Jaseng Hospital of Korean Medicine, Seoul, Korea.
Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Korea.
J Oral Rehabil. 2022 Jul;49(7):691-700. doi: 10.1111/joor.13333. Epub 2022 Apr 18.
Despite the availability of clinical practice guidelines for temporomandibular disorders (TMDs), research evidence on current clinical practice trends is scarce.
This study aimed to analyse the TMD treatment trends and patterns according to patient characteristics in Korea over a 9-year period.
The 2010-2018 Korean Health Insurance Review & Assessment Service National Patient Sample data were used. A total of 109 969 patients diagnosed with TMD as the principal diagnosis at least once in each year were included in the study. The types of visits and treatments were analysed by year. K-medoids clustering was then performed to analyse the treatment patterns according to patient characteristics.
The most commonly used drugs for pharmacological treatment were non-steroidal anti-inflammatory drugs (NSAIDs) and relaxants. The prescription of opioids, anxiolytics and antidepressants was reduced. Among non-pharmacological treatments, physiotherapy was the most utilised, and its use increased over the years. Cluster analysis showed that treatment patterns generally differed between sexes; the rate of outpatient visits and the use of NSAIDs, relaxants and physiotherapy were higher among female patients.
This study showed that TMD treatment prescriptions changed from 2010 to 2018 and found notable trends in NSAIDs, relaxants, opioids, anxiolytics, antidepressants and physiotherapy. Moreover, the treatment patterns differed between the sexes. These findings indicate that the prescriptions for TMD treatment changed over the years; these results may be useful in the development of future clinical guidelines and should be reflected in future guidelines.
尽管有关于颞下颌关节紊乱病（TMD）的临床实践指南，但目前关于临床实践趋势的研究证据很少。
本研究旨在分析韩国 9 年来 TMD 治疗趋势和模式，以及患者特征的影响。
使用了 2010-2018 年韩国健康保险审查和评估服务国家患者样本数据。共纳入了 109969 名每年至少被诊断为 TMD 作为主要诊断的患者。按年度分析了就诊类型和治疗方法。然后，通过 K-medoids 聚类分析，根据患者特征分析治疗模式。
药物治疗中最常用的药物是非甾体抗炎药（NSAIDs）和松弛剂。阿片类药物、抗焦虑药和抗抑郁药的处方减少。在非药物治疗中，物理治疗应用最广泛，且其应用逐年增加。聚类分析表明，治疗模式通常因性别而异；女性患者的门诊就诊率、NSAIDs、松弛剂和物理治疗的使用率较高。
本研究表明，2010 年至 2018 年 TMD 治疗处方发生了变化，发现了 NSAIDs、松弛剂、阿片类药物、抗焦虑药、抗抑郁药和物理治疗方面的显著趋势。此外，性别之间的治疗模式存在差异。这些发现表明，TMD 治疗的处方多年来发生了变化；这些结果可能有助于未来临床指南的制定，并应反映在未来的指南中。
