Longitudinal outcome of temporomandibular disorders: a 5-year epidemiologic study of muscle disorders defined by research diagnostic criteria for temporomandibular disorders.
Longitudinal outcome of temporomandibular disorders: a 5-year epidemiologic study of muscle disorders defined by research diagnostic criteria for temporomandibular disorders.
复制标题
DOI：
--
复制
发表时间：
2003
影响因子：
--
通讯作者：
P. Rammelsberg;L. Leresche;S. Dworkin;L. Mancl
中科院分区：
文献类型：
--
作者：
P. Rammelsberg;L. Leresche;S. Dworkin;L. Mancl
目的研究颞下颌关节紊乱病(RDC/TMD)研究诊断标准(RDC/TMD)所定义的肌筋膜痛的病程，并从基线数据中找出预后因素。方法从年龄分层的代表性人群样本中选取155例患者和80例社区患者作为研究对象，均符合报告颞下颌关节(TMJ)或咀嚼肌疼痛的主要选择标准。这两组人结合在一起，产生了235名受试者(男性50人，女性185人；平均年龄=39岁)。受试者在基线、1年、3年和5年由训练有素的考官使用标准化、可靠的方法进行评估。心理和行为因素采用自评量表进行评定。结果根据RDC/TMD标准，在165例基线表现为肌筋膜痛(MFP)的受试者中，有50例(31%)在5年内继续存在肌筋膜疼痛，55例(33%)缓解，60例(36%)复发。双变量统计和多因素Logistic回归分析表明，基线疼痛频率、疼痛触诊部位数量和身体疼痛部位总数是持续性与缓解性和复发性病例的显著预测因素。尚不能确定区分缓解和复发的预测因素。在70名基线未被诊断为MFP的受试者中，有30名出现了新的MFP。高基线躯体化评分(不含疼痛项目)是MFP发病的重要危险因素。结论肌肉疾患按RDC/TMD分类以慢性或波动性疼痛为主，缓解率适中(31%)。
AIMS To investigate the course of myofascial pain defined by Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) over a period of 5 years, and to identify prognostic factors from baseline data. METHODS Subjects were 155 consecutive patients and 80 community cases identified from an age-stratified representative population sample; all met the primary selection criterion of reporting pain in the temporomandibular joint (TMJ) or masticatory muscles. The 2 groups were combined to yield a total sample of 235 subjects (50 male, 185 female; mean age = 39 years). Subjects were evaluated at baseline, 1 year, 3 years, and 5 years by trained examiners using standardized, reliable methods. Psychological and behavioral factors were assessed by self report. RESULTS According to RDC/TMD criteria, 50 (31%) of the 165 subjects presenting with myofascial pain (MFP) at baseline continued to have their disorder over a period of 5 years; 55 (33%) remitted, and 60 (36%) were recurrent cases. Bivariate statistics and multivariate logistic regression analyses indicated that baseline pain frequency, number of painful palpation sites, and total number of body sites with pain were significant predictors of persistent vs remitted and recurrent cases. No predictors that distinguished remission vs recurrence could be identified. Thirty subjects from the 70 without a diagnosis of MFP at baseline developed a new MFP. A high baseline somatization score (without pain items) was a significant risk factor for onset of MFP. CONCLUSION Muscle disorders classified by RDC/TMD are predominantly chronic or fluctuating pain conditions, with a modest probability (31%) of remission.