- 期刊
中醫與口腔顎面外科合併治療之顳顎關節疾患病例報告
Temporomandibular Disorder under combined treatments of Traditional Chinese Medicine and Oral and Maxillofacial Surgery: A Case Report
摘要
患者為20歲女性，張口聲響數月後突發右側面部疼痛，於晨起張口、咀嚼更甚，伴右側肩頸緊繃不適、長期眠差且易於緊張。患者於109年8月5日至口腔顎面外科就診，診斷為咀嚼肌群疼痛、雙側顳顎關節可復位之關節盤位移及右側顳顎關節滑膜炎，經藥物及復健治療後，患者張口度改善，但咀嚼肌群疼痛反覆。8月20日起合併中醫治療，中醫診斷為上盛下虛、三焦經氣滯的氣血偏移失衡，治療中以脈診與症狀變化做為觀測方式，使用針刺使患者氣血達到「以平為期」的治療目標，協同處理疼痛及下顎活動度問題。在中西醫合併治療下，患者的顳顎關節功能於一個月內恢復，追蹤亦未復發。本文以中西合作診治的患者為例，探討中醫在顳顎關節疾患治療中的角色。為呈現全貌，文中詳述患者在中西醫兩方的檢查與治療，希望能提供一些不同的參考方向。
並列摘要
We present a case received combination treatments for Temporomandibular disorders (TMD) from Chinese medicine and Oral and maxillofacial surgery. The 20-year-old female suffered from pain over right face during opening mouth and chewing, discomforts over right shoulder and neck, and poor sleep quality. The patient also mentioned getting stressed easily. The patient visited Oral and maxillofacial surgery department on 5^(th) August 2020. The diagnosis were tonic contraction myalgia of masticatory muscles, disc displacement with reduction of bilateral temporomandibular joints and synovitis of right temporomandibular joint. The patient's opening mouth distance gained but the myofascial pain of masticatory muscles still on and off after 2 weeks of conservative treatment in Oral and maxillofacial surgery department. Therefore, the patient was suggested to receive combination treatment with Chinese medicine. The patient was diagnosed with syndrome of upper excess and lower deficiency with qi stagnation in Chinese medicine, and mainly received acupuncture and health education. Within one-month treatment, the patient recovered with normal function of temporomandibular joints and free of pain.