本文關(guān)鍵詞：偏側(cè)咀嚼誘發(fā)因素去除后的咀嚼功能及干預(yù)效果分析　出處：《皖南醫(yī)學(xué)院》2015年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 偏側(cè)咀嚼 誘發(fā)因素 肌電圖 咀嚼效率 干預(yù)

【摘要】：目的:本研究通過口腔流行病學(xué)調(diào)查篩選出偏側(cè)咀嚼患者,旨對(duì)去除誘發(fā)因素6個(gè)月后的偏側(cè)咀嚼患者進(jìn)行肌電圖和咀嚼效率分析,了解常規(guī)去除誘因治療后患者的咀嚼功能改善情況;結(jié)合分析結(jié)果隨機(jī)對(duì)部分偏側(cè)咀嚼患者進(jìn)行干預(yù)性治療,分析比較干預(yù)治療前后咀嚼肌肌電活動(dòng)和咀嚼效率的變化,探討干預(yù)治療的效果,為此類患者是否需要進(jìn)行進(jìn)一步干預(yù)治療提供相應(yīng)的實(shí)驗(yàn)依據(jù)。方法:1)采用口腔專科檢查和問診相結(jié)合的方法于2013年11—12月在皖南醫(yī)學(xué)院口腔醫(yī)學(xué)專業(yè)235名學(xué)生中篩選出76名偏側(cè)咀嚼患者,從中隨機(jī)選擇30名設(shè)為偏側(cè)咀嚼組,其中男15人,女15人,年齡(19.3±0.5)歲,其中左偏側(cè)咀嚼者17例,右偏側(cè)咀嚼者13例。同時(shí)隨機(jī)選擇雙側(cè)咀嚼組為正常對(duì)照(n=30,男15人,女15人),年齡(19.6±0.3)歲。實(shí)驗(yàn)前六個(gè)月已去除造成偏側(cè)咀嚼的常見誘發(fā)因素。用肌電圖儀分別記錄雙側(cè)咀嚼組和偏側(cè)咀嚼組在下頜姿勢(shì)位、最大開閉口運(yùn)動(dòng)和咀嚼運(yùn)動(dòng)時(shí)的咬肌、二腹肌前腹表面肌電圖,進(jìn)行相關(guān)參數(shù)分析。用吸光度法分別檢測(cè)兩組在隨意咀嚼、左側(cè)咀嚼、右側(cè)咀嚼三種咀嚼方式下的吸光度值,并進(jìn)行比較分析。2)將偏側(cè)咀嚼者隨機(jī)分為干預(yù)組和非干預(yù)組,六個(gè)月后分別記錄這兩組在下頜姿勢(shì)位、最大開閉口運(yùn)動(dòng)和咀嚼運(yùn)動(dòng)時(shí)的咬肌、二腹肌前腹肌電圖及隨意咀嚼效率,進(jìn)行比較分析。結(jié)果:1)偏側(cè)咀嚼組最大開閉口運(yùn)動(dòng)中右二腹肌前腹(RDA)平均肌電值低于雙側(cè)咀嚼組(P0.01),咀嚼運(yùn)動(dòng)中右咬肌(RMM)平均肌電值低于雙側(cè)咀嚼組(P0.05)。2)偏側(cè)咀嚼組最大開閉口運(yùn)動(dòng)中左二腹肌前腹(LDA)、右二腹肌前腹(RDA)平均肌電峰值低于雙側(cè)咀嚼組(P0.05),咀嚼運(yùn)動(dòng)中左咬肌(LMM)、右咬肌(RMM)平均肌電峰值低于雙側(cè)咀嚼組(P0.05)。3)偏側(cè)咀嚼組在下頜姿勢(shì)位、最大開閉口運(yùn)動(dòng)和咀嚼運(yùn)動(dòng)時(shí)咬肌活動(dòng)不對(duì)稱指數(shù)高于雙側(cè)咀嚼組(p0.05),最大開閉口、咀嚼運(yùn)動(dòng)時(shí)二腹肌前腹活動(dòng)不對(duì)稱指數(shù)高于雙側(cè)咀嚼組(p0.05)。4)偏側(cè)咀嚼干預(yù)組干預(yù)后最大開閉口運(yùn)動(dòng)中rda平均肌電值顯著高于干預(yù)前(p0.05),咀嚼運(yùn)動(dòng)中rmm平均肌電值較干預(yù)前有所升高(p0.05);干預(yù)組干預(yù)后在咀嚼運(yùn)動(dòng)中l(wèi)da平均肌電值高于非干預(yù)組(p0.05)。5)偏側(cè)咀嚼干預(yù)組干預(yù)后最大開閉口運(yùn)動(dòng)中l(wèi)da、rda平均肌電峰值顯著高于干預(yù)前(p0.05),咀嚼運(yùn)動(dòng)中l(wèi)mm、rmm平均肌電峰值較干預(yù)前有所升高(p0.05);干預(yù)組干預(yù)后在最大開閉口運(yùn)動(dòng)中l(wèi)da平均肌電峰值顯著高于非干預(yù)組(p0.05)。6)偏側(cè)咀嚼干預(yù)組干預(yù)后在下頜姿勢(shì)位、最大開閉口運(yùn)動(dòng)和咀嚼運(yùn)動(dòng)時(shí)咬肌活動(dòng)不對(duì)稱指數(shù)低于干預(yù)前(p0.05),最大開閉口、咀嚼運(yùn)動(dòng)時(shí)二腹肌前腹活動(dòng)不對(duì)稱指數(shù)較干預(yù)前顯著降低(p0.05);干預(yù)組干預(yù)后咬肌、二腹肌前腹活動(dòng)不對(duì)稱指數(shù)低于非干預(yù)組(p0.05)。7)偏側(cè)咀嚼組的吸光度值與雙側(cè)咀嚼組比較有顯著性差異(p0.01)。同時(shí),在偏側(cè)咀嚼組中,左偏側(cè)咀嚼者的隨意咀嚼、左側(cè)咀嚼吸光度值均高于右側(cè)咀嚼的吸光度值(p0.05);而右偏側(cè)咀嚼者的隨意咀嚼、右側(cè)咀嚼吸光度值均高于左側(cè)咀嚼的吸光度值(p0.05)。8)偏側(cè)咀嚼干預(yù)組干預(yù)后的隨意咀嚼效率顯著高于干預(yù)前(p0.05);干預(yù)組干預(yù)后隨意咀嚼效率顯著高于非干預(yù)組(p0.01)。結(jié)論:1)偏側(cè)咀嚼者去除誘發(fā)因素后測(cè)定的rmm、rda的平均肌電值、lmm、rmm、lda、rda的平均肌電峰值仍低于雙側(cè)咀嚼者,下頜姿勢(shì)位、最大開閉口運(yùn)動(dòng)、咀嚼運(yùn)動(dòng)時(shí)的咬肌活動(dòng)存在不對(duì)稱性,最大開閉口運(yùn)動(dòng)和咀嚼運(yùn)動(dòng)時(shí)的二腹肌活動(dòng)存在不對(duì)稱性,隨意咀嚼效率低于雙側(cè)咀嚼者。以上均提示常規(guī)的去誘因治療不能真正達(dá)到恢復(fù)雙側(cè)咀嚼功能的目的。2)偏側(cè)咀嚼者行干預(yù)性治療后咬肌和二腹肌前腹的平均肌電值、平均肌電峰值明顯升高,咬肌、二腹肌活動(dòng)對(duì)稱性顯著改善,咀嚼效率明顯提高,說明患者咀嚼功能得到了一定程度的改善。
