Yap Adrian U J, Chua E K, Dworkin Samuel F, Tan H H, Tan Keson B C
Department of Restorative Dentistry, Faculty of Dentistry, National University of Singapore, 5 Lower Kent Ridge Road, Singapore 119074, Republic of Singapore.
Int J Prosthodont. 2002 Sep-Oct;15(5):461-6.
This study assessed multiple pain conditions and their association with psychosocial functioning, psychologic distress, and somatization in patients with temporomandibular disorders (TMD) based on RDC/TMD Axis II findings. Nonspecific pain items examined included headaches, heart/chest pain, lower back pain, nausea/abdominal pain, and muscle pain.
In this study, 202 TMD patients (58 men and 144 women) referred to two TMD clinics participated. The mean age of the predominantly Chinese patient population (82%) was 32.6 years (range 13 to 65). The RDC/TMD history questionnaire was input directly into computers by patients. Graded chronic pain and SCL-90 scales were generated online and automatically archived for statistical analysis. Data were subjected to Spearman's rank-order correlation and Kruskal-Wallis and Mann-Whitney tests at a significance level of .05.
Of the patients, 43% were moderately to extremely distressed by headaches. The percentage of patients who were distressed by heart/chest pain (7%), lower back pain (26%), nausea/abdominal pain (17%) and soreness of muscles (22%) was lower. Of the TMD patients, 16% experienced more than three pain items. Significant and positive correlations were observed between number of pain items experienced and graded chronic pain severity, depression, and somatization. Correlation coefficients ranged from .27 to .65 for graded chronic pain scales and somatization (without pain items) scores, respectively.
Results suggest that the number of nonspecific pain conditions reported may be a predictor of psychosocial dysfunction, depression, and somatization.
本研究基于RDC/TMD轴II的研究结果，评估了颞下颌关节紊乱症（TMD）患者的多种疼痛状况及其与心理社会功能、心理困扰和躯体化的关系。所检查的非特异性疼痛项目包括头痛、心脏/胸痛、下背痛、恶心/腹痛和肌肉疼痛。
在本研究中，202名转诊至两家颞下颌关节紊乱症诊所的患者（58名男性和144名女性）参与其中。以华裔为主的患者群体（82%）的平均年龄为32.6岁（范围为13至65岁）。患者直接将RDC/TMD病史问卷输入计算机。在线生成分级慢性疼痛和SCL - 90量表，并自动存档以进行统计分析。数据进行Spearman等级相关分析以及Kruskal - Wallis和Mann - Whitney检验，显著性水平为0.05。
在患者中，43%因头痛而中度至极度困扰。因心脏/胸痛（7%）、下背痛（26%）、恶心/腹痛（17%）和肌肉酸痛（22%）而困扰的患者比例较低。在颞下颌关节紊乱症患者中，16%经历了三种以上的疼痛项目。在经历的疼痛项目数量与分级慢性疼痛严重程度、抑郁和躯体化之间观察到显著的正相关。分级慢性疼痛量表和躯体化（无疼痛项目）得分的相关系数分别为0.27至0.65。
结果表明，所报告的非特异性疼痛状况的数量可能是心理社会功能障碍、抑郁和躯体化的一个预测指标。
