本文選題：顳下頜關(guān)節(jié)　切入點(diǎn)：彈響　出處：《青島大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:肌功能鍛煉是一種臨床常用的治療方式,但常見(jiàn)于軀干四肢的肌功能鍛煉,然而咀嚼肌進(jìn)行肌功能鍛煉的療效研究較少。超短波理療是一種臨床廣泛應(yīng)用的理療方式,有一定的臨床療效。為了比較咀嚼肌功能鍛煉和超短波理療治療顳下頜關(guān)節(jié)彈響的效果,指導(dǎo)臨床顳下頜關(guān)節(jié)彈響治療方式的選擇設(shè)計(jì)了該實(shí)驗(yàn),并且結(jié)合中醫(yī)的經(jīng)筋理論對(duì)顳下頜關(guān)節(jié)彈響發(fā)生的可能機(jī)制進(jìn)一步探討。方法:選擇2012年6月至2014年6月因顳下頜關(guān)節(jié)彈響來(lái)我院就診的128例患者,年齡在14~65歲之間,病史為3天~2年,同時(shí)患者牙列完整未見(jiàn)異常,無(wú)明顯咬合干擾和錯(cuò)合畸形,曲面體層片或CT檢查未發(fā)現(xiàn)髁突骨質(zhì)破壞,且無(wú)頜面部創(chuàng)傷史,既往無(wú)精神、心理疾患史。將128例患者隨機(jī)分為實(shí)驗(yàn)組和對(duì)照組,每組64例。實(shí)驗(yàn)組和對(duì)照組在治療之前均進(jìn)行詳細(xì)的健康教育,以破除患者之前不良的生活或工作習(xí)慣。并且咀嚼肌功能鍛煉要求患者具有較好的依從性,通過(guò)健康教育可以讓患者對(duì)發(fā)病原因有一定的了解,積極主動(dòng)地進(jìn)行肌功能鍛煉。實(shí)驗(yàn)組指導(dǎo)患者進(jìn)行咀嚼肌功能鍛煉,并仔細(xì)反復(fù)確認(rèn)患者已正確掌握咀嚼肌功能鍛煉的方式。對(duì)照組采用上海產(chǎn)50型五官超短波治療機(jī)對(duì)患者進(jìn)行超短波理療。實(shí)驗(yàn)組和對(duì)照組療程均為兩周,3個(gè)月后進(jìn)行隨訪。并詳細(xì)記錄2周后復(fù)診和3個(gè)月后隨訪的結(jié)果,采集記錄患者在一定時(shí)間內(nèi)關(guān)節(jié)彈響出現(xiàn)的次數(shù)及時(shí)間,與初診時(shí)記錄數(shù)據(jù)比較,將彈響消失和彈響次數(shù)減少定義為治療有效,將彈響次數(shù)無(wú)變化定義為治療無(wú)效。采用SPSS17.0對(duì)兩組數(shù)據(jù)進(jìn)行卡方檢驗(yàn),比較兩種方法的近遠(yuǎn)期治療效果。結(jié)果:治療2周后復(fù)診,實(shí)驗(yàn)組的64例患者彈響全部消失,總有效率100%;對(duì)照組的64例患者33例彈響消失,20例彈響次數(shù)減少,11例彈響次數(shù)無(wú)改變,總有效率82.81%,兩組結(jié)果有顯著性差異(P0.05)。治療3個(gè)月后回訪,治療組隨訪率95.31%,對(duì)照組隨訪率93.75%,治療組總有效率100%,對(duì)照組總有效率66.67%,兩組療效差異明顯(χ2=22.004,P0.05),3月后對(duì)照組治療總有效率下降(χ2=4.306,P0.05)。經(jīng)統(tǒng)計(jì)學(xué)分析比較,實(shí)驗(yàn)組的近遠(yuǎn)期療效均優(yōu)于對(duì)照組。結(jié)論:臨床實(shí)驗(yàn)表明,咀嚼肌功能鍛煉和超短波理療治療顳下頜關(guān)節(jié)彈響均有效,但咀嚼肌功能鍛煉治療顳下頜關(guān)節(jié)彈響的效果優(yōu)于超短波理療。且咀嚼肌功能鍛煉讓患者形成了良好的咀嚼肌運(yùn)動(dòng)習(xí)慣,以徹底破除不健康的運(yùn)動(dòng)方式造成的不良影響,所以咀嚼肌功能鍛煉治療顳下頜關(guān)節(jié)彈響較超短波理療治療顳下頜關(guān)節(jié)彈響的療效更為顯著,并且咀嚼肌功能鍛煉治療顳下頜關(guān)節(jié)彈響的遠(yuǎn)期效果也更加穩(wěn)定。
[Abstract]:Objective: muscle function exercise is a commonly used clinical treatment method, but it is usually used in trunk and extremities, but the curative effect of masticatory muscle exercise is less. Ultrashort wave physiotherapy is a widely used physiotherapy method in clinic. In order to compare the effect of masticatory muscle exercise and ultrashort wave physiotherapy on temporomandibular joint bounce, the experiment was designed to guide the choice of clinical temporomandibular joint elastic response. The possible mechanism of temporomandibular joint (TMJ) bouncing was further explored with the meridian theory of traditional Chinese medicine. Methods: 128 patients with temporomandibular joint bounce from June 2012 to June 2014, aged between 14 and 65 years, were selected. The history ranged from 3 days to 2 years. At the same time, there was no abnormal dentition, no obvious occlusal interference and malocclusion, no condylar bone destruction, no maxillofacial trauma and no previous mental state. The history of psychological disorders. 