目的 分析医用几丁糖治疗不可复性关节盘前移位患者的临床疗效及其对患者生活质量、恐惧疾病进展的影响。方法 将200例确诊为不可复性关节盘前移位患者分为2组,实验组以颞下颌关节微创灌洗术联合几丁糖治疗,对照组采用单一颞下颌关节微创灌洗术治疗,分别于治疗前和治疗后1、3、6、12个月采用一般资料调查表、口腔健康影响程度量表（OHIP）-14中文版、恐惧疾病进展简化量表（FoP-Q-SF）、视觉疼痛模拟量表等进行问卷调查并进行统计学分析。结果 治疗后,2组患者最大张口度、疼痛评分、生活质量及恐惧疾病进展水平较治疗前明显改善（P>0.05）,且2组间比较,颞下颌关节微创灌洗术联合医用几丁糖在临床效果、生活质量及恐惧疾病进展水平长期效果明显优于单一颞下颌关节微创灌洗术（P>0.05）。结论 颞下颌关节微创灌洗术单一应用或联合医用几丁糖均对不可复性关节盘前移位患者疗效良好,对提升患者生活质量和缓解恐惧心理方面也有着重要意义,其中不可复性关节盘前移位联合应用几丁糖的长期疗效优于其单一应用。

Objective To analyze the efficacy of medical chitosan and its effect on the quality of life and fear of disease progression of patients with anterior disc displacement without reduction．Methods A total of 200 patients with anterior disc displacement without reduction were selected and divided into two groups,the experimental group was treated with temporomandibular joint lavage and medical chitosan,the control group was treated with temporomandibular joint lavage only．Before and after treatment with 1 month,3 months,6 months and 12 months,general data questionnaire,OHIP-14 Chinese version,FoP-Q-SF and visual analogue scale were used to investigate and the data were analyzed statistically．Results After treatment,the maximum mouth opening degree,pain score,quality of life and fear of disease progression were significantly improved compared with those before treatment,the differences were statistically significant（P>0.05）．The long-term curative effect of the temporomandibular joint lavage and medical chitosan was better than that of the temporomandibular joint lavage only in clinical outcome,quality of life and fear of disease progression（P>0.05）．Conclusions Temporomandibular joint lavage combined with medical chitosan and temporomandibular joint lavage only are effective in the treating anterior disc displacement without reduction,and can improve the quality of life and fear of disease progression,while the combined treatment has better long-term effect．

目的 评估关节松动联合运动疗法对颞下颌关节慢性不可复性盘前移位患者的疗效。方法 采用随机对照方法,将46例慢性不可复性盘前移位患者随机分为联合治疗组(n=24)及对照组(n=22), 对照组仅接受传统治疗(包括超短波、超声波、软组织按摩及健康教育),治疗组在传统治疗的基础上应用关节松动联合运动疗法。在治疗前和治疗后2周采用最大张口度(maximal interincisal opening,MIO)、目测类比法(visual analog scale,VAS)、口腔健康影响程度量表(health impact profile-14,HIP-14)评价疗效。结果 治疗前两组患者一般情况类似。治疗后两组颞下颌关节MIO、VAS、HIP-14得分较治疗前改善(P<0.05),组间比较,治疗组在MIO、VAS、HIP-14评分比对照组改善(P<0.05)。结论 关节松动联合运动疗法治疗颞下颌关节慢性不可复性盘前移位疗效明显,值得推广。

Objective To evaluate the effectiveness of joint mobilization combined with therapeutic exercise in patients with chronic anterior disc displacement without reduction of temporomandibular joints. Methods 46 patients with chronic anterior disc displacement without reduction were randomly divided into two groups. The treatment group of 24 cases received joint mobilization combined with therapeutic exercise and conventional therapy (ultrashort-wave diathermy, ultrasound therapy, soft tissue massage, health education), 22 cases in the control group received conventional treatment.The treatment was administered for 2 weeks. The baseline and endpoint outcome assessment measures were maximal interincisal opening (MIO),visual analogue scale(VAS)score and oral health impact profile (HIP-14). Results After the treatment, significant improvements were observed in the two groups of all the outcome measurements (P<0.05).Maximal interincisal opening, visual analogue scale and oral health impact profile were improved significantly in the treatment group than in the control group (P<0.05). Conclusion Joint mobilization combined with therapeutic exercise can improve the symptoms of chronic anterior disc displacement without reduction.