体外冲击波联合3M物理治疗颞下颌关节紊乱病的临床疗效分析

目的 探讨体外冲击波（ESWT）联合3M物理治疗颞下颌关节紊乱病（TMD）的临床疗效。方法 选取2021年1月—2022年10月齐齐哈尔医学院附属第二医院收治的40例TMD患者为研究对象，按照随机数字表法分为对照组和观察组，每组20例。对照组采用3M物理治疗（包括物理因子治疗、手法治疗及运动治疗），观察组在对照组的基础上增加ESWT。比较两组治疗前后疼痛情况、最大张口度及颞下颌关节功能。结果 两组治疗前后最大张口度差值比较，差异有统计学意义（P <0.05），观察组高于对照组。两组治疗前后安静、张口及咀嚼状态下视觉模拟评分法差值比较，差异有统计学意义（P <0.05），观察组高于对照组。两组治疗前后关节杂音、关节压诊、下颌运动、肌肉压诊评分，以及颞下颌关节功能障碍指数、肌肉压痛指数、Fricton颞下颌关节紊乱指数差值比较，差异有统计学意义（P <0.05），观察组高于对照组。结论 在3M物理治疗的基础上增加ESWT有利于降低TMD患者疼痛程度，提高最大张口度，促进颞下颌关节功能恢复。

Clinical analysis of extracorporeal shock wave combined with 3M physical therapy for temporomandibular joint disorders

Objective To investigate the clinical effect of extracorporeal shock wave therapy (ESWT) combined with 3M physical therapy on temporomandibular joint disorder (TMD).Methods Forty patients with TMD admitted to our hospital were selected as research objects from January 2021 to October 2022, and they were divided into control group (n = 20) and observation group (n = 20) by random number table. The control group was treated with 3M physical therapy (including physical factor therapy, manual therapy and exercise therapy), and the observation group was treated with ESWT on the basis of the control group. The pain, maximum mouth opening and temporomandibular joint function were compared between the two groups before and after treatment.Results The difference between the two groups before and after treatment was statistically significant (P <0.05), and the observation group was larger than the control group. The difference between the two groups in visual analogue score (VAS) before and after treatment was statistically significant (P < 0.05). The observation group was larger than the control group. The differences between the two groups in the scores of joint murmur (JN), joint compression test (JP), mandibular movement (MM), muscle compression test (MP), and the differences of temporomandibular joint dysfunction index (DI), muscle tenderness index (PI), and Friton temporomandibular joint disorder index (CMI) before and after treatment were statistically significant (P < 0.05), and the observation group was greater than the control group.Conclusion Combined with ESWT on the basis of 3M physical therapy is beneficial to relieve the pain degree of TMD patients, increase the maximum opening limit, and promote the recovery of temporomandibular joint function.