT, CPT, HPT, PPT between the two groups in hand. There was no significant difference in CDT, WDT between the patients and control groups. HPTs of bilateral masseter in pain patients were more sensitive than in controls. PPTs of pain side masseter in pain patients were lower than in controls. PPTs of pain side masseter were also lower than contralateral side in patient group. Conclusion Patients with masseter pain show more sensitivities to thermo and mechanical noxious thresholds.
Objective To explore the characteristics of somatosensory function of patients with unilateral masseter pain and normal subjects by quantitative sensory test. Methods 20 patients suffering from unilateral masseter pain and 20 healthy controls were enrolled. The cold/warm detection threshold(CDT, WDT), cold/hot pain threshold(CPT, HPT), pressure pain threshold(PPT) were measured at three sites: the center of bilateral masseter muscles and the surface overlying the dorsum of the homolateral hand. Data were statistically analyzed with independent sample t test. Results There was no significant difference in CDT, WDT, CPT, HPT, PPT between the two groups in hand. There was no significant difference in CDT, WDT between the patients and control groups. HPTs of bilateral masseter in pain patients were more sensitive than in controls. PPTs of pain side masseter in pain patients were lower than in controls. PPTs of pain side masseter were also lower than contralateral side in patient group. Conclusion Patients with masseter pain show more sensitivities to thermo and mechanical noxious thresholds.
引文
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[3] Dimova V,Oertel BG,L?tsch J.Using astandardized clinical quantitative sensory testing battery to judge the clinical relevance of sensory differences between adjacent body areas[J].Clin J Pain,2017,33(1):37-43.
[4] Dyck PJ,Kratz KM,Lehman KA,et al.The rochester diabetic neuropathy study:design,criteria for types of neuropathy,selection bias,and reproducibility of neuro-pathic tests[J].Neurology,1991,41(6):799-807.
[5] Dworkin SF,Le Resche L.Research diagnostic criteria for temporomandibular disorders:review,criteria,examinations and specifications,critique[J].J Craniomandib Disord,1992,6(4):301-355.
[6] Maier C,Baron R,T?lle TR,et al.Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS):somatosensory abnormalities in 1236 patients with different neuropathic pain syndromes[J].Pain,2010,150(3):439-450.
[7] Yarnitsky D,Sprecher E,Zaslansky R,et al.Heat pain thresholds:normative data and repeatability[J].Pain,1995,60(3):329-332.
[8] Yarnitsky D.Quantitative sensory testing[J].Muscle Nerve,1997,20(2):198-204.
[9] Weinstein S.Effects of local anesthetics on tactile sensitivity thresholds for cutaneous and mucous membranes[J].J Invest Dermatol,1977,69(1):136-145.
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[11] Roldan CJ,Abdi S.Quantitative sensory testing in pain manag-ement[J].Pain Management,2015,5(6):483-491.
[12] Uddin Z,MacDermid JC.Quantitative sensory testing in chronic musculoskeletal pain[J].Pain Med,2016,17(9):694-703.
[13] Sarlani E,Grace EG,Reynolds MA.Evidence for up-regulated central nociceptive processing in patients with masticatory myofascial pain[J].J Orofac Pain,2004,18(1):41-55.
[14] Rolke R,Baron C,Maier C,et al.Quantitative sensory testing in the german research network on neuropathic Pain(DFNS) :standardized protocol and reference value[J].Pain,2006,123(3):231-243.
[15] Mücke M,Cuhls H,Radbruch L,et al.Quantitative sensory testing (QST).English version[J/OL].Schmerz,(2016-01-29)[2018-11-01].https://dx.doi.org/10.1007/s00482-015-0093-2.
[16] Matos R,Wang K,Jensen JD,et al.Quantitative sensory testing in the trigeminal region:site and gender differences[J].J Orofac Pain,2011,25(2):161-169.
[17] Yang G,Luo Y,Baad-Hansen L,et al.Ethnic differences in orofacial somatosensory profiles-quantitative sensory testing in Chinese and Danes[J].J Oral Rehabil,2013,40(11):844-853.
[18] Sarlani E,Grace EG,Reynolds MA,et al.Evidence for up-regulated central nociceptive processing in patients with masticatory myofascial pain[J].J Orofacial Pain,2004,18(1):41-55.
[19] Greenspan JD,Slade GD,Bair E,et al.Pain sensitivity risk factors for chronic TMD:descriptive data and empirically identified domains from the OPPERA case control study[J].J Pain,2011,12(11):T61-T74.
[20] 杨广聚,曹烨,张磊,等.健康人口的颌面部定量躯体感觉功能数据及其影响因素分析[J].北京大学学报(医学版),2015,47(3):521-528.