Lindroth John E, Schmidt John E, Carlson Charles R
Orofacial Pain Center, College of Dentistry, University of Kentucky, 800 Rose Street, Lexington, KY 40532-0297, USA.
J Orofac Pain. 2002 Fall;16(4):277-83.
To identify differences between 2 groups of patients with temporomandibular disorders (TMD), those with masticatory muscle pain (MMP) versus intracapsular pain (ICP), and to compare these differences on behavioral and psychosocial domains.
There were 435 patients in the MMP group and 139 patients in the ICP group. The overall sample was 88.2% female and had an average age of 36.1 years (SD = 11.7). Patients completed measures of psychological symptoms (SCL-90), pain severity (MPI), sleep (PSQI), activity (MBI), and life stressors (PCL). Heart rate and blood pressure were also measured, and a complete medical/dental history was taken for each patients.
Results indicated no significant difference in pain severity or duration between the 2 groups (P > 05). The ICP group, however, reported fewer affective symptoms of pain than the MMP group (t = 6.8, P = .01). The ICP group had twice as many adaptive copers as dysfunctional patients (chi 2 = 7.84, P < .01), while there was no significant difference between these 2 categories for the MMP group (P > .05). Finally, the ICP group reported fewer psychological symptoms (P < .05), better sleep quality (F = 7.54, P = .01), and fewer life stressors (F = 7.00, P = .01) than the MMP group.
In contrast to many previous studies, the data set in this study showed no differences in pain severity and duration between the MMP and the ICP groups. Even though pain severity levels were equivalent, the MMP diagnostic group of chronic TMD patients demonstrated more dysfunctional behavioral profiles and significantly higher psychological distress than the ICP subgroup.
确定两组颞下颌关节紊乱症(TMD)患者之间的差异,即咀嚼肌疼痛(MMP)患者与关节内疼痛(ICP)患者,并比较这些差异在行为和心理社会领域的表现。
MMP组有435例患者,ICP组有139例患者。总体样本中88.2%为女性,平均年龄36.1岁(标准差=11.7)。患者完成了心理症状(SCL-90)、疼痛严重程度(MPI)、睡眠(PSQI)、活动(MBI)和生活应激源(PCL)的测量。还测量了心率和血压,并为每位患者记录了完整的医学/牙科病史。
结果表明两组之间在疼痛严重程度或持续时间上无显著差异(P>0.05)。然而,ICP组报告的疼痛情感症状比MMP组少(t=6.8,P=0.01)。ICP组适应性应对者的数量是功能失调患者的两倍(卡方=7.84,P<0.01),而MMP组这两类患者之间无显著差异(P>0.05)。最后,ICP组报告的心理症状比MMP组少(P<0.05),睡眠质量更好(F=7.54,P=0.01),生活应激源也比MMP组少(F=7.00,P=0.01)。
与许多先前的研究不同,本研究的数据显示MMP组和ICP组在疼痛严重程度和持续时间上没有差异。尽管疼痛严重程度相当,但慢性TMD患者的MMP诊断组比ICP亚组表现出更多功能失调的行为特征和显著更高的心理困扰。