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[经皮电刺激神经疗法(TENS)缓解磨牙症的肌肉松弛作用。一项肌电图研究]

[Muscle relaxation by transcutaneous electric nerve stimulation (TENS) in bruxism. An electromyographic study].

作者信息

Frucht S, Jonas I, Kappert H F

机构信息

Abteilung Poliklinik für Kieferorthopädie, Albert-Ludwigs-Universität, Freiburg i. Br.

出版信息

Fortschr Kieferorthop. 1995 Sep;56(5):245-53. doi: 10.1007/BF02299665.

Abstract

In recent years transcutaneous electrical neuromuscular stimulation (TENS) has become increasingly more common in the treatment of functional diseases of the masticatory muscles and currently the practitioner can choose among a variety of stimulators. In an electromyographic study of 17 adults suffering from nocturnal bruxism and of a control group consisting of 18 adults without any functional disturbances of the masticatory muscles, the effect of this kind of neuromuscular stimulation on the temporal and masseter muscle was examined. The myoelectric signals were registered before and after TENS treatment in 3 different positions of the mandible. Each person was treated 3 times with both the Myo-Monitor (Myo-Tronics, Seattle) and the TNS SM2 MF stimulator (schwa-medico, Giessen). The different effects of continuous low frequency and intermittent high frequency muscular stimulation were studied simultaneously. Muscular activity was determined by computer aided integration of the electromyographically measured raw signals. A fourier analysis of the power spectrum yielded information on the frequency behavior of the studied muscles resulting from the TENS treatment. A statistical analysis of the results led to the following significant conclusions: 1. TENS treatment decreased the values of the registered integrated signals on all test persons, however, the treatment increased the median frequency and the mean power frequency (MPF). Since this effect is contrary to muscle fatigue, these electromyographic results can be interpreted as providing objective proof of a relaxation in the treated muscles. 2. The electromyographic changes after TENS treatment were similar when using either the Myo-Monitor or the TNS SM2 MF stimulator. In addition, the 2 different types of stimulation (high or low frequency) showed the same effects. 3. Compared to the persons in the control group, there was no significant increased muscular activity in patients with nocturnal bruxism. Following TENS treatment both groups showed the same alterations in the electromyograms. The results of the study provide further evidence that TENS treatment is an adequate supportive procedure in the treatment of nocturnal bruxism.

摘要

近年来,经皮电刺激神经肌肉疗法(TENS)在咀嚼肌功能性疾病的治疗中越来越普遍,目前从业者可以在多种刺激器中进行选择。在一项针对17名患有夜间磨牙症的成年人以及由18名无咀嚼肌功能障碍的成年人组成的对照组的肌电图研究中,考察了这种神经肌肉刺激对颞肌和咬肌的影响。在下颌骨的3个不同位置记录了TENS治疗前后的肌电信号。每个人分别使用Myo - Monitor(Myo - Tronics,西雅图)和TNS SM2 MF刺激器(schwa - medico,吉森)进行了3次治疗。同时研究了连续低频和间歇性高频肌肉刺激的不同效果。通过计算机辅助积分肌电图测量的原始信号来确定肌肉活动。对功率谱进行傅里叶分析,得出了TENS治疗后所研究肌肉的频率行为信息。对结果的统计分析得出了以下重要结论:1. TENS治疗使所有测试对象记录的积分信号值降低,然而,治疗增加了中频和平均功率频率(MPF)。由于这种效应与肌肉疲劳相反,这些肌电图结果可解释为为治疗肌肉的放松提供了客观证据。2. 使用Myo - Monitor或TNS SM2 MF刺激器时,TENS治疗后的肌电图变化相似。此外,两种不同类型的刺激(高频或低频)显示出相同的效果。3. 与对照组人员相比,夜间磨牙症患者的肌肉活动没有显著增加。TENS治疗后,两组的肌电图变化相同。该研究结果进一步证明,TENS治疗是治疗夜间磨牙症的一种适当的辅助方法。

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