[Abstract]:Objective: To study the oral epidemiological survey screened Hemimastication patients, aims for unilateral removal of the predisposing factors of 6 months after the patients were chewing EMG and masticatory efficiency analysis, understand the routine removal of incentives after treatment of patients with masticatory function improvement; combined with the results of the random part of Hemimastication patients for the treatment. Analysis and comparison of intervention before and after the treatment of masticatory muscle EMG activity of masticatory efficiency and change of therapeutic effects, such as whether patients need further intervention to provide experimental basis for the corresponding treatment. Methods: 1) using the method of oral examination and interrogation combined chewing in 2013 11 - December in Wangnan Medical College Stomatology 235 the student identified 76 patients of unilateral chewing, group side from 30 randomly selected, including 15 male and 15 female, age (19.3 + 0.5) years old, the Hemimastication left 17 cases, right Hemimastication in 13 cases. At the same time randomly selected bilateral chewing group was normal control (n=30, male 15, female 15), age (19.6 + 0.3) years old. The first six months has caused removal of common causative factors Hemimastication. With the electromyography were recorded in bilateral chewing group and Hemimastication group in the mandibular position and the largest open close movement and mastication of the masseter muscle, two abdominal anterior abdominal surface electromyography, related parameters were analyzed. The two groups were detected in a casual chew, chew on the left side by spectrophotometry, absorbance of three kinds of chewing chewing on the right side of the value, and comparative analysis of.2) will Hemimastication were randomly divided into intervention group and non intervention group. After six months of the two groups were recorded in the mandibular position and the largest open close movement and mastication of the masseter muscle, abdominal muscle and abdominal electrocardiogram before two free chewing efficiency, compare Analysis. Results: 1) Hemimastication group the maximum opening and closing movement right anterior abdominal muscle two (RDA) value is lower than the average EMG of bilateral chewing group (P0.01), the right masseter chewing movement (RMM) value is lower than the average EMG of bilateral chewing group (P0.05).2) Hemimastication group the largest open close movement of Naka Saji before the abdominal muscle (LDA), two right anterior abdominal muscles (RDA) the average EMG peak was lower than the bilateral chewing group (P0.05), the left masseter chewing movement (LMM), the right masseter muscle (RMM) average EMG peak lower than bilateral chewing group (P0.05).3) Hemimastication group in the mandibular position and the largest open close movement and masticatory movement when the masseter muscle activity asymmetry index is higher than that of bilateral chewing group (P0.05), the maximum opening and closing, mastication two abdominal ventral asymmetry index is higher than that of bilateral chewing activity group (P0.05).4) Hemimastication intervention