Clinical Effect Observation Of Needling Distal Point Along Meridian Plus Exercising Combined With Ultrasound In The Treatment Of Temporomandibular Disorders

Objective: To observe the clinical efficacy of needling distal point along meridian plus exercising combined with ultrasound in treating temporomandibular disorders,and through clinical symptoms and functional scores,objective evaluation of the effects.To provide the clinical application basis for needling distal point along meridian plus exercising is used for treating temporomandibular disorders.Methods: A total of 90 patients with temporomandibular disorders who meet the inclusion criteria and exclusion were selected,and the patients were divided into group A,group B and group C,according to the time sequence of the first visit using the random number table method,30 cases in each group.Group A adopted the ultrasound method;group B adopted acupuncture at distal points along the meridian combined with ultrasound method;group C adopted needling distal point along meridian plus exercising combined with ultrasound method,that is,instruct patients to take continuous,slow mouth and held activities on the basis of acupuncture.Once a day,6 times a week,2weeks are a course of treatment,a total of 2 courses of treatment.The scores of visual analogue scale(VAS),maximum active mouth opening(MMO)and craniomandibular index fricton of the three groups were observed respectively.The clinical efficacy of the three groups was evaluated and compared according to the scores of each group.The data obtained were statistically analyzed using the software SPSS 26.0.Results:1.5 cases were removed or dropped during the trial process,28 cases in group A,29 cases in group B,28 cases in group C completed the test.2.VAS score: Before treatment,using the nonparametric test statistics,there was no significant difference between the three groups(P=0.678>0.05),suggesting VAS score of three groups were comparability.After treatment,after comparison within the group,VAS scores of three groups of patients were lower than before treatment,the difference is statistically significant(P<0.05).After multiple comparisons,group C compared with group A,P=0.000<0.05,and compared with group B,P=0.013<0.05,group B compared with group A,P=0.039<0.05,statistically significant difference,indicating that group C is better than group A and B in reducing pain,and group B is better than group A.3.MMO: Before treatment,comparing the differences in MMO of the three groups of patients by one-way analysis of variance,P=0.269>0.05,no statistical significance,and comparable.After treatment,after comparison within the group,the MMO of the three groups of patients were enlarger than before treatment,which was statistically significant(P<0.05),indicating that the three treatment methods were all effective in enlarging the MMO.Further multiple comparisons afterwards,no significant difference between group A and B(P=0.062>0.05),prompt there was no significant difference between group A and B in enlarging the MMO.And then,group C compared with group A and B,P<0.05,indicating that group C is better than group A and B in enlarging MMO.4.Fricton index: Before treatment,after one-way analysis of variance,P>0.05,there was no significant difference,and comparable.After treatment,DI,PI and CMI scores of the three groups of patients are non normal distribution,using the nonparametric test statistics,the difference is statistically significant(P<0.05),indicating that the DI,PI and CMI scores of the three groups of patients were lower than before treatment.After multiple comparisons,the score of group C was significantly lower than that of group A and B,P=0.000<0.05,P=0.011<0.05,and group A compared with group B,P=0.023<0.05,the difference is statistically significant.Indicating that group C is better than group A and B in improving patients’ function of the temporomandibula joints,and group B is better than group A.5.Comparison of clinical efficacy: The total effective rate was 75.00% in group A,86.21% in group B,and 92.86% in group C.The rank sum test showed that P<0.05,the difference was statistically significant.Further comparison between group C and group A,B,and group B compared with group A,P<0.05 and the difference was statistically significant,indicating that the overall efficacy of group C was better than that of group A and B,and group B was better than group A.Conclusion:1.Ultrasound method,acupuncture at distal points along the meridian combined with ultrasound method,needling distal point along meridian plus exercising combined with ultrasound method can significantly improve the pain and maximum active mouth opening and patients’ function of the temporomandibula joints,and the curative effect is positive.2.The effect of needling distal point along meridian plus exercising combined with ultrasound method on temporomandibular disorders is better than ultrasound method and acupuncture at distal points along the meridian and ultrasound method,and the effect of acupuncture at distal points along the meridian combined with ultrasound method is better than ultrasound method,but the effect in enlarging the MMO is quite.