Adiels Anne-Marie, Helkimo Martti, Magnusson Tomas
Department of Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jönköping, Sweden.
Swed Dent J. 2005;29(1):17-25.
Pain of long duration is a common suffering in modern man. One such pain condition is fibromyalgia syndrome (FMS). Opinions about what treatment regimen that are to be used in these patients are diverging, and many of the treatments suggested are not, or only poorly, scientifically investigated. The aim of this pilot investigation was to evaluate if FMS patients with signs and symptoms of temporomandibular disorders (TMDs) refractory to conservative TMD treatment would respond positively to tactile stimulation in respect of local and/or general symptoms. Ten female patients fulfilling the inclusion criteria received such treatment once a week during a 10-week period. At the end of treatment, a positive effect on both clinical signs and subjective symptoms of TMD, as well as on general body pain, was registered. Eight out of 10 patients also perceived an improved quality of their sleep. At follow-ups after 3 and 6 months some relapse of both signs and symptoms could be seen, but there was still an improvement compared to the initial degree of local and general complaints. At the 6-months follow-up, half of the patients also reported a lasting improvement of their sleep quality. One hypothetical explanation to the positive treatment effect experienced by the tactile stimulation might be the resulting improvement of the patients' quality of sleep leading to increased serotonin levels. The results of the present pilot study are so encouraging that they warrant an extended, controlled study.
长期疼痛是现代人常见的困扰。纤维肌痛综合征(FMS)就是这样一种疼痛病症。对于这些患者应采用何种治疗方案,意见不一,而且许多建议的治疗方法尚未经过科学研究,或仅有粗略的研究。这项初步调查的目的是评估患有颞下颌关节紊乱症(TMD)体征和症状且对保守TMD治疗无效的FMS患者,在局部和/或全身症状方面对触觉刺激是否会产生积极反应。10名符合纳入标准的女性患者在10周内每周接受一次这种治疗。治疗结束时,记录到对TMD的临床体征和主观症状以及全身疼痛均有积极影响。10名患者中有8名还感觉睡眠质量有所改善。在3个月和6个月的随访中,可以看到体征和症状有一些复发,但与最初的局部和全身不适程度相比仍有改善。在6个月的随访中,一半的患者还报告睡眠质量持续改善。触觉刺激产生积极治疗效果的一种假设解释可能是患者睡眠质量的改善导致血清素水平升高。本初步研究的结果非常令人鼓舞,值得进行一项扩大规模的对照研究。