group the largest open close movement in RDA average EMG values were significantly higher than before (P0.05), Masticatory movement RMM average EMG values increased compared with before intervention (P0.05); the intervention group in the masticatory movement LDA average EMG value is higher than the non intervention group (P0.05).5) Hemimastication intervention group the largest open close movement in LDA RDA, the average peak EMG was significantly higher than that before the intervention (P0.05). Masticatory movement LMM, RMM average EMG peak increased compared with before intervention (P0.05); the intervention group in the opening and closing movement LDA average EMG peak was higher than that in the non intervention group at the maximum (P0.05).6) Hemimastication intervention group in the mandibular position and the largest open close movement and masseter muscle activity during mastication the asymmetry index was lower than that before intervention (P0.05), the maximum opening and closing, mastication two abdominal anterior abdominal activity asymmetry index was significantly lower than before intervention (P0.05); intervention group two masseter, anterior abdominal muscle activity asymmetry index was lower than that of non intervention group (P0.05 ).7) absorbance Hemimastication group was compared between the group and the bilateral mastication (P0.01). At the same time, in Hemimastication group, left Hemimastication are free to chew, chew on the left side were higher than the absorbance absorbance value (P0.05) on the right side of chewing; free to chew while the right side chewing subjects the absorbance values were higher than the right chewing chewing left the value of absorbance (P0.05).8) Hemimastication intervention group randomly masticatory efficiency were significantly higher than before (P0.05); the intervention group was significantly higher than that of free chewing efficiency in non intervention group (P0.01). Conclusion: 1) Hemimastication was removed by after RMM, the average EMG values of RDA, LMM, RMM, LDA, RDA is still lower than the average peak EMG of bilateral chewing, mandibular position, maximum opening and closing movement, the masseter muscle activity during mastication is asymmetric, the opening and closing movement and two abdominal muscles during mastication Activity is asymmetric, freely chewing efficiency is lower than the bilateral chewing. All suggest that in order to cause treatment cannot reach the purpose of bilateral masticatory function recovery.2) Hemimastication average EMG for intervention treatment of masseter and anterior abdominal muscle two values, the average peak EMG increased significantly, masseter muscle, abdominal muscle activity two symmetry improved, masticatory efficiency improved significantly, indicating the masticatory function has been improved to some extent.

【學(xué)位授予單位】：皖南醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R782.6

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