Balasubramaniam Ramesh, de Leeuw Reny, Zhu Hua, Nickerson Robert B, Okeson Jeffrey P, Carlson Charles R
Orofacial Pain Center, University of Kentucky, Lexington, KY, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Aug;104(2):204-16. doi: 10.1016/j.tripleo.2007.01.012. Epub 2007 May 7.
The objective of this study was to determine the prevalence of temporomandibular disorders (TMD) and evaluate psychosocial domains in patients with fibromyalgia (FM) compared with patients with failed back syndrome (FBS).
The study included 51 (32 FM and 19 FBS) adult patients who were administered orofacial pain and psychological questionnaires before a clinical examination. Presence of TMD was diagnosed according to the Research Diagnostic Criteria for TMD.
Fifty-three percent of the FM patients reported having face pain compared with 11% of the FBS patients. Of those FM patients who reported face pain, 71% fulfilled the criteria for a diagnosable TMD. FM patients had significantly higher subscale scores for somatization, obsessive-compulsive, medication used for sleep, and fatigue compared with FBS patients. Eighty-seven percent of the FM patients reported a stressful event and 42.3% had symptoms indicating posttraumatic stress disorder.
The high prevalence of TMD and psychosocial dysfunction among FM patients suggests wide-reaching dysregulation of autonomic and hypothalamic-pituitary-adrenal axis functions.
本研究的目的是确定颞下颌关节紊乱病(TMD)的患病率,并与腰椎术后失败综合征(FBS)患者相比,评估纤维肌痛(FM)患者的心理社会领域。
该研究纳入了51名成年患者(32名FM患者和19名FBS患者),在临床检查前对其进行了口腔面部疼痛和心理问卷调查。根据TMD的研究诊断标准诊断TMD的存在。
53%的FM患者报告有面部疼痛,而FBS患者为11%。在那些报告有面部疼痛的FM患者中,71%符合可诊断TMD的标准。与FBS患者相比,FM患者在躯体化、强迫观念、助眠药物使用和疲劳方面的分量表得分显著更高。87%的FM患者报告有应激事件,42.3%有创伤后应激障碍的症状。
FM患者中TMD和心理社会功能障碍的高患病率表明自主神经和下丘脑-垂体-肾上腺轴功能存在广泛的失调。