Міждисциплінарний підхід у лікуванні пацієнтів із больовою дисфункцією скронево-нижньощелепного суглоба на фоні остеохондрозу шийного відділу хребта

Abstract

Алгоритм лікування хворих із больовою дисфункцією СНЩС на фоні остеохондрозу шийного відділу хребта складався із застосування мануальної терапії, ЦИГУН-терапії, рефлексоаналгезії, світлолікування, виготовлення індивідуальної суглобової капи, профілактики ускладнень з урахуванням виконання індиві- дуальної програми реабілітації. Одержані позитивні результати застосування запропонованого алгоритму лікування 14 пацієнтів у терміни від 2 до 4,5 місяців, які підтверджені клінічними і параклінічними дослі- дженнями. ; Алгоритм лечения больных с болевой дисфункцией височно-нижнечелюстного сустава на фоне ос- теохондроза шейного отдела позвоночника состоял из применения мануальной терапии, ЦИГУН- терапии, рефлексоаналгезии, светолечения, изготовления индивидуальной суставной каппы, профилак- тики осложнений с учетом выполнения индивидуальной программы реабилитации. Получены положите- льные результаты применения предложенного алгоритма лечения 14 пациентов в сроки от 2 до 4,5 ме- сяцев, которые подтверджены клиническими и параклиническими исследованиями. ; According to the literature in present Ukraine, 80% of young people aged 18 to 39 years diagnosed osteochondrosis. This is primarily manifested by dizziness, headache in the occipital region, tinnitus. With head- turning set of symptoms may increase and sharp movement often leads to loss of consciousness. Such symptoms manifested by temporo-mandibular pain-dysfunction syndrome, which is characterized by the presence of trigger points of muscles of the head, headache different nature and location of pain in the neck, ears, in the joints, tooth-ache, cracking and crunching during opening or closing the mouth. This condition conducive to long monotonous working at the computer, the same type of movements of the head and neck associated with the profession. In these cases, there are destructive changes of cartilage with subsequent salt deposits, deteriorating shock absorbing properties of intervertebral discs having pain and discomfort. Concomitant factors that accelerate the development of disease is dynamic and static overloading, back injury, vibration. Therefore, the aim of our study was to: 1.Create a new algorithm for the treatment of patients with temporomandibular pain-dysfunction syndrome against the backdrop of cervical osteochondrosis; 2.Verify the effectiveness of methods of anesthesia in patients with temporo-mandibular pain-dysfunction against the backdrop of cervical osteochondrosis in applying acupuncture and light therapy; 3.Estimate the effectiveness of the proposed algorithm for treatment. Clinical observations were carried out in 14 patients (7 men and 7 women aged 20 to 37 years). Diagnosis and treatment of these patients was carried out jointly with the osteopath, and prosthodontist. The specificity of the treatment effect was in pain components in patients in problem areas right and left temporo-mandibular joint and cervical spine using non-traditional methods (methods for acupuncture analgesia Peking school, phototherapy - blue light (B2 mode) apparatus LuxDent «UFL 122» use applicator Lyapko, methods of Chi Kung therapy). We proposed treatment algorithm included: 1.Eliminating pain component in the region of the right and left temporo-mandibular joint and cervical spine (osteopaths , Chi Kung Therapy , acupuncture analgesia, blue light (B2) apparatus LuxDent «UFL 122». 2.Prevention complications of occlusion (making an orthopedic mouthguards for temporary fixation of prosthetic occlusion followed if it is necessary). 3.Fixing the outcome of the central bite central occlusion. 4.Prevention of complications (patients individual work at home Chi Kung - therapy, massage , exercises of recreational gymnastics). 5.Consummation and stabilization the process based on the performance of individual rehabilitation program prepared for each patient. As a result of applying our proposed algorithm of treatment in this group of patients over a period of 2 to 4.5 months of positive results to help you believe this algorithm is effective when used in integrated the multidisciplinary approach to treating patients with temporo-mandibular pain-dysfunction against the backdrop of cervical osteochondrosis. The feasibility of using our proposed treatment of clinical and paraclinical research results were conducted.