128 patients were randomly divided into experimental group and control group, 64 cases in each group. The experimental group and control group were given detailed health education before treatment. In order to break the bad life or work habits of the patients before, and the masticatory muscle function exercise requires the patients to have good compliance, through health education, we can let the patients have a certain understanding of the causes of the disease. The patients in the experimental group were instructed to exercise the masticatory muscles. The patients in the control group were given ultrashort wave therapy with Shanghai 50 type ultrashort wave therapy machine. The course of treatment in both the experimental group and the control group was two weeks and three months. The results of follow-up after 2 weeks and 3 months were recorded in detail. The frequency and time of the joint bounce in a certain time were collected and recorded. Compared with the data recorded during the first visit, the reduction of the number of the bounce and the number of the bounce was defined as the effective treatment. SPSS17.0 was used to carry out chi-square test on the two groups of data to compare the short-term and long-term therapeutic effects of the two methods. Results: after 2 weeks of treatment, 64 patients in the experimental group all disappeared. The total effective rate was 100%, in the control group, 33 cases (33 cases) with missing bounce sound and 20 cases (20 cases) with the reduction of the number of bounce sounds were not changed, and the total effective rate was 82.81%. There was a significant difference between the two groups (P 0.05). After 3 months of treatment, the results of the two groups were returned. The follow-up rate of the treatment group was 95.31, the follow-up rate of the control group was 93.755.The total effective rate of the treatment group was 100, and the total effective rate of the control group was 66.67. The difference between the two groups was significant (蠂 ~ 2, 22.004, P 0.05, 蠂 ~ (2)), and the total effective rate of the control group was decreased after March (蠂 ~ 2, P = 4.306, P 0.05). Conclusion: the clinical experiment shows that the masticatory muscle function exercise and ultrashort wave physiotherapy are effective in the treatment of temporomandibular joint elastic response. But the effect of masticatory muscle exercise on temporomandibular joint bounce was better than that of ultrashort wave physiotherapy. Therefore, masticatory muscle function exercise in the treatment of temporomandibular joint bounce is more effective than ultrashort wave physiotherapy in the treatment of temporomandibular joint bounce, and the long-term effect of masticatory muscle exercise in the treatment of temporomandibular joint bounce is more stable.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R782.6

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