活血化瘀方结合翼外肌封闭法对风寒瘀阻型颞下颌关节功能紊乱综合征患者的影响

摘要

AIM To investigate the clinical effects of Huoxue Huayu Decoction (Angelicae sinensis Radix,Saposhnikoviae Radix,Schizonepetae Herba,etc.) combined with musculus pterygoideus lateralis closure in managing patients with temporomandibular joint dysfunction syndrome (TMJ) due to wind-cold stasis.METHODS From January 2015 to December 2015,68 cases of patients with TMJ due to wind-cold stasis identified and recruited by the department of stomatology of Hebei Provincial Hospital of Traditional Chinese Medicine were randomly assigned to treatment group and control group,each with 34 cases and given the musculus pterygoideus lateralis closure.But the treatment group was administered with an extra two-week adjuvant therapy of Huoxue Huayu Decoction,and generally one week such medication was taken as a therapeutic course.RESULTS After the intervention,the treatment group presented an overall better performance than the control group in terms of the open limit,NRS score,and the differences were statistically significant (P ＜ 0.05);and the values of CMI,PI,DI (P ＜0.05),in contrast to the not significantly varied values between the groups before the intervention (P ＞ 0.05).The treatment group also displayed its advantage if evaluated by TCM criteria,extent of the mandibular movementabnormalities,facial pain,temporomandibular joint sound or noise,irritability,sleeping difficulty,dark purple lips,tongue scores and wind-cold stasis scores (P ＜ 0.05).And generally a remarkably higher total effective rate was observed in the treatment group,and its difference to the control group was statistically significant (P ＜0.05).CONCLUSION Huoxue Huayu Decoction combined with conventional western medicinal approach in the management of TMJ due to wind-cold stasis can achieve a better therapeutic efficacy.%目的 探讨活血化瘀方(当归、防风、荆芥等)结合翼外肌封闭法对风寒瘀阻型颞下颌关节功能紊乱综合征患者的临床效果.方法选取2015年1月-2015年12月在河北省中医院口腔科就诊的68例风寒瘀阻型颞下颌关节紊乱病患者,随机分为治疗组和对照组各34例,两组患者均给予翼外肌封闭法,治疗组同时给予自拟当归活血汤辅助治疗,1周为一个疗程,连续治疗2周.结果治疗后,治疗组患者的最大张口限度大于对照组,NRS评分低于对照组,差异均具有统计学意义(P＜0.05);治疗前两组患者的Fricton指数DI、PI、CMI值差异均无统计学意义(P＞0.05);治疗后,治疗组DI、PI、CMI值均显著低于对照组(P＜0.05);治疗组的下颌运动异常、颌面部疼痛、下颌关节弹响或杂音、烦躁易怒、口唇紫暗、入睡困难、舌象和风寒瘀阻积分均显著低于对照组(P＜0.05);治疗组的愈显率显著高于对照组,差异具有统计学意义(P＜0.05).结论活血化瘀方结合常规西医疗法治疗风寒瘀阻型颞下颌关节功能紊乱综合征时,能够进一步提升治疗效果.