Specific and number of comorbidities are associated with increased levels of temporomandibular pain intensity and duration
Specific and number of comorbidities are associated with increased levels of temporomandibular pain intensity and duration
复制标题
DOI：
10.1186/s10194-015-0528-2
复制
发表时间：
2015-05-20
影响因子：
7.4
通讯作者：
Allison, Paul
中科院分区：
文献类型：
--
作者：
Dahan, Haissam;Shir, Yoram;Allison, Paul
颞下颌关节痛障碍(TMD)是一种常见的面部疼痛状态。患有TMD的人报告说有多种疼痛共病。TMD患者纤维肌痛和偏头痛的出现与TMD疼痛强度和持续时间的增加有关。然而，越来越多的疼痛合并症与TMD疼痛之间的关系的数据很少。这项研究的目的是：首先，评估并发症的增加在多大程度上与TMD疼痛强度和持续时间的增加相关；其次，评估特定并发症的存在与TMD疼痛强度和持续时间增加的关联程度。样本包括180名在波士顿和蒙特利尔诊所寻求TMD治疗的人。使用TMD研究诊断标准对TMD进行诊断。数字疼痛分级量表评估TMD疼痛强度，参与者在研究问卷中提供他们的TMD疼痛持续时间。通过5份有效诊断问卷对偏头痛、慢性疲劳综合征、肠易激综合征、间质性膀胱炎和不宁腿综合征的并存进行诊断。通过对混杂因素进行线性回归分析，发现存在合并症的数量与TMD疼痛强度呈正相关(p<；0.01)，存在合并症的数量与TMD疼痛持续时间(p<；0.01)呈正相关。此外，偏头痛的出现与TMD疼痛强度呈正相关(p<；0.01)，慢性疲劳综合征的出现与TMD疼痛强度(p<；0.05)和TMD疼痛持续时间(p<；0.01)呈正相关。当TMD患者分组时，肌筋膜疼痛组的这些关联没有改变，而在非肌肉筋膜疼痛组中，合并疾病的数量与TMD疼痛持续时间之间的关系仍然存在。本研究表明，合并疾病的数量与TMD疼痛持续时间和强度正相关。特定情况的出现，如偏头痛和慢性疲劳综合征，与TMD强度和持续时间的增加有关。
Temporomandibular pain disorder (TMD) is a common pain condition in the face. People with TMD report multiple pain comorbidities. The presence of fibromyalgia and migraine in people with TMD is associated with an increase in TMD pain intensity and duration. However, data on the relationship between increasing number of pain comorbidities and TMD pain are rare. The aims of this study were: firstly to evaluate the extent to which increasing number of comorbidities is associated with increasing TMD pain intensity and duration; and secondly to evaluate the extent to which the presence of specific comorbidities is associated with increasing TMD pain intensity and duration.The sample included 180 people seeking TMD treatment at Boston and Montreal clinics. TMD was diagnosed using the Research Diagnostic Criteria for TMD. A Numerical Pain Rating Scale assessed TMD pain intensity and participants provided their TMD pain duration in a study questionnaire. The comorbidities of migraine, chronic fatigue syndrome, irritable bowel syndrome, interstitial cystitis and restless leg syndrome were diagnosed by 5 validated diagnostic questionnaires. The associations were analyzed by linear regression, controlling for confounders.There was a positive association between the number of comorbidities present and TMD pain intensity (p < 0.01) and between the number of comorbidities present and TMD pain duration (p < 0.01). Also, the presence of migraine was positively associated with TMD pain intensity (p < 0.01) and the presence of chronic fatigue syndrome was positively associated with TMD pain intensity (p < 0.05) and with TMD pain duration (p < 0.01). When TMD patients were separated into groups, these associations did not change for the myofascial pain group, whereas in the non-myofascial pain group, the relationship between number of comorbidities and TMD pain duration was the only one still present.This study shows that the number of comorbidities is positively associated with TMD pain duration and intensity. The presence of specific conditions, such as migraine and chronic fatigue syndrome, is associated with an increase in TMD intensity and duration.