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肌筋膜触发点干针疗法对磨牙症和颞下颌关节紊乱症患者的影响:一项前瞻性病例系列研究

Effects of myofascial trigger point dry needling in patients with sleep bruxism and temporomandibular disorders: a prospective case series.

作者信息

Blasco-Bonora Paloma María, Martín-Pintado-Zugasti Aitor

机构信息

Private Practice, Physical Therapy, Valencia, Spain.

Department of Nursery and Physical Therapy, Faculty of Medicine, CEU-San Pablo University, Madrid, Spain.

出版信息

Acupunct Med. 2017 Mar;35(1):69-74. doi: 10.1136/acupmed-2016-011102. Epub 2016 Oct 3.

Abstract

OBJECTIVES

To investigate the effects of deep dry needling (DN) of myofascial trigger points (MTrPs) of the masseter and temporalis on pain, pressure pain threshold (PPT), pain-free maximal jaw opening and temporomandibular disorder (TMD)-related disability in patients with sleep bruxism (SB) and myofascial TMD.

METHODS

Seventeen subjects (11 women, 6 men) aged 39±13 years (range 23-66) diagnosed with SB and myofascial TMD were invited to participate in this prospective case series study. Each subject received a deep DN intervention in the masseter and temporalis MTrPs. Pain intensity, PPT, pain-free maximal jaw opening and TMD-related disability were assessed before treatment, immediately after treatment and at 1-week follow-up. Jaw disability was assessed using the jaw disability checklist (JDC) at baseline and 1 week post-treatment only.

RESULTS

One-way analyses of variance showed significant improvements in pain intensity, PPT and jaw opening (p<0.001). Post-hoc analysis revealed significant differences between baseline and post-intervention follow-up time points in pain (immediate: Cohen's d=1.72, p<0.001; 1 week: d=3.24, p<0.001), jaw opening (immediate: d=0.77, p<0.001; 1 week: d=1.02, p<0.001) and PPT in the masseter (immediate: d=1.02, p<0.001; 1 week: d=1.64, p<0.001) and temporalis (immediate: d=0.91, p=0.006; 1 week: d=1.8, p<0.001). A dependent t-test showed a significant improvement in jaw functioning, reflected by a large reduction in 1-week JDC scores relative to baseline (d=3.15, p<0.001).

CONCLUSIONS

Deep DN of active MTrPs in the masseter and temporalis in patients with myofascial TMD and SB was associated with immediate and 1-week improvements in pain, sensitivity, jaw opening and TMD-related disability.

TRIAL REGISTRATION NUMBER

NCT02587182; Results.

摘要

目的

探讨对磨牙症(SB)和肌筋膜性颞下颌关节紊乱病(TMD)患者的咬肌和颞肌肌筋膜触发点(MTrP)进行深部干针疗法(DN)对疼痛、压痛阈(PPT)、无痛最大张口度和颞下颌关节紊乱病(TMD)相关功能障碍的影响。

方法

邀请17名年龄39±13岁(范围23 - 66岁)、诊断为SB和肌筋膜性TMD的受试者(11名女性,6名男性)参与这项前瞻性病例系列研究。每位受试者均接受咬肌和颞肌MTrP的深部DN干预。在治疗前、治疗后即刻和1周随访时评估疼痛强度、PPT、无痛最大张口度和TMD相关功能障碍。仅在基线和治疗后1周使用下颌功能障碍检查表(JDC)评估下颌功能障碍。

结果

单因素方差分析显示疼痛强度、PPT和张口度有显著改善(p<0.001)。事后分析显示,在疼痛方面(即刻:Cohen's d = 1.72,p<0.001;1周:d = 3.24,p<0.001)、张口度方面(即刻:d = 0.77,p<0.001;1周:d = 1.02,p<0.001)以及咬肌的PPT方面(即刻:d = 1.02,p<0.001;1周:d = 1.64,p<0.001)和颞肌的PPT方面(即刻:d = 0.91,p = 0.006;1周:d = 1.8,p<0.001),基线与干预后随访时间点之间存在显著差异。相关样本t检验显示下颌功能有显著改善,表现为1周JDC评分相对于基线大幅降低(d = 3.15,p<0.001)。

结论

对肌筋膜性TMD和SB患者的咬肌和颞肌中的活跃MTrP进行深部DN,与疼痛、敏感性、张口度和TMD相关功能障碍在即刻和1周时的改善相关。

试验注册号

NCT02587182;结果

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