Uhac Ivone, Tariba Petra, Kovac Zoran, Simonić-Kocijan Suncana, Lajnert Vlatka, Mesić Vesna Fugosić, Kuis Davor, Braut Vedrana
University of Rijeka, School of Dental Medicine, Department of Prosthodontics, Rijeka, Croatia.
Coll Antropol. 2011 Dec;35(4):1161-6.
The aim of this study was to investigate the prevalence and intensity of masticatory muscle and temporomandibular joint (TMJ) pain in Croatian war veterans with posttraumatic stress disorder (PTSD). The examined group consisted of 100 Croatian war veterans, in whom PTSD had previously been diagnosed. Patients were compared with 92 subjects who had not taken part in the war and in whom PTSD was excluded by psychiatric examination. The clinical examination consisted of palpation of the masticatory muscles, the prominent neck musculature, and TMJ. The examination technique used and the definition of items were previously tested for reliability and validity. 93% of the subjects with PTSD had masticatory muscle tenderness compared to 45.65% of the subjects in the control group (chi2 = 51.46, p < 0.0001). The most frequent painful location in the subjects with PTSD was the left lateral pterygoid site in 88%, and in subjects of the control group the right lateral pterygoid site in 28.26% of cases. The most painful location in the PTSD group was the left lateral pterygoid site in 72%, and in the control group the left posterior digastric in 4.35% of cases. 58% of the subjects with PTSD had TMJ tenderness compared to 3.26% of subjects in the control group (chi2 = 66.23, p < 0.0001). The most frequent painful location of TMJ in both groups was the left posterior capsule; in the PTSD group 38% and in subjects in the control group 2.17% of cases. The most painful location was the left posterior capsule in 28% of subjects with PTSD, while not one subject in the control group reported severe painful sensitivity. The very high frequency and intensity of pain in subjects with PTSD confirms the effect of stress on muscle and joint sensitivity, i.e. perception of pain.
本研究旨在调查患有创伤后应激障碍（PTSD）的克罗地亚退伍军人咀嚼肌和颞下颌关节（TMJ）疼痛的患病率及疼痛强度。被检查组由100名先前已被诊断患有PTSD的克罗地亚退伍军人组成。将这些患者与92名未参加过战争且经精神科检查排除PTSD的受试者进行比较。临床检查包括对咀嚼肌、颈部突出肌肉组织和颞下颌关节的触诊。所使用的检查技术和项目定义先前已进行过可靠性和有效性测试。患有PTSD的受试者中有93%存在咀嚼肌压痛，而对照组受试者中这一比例为45.65%（卡方=51.46，p<0.0001）。患有PTSD的受试者中最常见的疼痛部位是左侧翼外肌部位，占88%，而对照组受试者中右侧翼外肌部位疼痛的病例占28.26%。PTSD组中最疼痛的部位是左侧翼外肌部位，占72%，而对照组中左侧二腹肌后腹疼痛的病例占4.35%。患有PTSD的受试者中有58%存在颞下颌关节压痛，而对照组受试者中这一比例为3.26%（卡方=66.23，p<0.0001）。两组中颞下颌关节最常见的疼痛部位均为左侧后关节囊；PTSD组中该部位疼痛的病例占38%，对照组中占2.17%。患有PTSD的受试者中有28%最疼痛的部位是左侧后关节囊，而对照组中没有一名受试者报告有严重的疼痛敏感性。患有PTSD的受试者中疼痛的极高频率和强度证实了压力对肌肉和关节敏感性即疼痛感知的影响。
