Vranceanu Ana-Maria, Shaefer Jeffery R, Saadi Ashkan Fahandej, Slawsby Ellen, Sarin Jaya, Scult Matthew, Benson Herbert, Denninger John W
Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
J Musculoskelet Pain. 2013;21(3):224-230. doi: 10.3109/10582452.2013.827289. Epub 2013 Aug 24.
This is an open-pilot study to evaluate the feasibility, acceptability and efficacy of a pain-specific version of an established mind-body medicine program, the Relaxation Response [RR] Resiliency Program [RP], in patients with chronic temporomandibular disorder [TMD].
Male and female with at least a six-month history of pain involving the masticatory muscles were sought in the Orofacial Pain Centers of the Massachusetts General Hospital [MGH] or through an advertisement sent to MGH employees from 2008 to 2010. Eligible participants underwent the RP intervention [eight group sessions] after standard medical management. Pre- and post-group patients underwent objective measures of impairment [vertical and lateral range of motion with and without pain, temporomandibular joint and muscle pain palpation, and algometer measures] and completed psychosocial measures [Symptom Severity Index, Perceived Stress Scale, the Symptom Checklist-90-Revised and Short Form 36 Health Survey].
Twenty-four subjects [16 females, 90% from MGH Orofacial Pain Centers,10% from among MGH employees], mean age 38 years, met eligibility criteria and participated in the study. The intervention was highly feasible and accepted by patients, as evidenced by a 92% rate of completion. Paired -test analyses revealed improvement on self-reported pain measures: pain intensity [<0.02], pain frequency [<0.002], pain duration [<0.027], pain tolerability [<0.009] and on several objective tests.
The pain specific RP is efficacious in reducing objective and subjective symptoms in patients with chronic refractory TMD. The comprehensive intervention, which combines educational information about pain with RR, cognitive behavioral and resiliency-enhancement skills, is accepted by patients and may be more efficacious than other treatments with fewer elements.
这是一项开放性先导研究，旨在评估既定身心医学项目“放松反应[RR]弹性计划[RP]”的疼痛特定版本对慢性颞下颌关节紊乱病[TMD]患者的可行性、可接受性和疗效。
2008年至2010年期间，在马萨诸塞州总医院[MGH]的口腔面部疼痛中心或通过向MGH员工发送的广告招募有至少6个月咀嚼肌疼痛病史的男性和女性。符合条件的参与者在接受标准医疗管理后接受RP干预[八次小组课程]。干预前后，患者接受了功能损害的客观测量[有无疼痛时的垂直和侧向运动范围、颞下颌关节和肌肉疼痛触诊以及痛觉计测量]，并完成了社会心理测量[症状严重程度指数、感知压力量表、症状自评量表90修订版和健康调查简表36]。
24名受试者[16名女性，90%来自MGH口腔面部疼痛中心，10%来自MGH员工]，平均年龄38岁，符合入选标准并参与了研究。干预具有高度可行性且为患者所接受，完成率达92%即证明了这一点。配对t检验分析显示，自我报告的疼痛指标有所改善：疼痛强度[<0.02]、疼痛频率[<0.002]、疼痛持续时间[<0.027]、疼痛耐受性[<0.009]以及多项客观测试指标。
针对疼痛的RP对减轻慢性难治性TMD患者的客观和主观症状有效。这种综合干预将有关疼痛的教育信息与RR、认知行为和增强弹性技能相结合，为患者所接受，可能比其他要素较少的治疗方法更有效。
