| ObjectiveTo observe the clinical efficacy of acupuncture combined with 3-step manual therapy on temporomandibular disorder,and to explore a targeted and comprehensive method for the treatment of temporomandibular disorder.MethodsIn this study,118 patients who met the inclusive criteria were randomly divided into acupuncture group(n=40),manual therapy group(n=36),acupuncture + manual therapy group(n=42).All groups are treated on the basis of health education.In acupuncture group,acupoints such as Xiaguan,Xiache,Shangguan,Tinggong,Yifeng,Quanliao and Hegu on the injured side were selected,and using the insertion and twisting method and mild-reinforcing method,then retaining the needle for 30 mins and doing hand-manipulating of needles every 10 mins.The patients in the 3-step manual therapy group are treated with soft tissue releasing,mobilization with movement and joint coordination training.The patients in acupuncture + manual therapy group are treated with acupuncture combined with 3-step manual therapy,the acupuncture method used in this group is the same as that in acupuncture group while the 3-step manual therapy is the same as the method in manual therapy group.The treatments are all given 3 times every week,and the course of these treatments is 2 weeks,and three groups are given 1 to 2 course.Then,comparing the clinical treatment effect to the change of the visual analog scale(VAS),the maximum active mouth opening(MMO),the clicking level of the joint and the disorder index of the temporomandibular joint before and after these treatments.Results(1)The cure rate of the acupuncture group,the manual therapy group and the acupuncture + manual therapy group is separately 63%,75% and 83%,which shows that the cure rate of acupuncture + manual therapy group is obviously highest.(2)After treatment,the VAS of the three groups are decreased(P < 0.01)and the difference between them before and after treatment is extremely significant(P < 0.01);the VAS of the acupuncture + manual therapy group and acupuncture group is obviously lower than that in manual therapy(P < 0.01);and there is no obvious difference between the VAS of the acupuncture + manual therapy group and acupuncture group(P > 0.05).After the treatment,all the clicking levels are decreased(P < 0.01)and there are significant differences in the clicking level between the three groups before and after treatment(P < 0.01).The clicking levels of the acupuncture + manual therapy group and manual therapy group is obviously lower than that in acupuncture group(P < 0.01)and no obvious difference between acupuncture + manual therapy group and manual therapy group(P > 0.05).The MMO of the three groups has increased after the treatment(P < 0.01)and no obvious difference among them(P > 0.05).(3)General Friction index: and after the treatment,the DI,PI,CMI of the three groups are significantly reduced(P < 0.01),among the three groups,the difference in DI after treatment are extremely obvious(P < 0.01)and the differences in PI,CMI after treatment are obvious(P < 0.05);the DI of the acupuncture + manual therapy group and manual therapy group is extremely lower than that in acupuncture group(P < 0.01)while there is no obvious difference between the DI Index of the acupuncture + manual therapy group and manual therapy group(P > 0.05).The PI Index of the acupuncture + massage group and acupuncture group is extremely lower than that in the manual therapy group(P < 0.01)while there is no obvious difference between the PI in the acupuncture + manual therapy group and acupuncture group(P > 0.05)and the PI of the acupuncture group is extremely lower than that in the manual therapy group(P < 0.05).The CMI of the acupuncture + manual therapy group is extremely lower than that of the acupuncture group(P < 0.01)and manual therapy group(P < 0.05)while there is no obvious difference between the CMI of the acupuncture group and manual therapy group(P > 0.05).ConclusionAcupuncture,3-step manual therapy and acupuncture combined with 3-step manual therapy can treat the temporomandibular joint disorder,all of them can improve the syptoms of pain,restrict clicking level and mouth,and reduce the Fricton Index(DI,PI,CMI),but they have different emphases on improving their clinical symptoms and joint function.The effect of the acupuncture on reducing clicking level and DI Index is not obvious,so as the 3-step manual therapy on reducing pain level and PI Index.Acupuncture combined with 3-step manual therapy can not only improve the symptoms of the pain,joint clicking and the limitation of mouth opening,reduce DI/PI Index,but also have more advantages in improving CMI,so as to treat TMJ disorders more comprehensively in terms of clinical symptoms and functions,worthy of clinical promotion. |
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