慢性咀嚼肌疼痛患者面部和手指电刺激痛阈的初步观察

目的 通过测定和对比慢性咀嚼肌痛(masticatory muscle pain,MMP)患者及健康对照组双侧咬肌区、双侧颞肌区及左手中指的电刺激感觉阈和痛阈,初步探讨慢性MMP患者的三叉神经感觉功能是否出现变化.方法 收集慢性MMP患者12例(慢性MMP患者组),以及年龄、性别与慢性MMP患者组相似的健康对照者12名(健康对照组),分别行咬肌区、颞肌区疼痛的视觉模拟量表(visual analogy scale,VAS)评分;对两组双侧咬肌区、双侧颞肌区和左手中指的电刺激感觉阈和痛阈进行榆查.对两组5个部位的电刺激感觉阈和痛阈进行分析对比.结果 与健康对照组相比,慢性MMP患者组左侧咬肌、右侧咬肌、左侧颞肌、右侧颞肌和左手中指的电刺激痛阈均明显降低[分别为(5.9±1.1)、(5.7±1.0)、(5.3±1.4)、(5.5±1.7)和(5.2±1.0)mA],差异均有统计学意义(F=24.433,P＜0.001);而两组电刺激感觉阈的差异无统计学意义(F=0.341,P=0.959).慢性MMP患者组VAS得分与咀嚼肌电刺激感觉阈和痛阈之间未发现相关关系.结论 相比健康对照组,慢性MMP患者的咬肌、颞肌及手指的电刺激痛阈均显著降低,提示患者三叉神经感觉功能出现变化,其机制可能涉及高级神经中枢.

Electrical pain thresholds of face and finger in patients with chronic masticatory muscle pain

Objective To compare electrical sensory threshold(EST)and electrical pain threshold(EPT)of bilateral masseters,temporal muscles and finger region of chronic masticatory muscle pain(MMP)patients and the controls,and to analyze the mechanism of pain threshold change.Methods Twelve patients with MMP and 12 matched controls participated in this study.EST and EPT of bilateral masseters,bilateral temporal muscles,and left middle finger were recorded and compared within group and between groups. Results Compared to the controls,the EPTs of patients significantly decreased[left masseter(5.9±1.1)mA,right masseter(5.7±1.0)mA,left temporal muscle(5.3±1.4)mA,right temporal muscle(5.5±1.7)mA,finger(5.2±1.O)mA](P＜0.001).There Was no significant difference in EST between patients and the controls.No relationship Was found among VAS,ESP,and EPT. Conclusions Decreased pain thresholds of masseters,temporal muscles and fingers in MMP indicated that peripheral sensitization Was induced in MMP patients.Decreased pain threshold in patients meant that MMP might influence the central modulation of nervous system.