A 型肉毒毒素对减轻颞下颌关节功能障碍患者慢性紧张性头痛的疗效

Ihor Anatoliiovych Shynchukovskyi
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摘要

颞下颌关节功能障碍的发病率很高,根据最近的研究,其发病率约占总人口的 34%。颞下颌关节功能障碍的一个主要症状是咀嚼肌紧张度增加,因此患有这种功能障碍的人经常会感到紧张性头痛。向这些肌肉注射 A 型肉毒杆菌毒素可减轻功能障碍,因为这种药物可抑制神经肌肉冲动,从而减轻肌肉紧张。本研究旨在评估通过在咀嚼肌触发点注射 A 型肉毒毒素缓解颞下颌关节功能障碍患者慢性紧张性头痛的疗效。60名有颞下颌关节功能障碍和慢性紧张性头痛症状的患者参加了这项研究。他们被随机分配到接受 A 型肉毒毒素注射的实验组或接受生理盐水咀嚼肌注射的对照组。注射部位为肌肉张力最高的咀嚼肌和颞肌。采用视觉模拟疼痛量表对慢性紧张型头痛的缓解情况进行评估。结果表明,与对照组相比,实验组的头痛强度在统计学上有显著降低(P<0.001)。此外,根据用药前后 12 周的头痛强度,实验组的治疗效果显著(P<0.001)。
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EFFICACY OF BOTULINUM TOXIN TYPE A IN REDUCING CHRONIC TENSION HEADACHE IN PATIENTS WITH TEMPOROMANDIBULAR JOINT DYSFUNCTION
There is a notable prevalence of temporomandibular joint dysfunction, reaching approximately 34% in the general population according to the recent studies. Individuals with such dysfunction often experience tension headaches due to increased tension in the masticatory muscles, a key symptom of temporomandibular joint dysfunction. Botulinum toxin type A injections into these muscles are utilized to alleviate the dysfunction, as this drug inhibits neuromuscular impulses, thereby reducing muscle tension. This study aimed to assess the efficacy of alleviating chronic tension headaches in patients with temporomandibular joint dysfunction through botulinum toxin type A injections into trigger points of the masticatory muscles. Sixty patients exhibiting signs of temporomandibular joint dysfunction and chronic tension headaches participated in the study. They were randomly assigned to either an experimental group receiving botulinum toxin type A injections or a control group receiving saline injections into the masticatory muscles. Injections were administered at sites with the highest muscle tension in the masseter and temporalis muscles. The reduction in chronic tension-type headaches was evaluated using a visual analogue pain scale. The results indicated a statistically significant decrease in headache intensity in the experimental group compared to the control group (P<0.001). Furthermore, the experimental group demonstrated significant treatment efficacy based on headache intensity before and after 12 weeks from the drug administration date (P<0.001).
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