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題 名 | 顳顎障礙分類中單項與多項診斷族群間之差異=The Differences between Single and Multiple Diagnostic Groups in the Classification of Temporomandibular Disorders |
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作 者 | 王若松; 林立德; 洪志遠; 蔡宗一; 林俊彬; 李萬萱; 蕭裕源; | 書刊名 | 中華牙醫學雜誌 |
卷 期 | 18:3 1999.09[民88.09] |
頁 次 | 頁207-216 |
分類號 | 416.94 |
關鍵詞 | 顳顎障礙; 診斷分類; 單項與多項診斷; Temporomandibular disorders; Diagnostic classification; Single and multiple diagnosis; |
語 文 | 中文(Chinese) |
中文摘要 | 顳顎障礙的分類在臨床上及研究上皆日形重要。本研究的目的在瞭解分類中具單 項與多項診斷族群間的差異。研究中選取臺大顳顎障礙特別門診就診之1201位病患,依照訂 定之納入標準將病患診斷為咀嚼肌障礙、關節盤移位及關節痛及/或關節炎。由於並未訂立 排除標準因此病患可能具單項或多項診斷。結果顯示有56.9%病患為單項診斷,41.7% 病患 具多項診斷,另有1.4%病患無初步診斷。 診斷中包含咀嚼肌障礙者佔65%,包含關節盤移位 病患佔42.4%,而包含關節痛及/或關節炎病患佔24.6%。以統計觀察各分類中單項診斷與多 項診斷族群間之差異,結果顯示在三種分類的單項診斷族群間,以單項變異數分析顯示年 齡(p<0.001)、就診前帶病期(p<0.01)及最大張口程度(p<0.001)在組間具顯著差異;關節 盤移位單項診斷病患之平均年齡最輕(29.4歲),就診前帶病期最長(24.48個月),並且 最大張口程度最大(43.9毫米)。在各分類中包含咀嚼肌障礙與包含關節盤移位病患中,其 單項與多項診斷族群間在年齡分布(p<0.01),就診前帶病期(p<0.05)與最大張口程度 (p<0.05)皆具統計上明顯之差異;但在關節痛及/或關節炎病患中單項與多項診斷族群間 皆不具明顯差異。基於本研究之結果我們認為在部分顳顎障礙的分類中訂立清楚排除標準所 造成的單項診斷族群所代表的意義可能不同於包含多項診斷的同類族群。 |
英文摘要 | Classification of temporomandibular disorders (TMD) is very important for both clinical management and research purposes. The objective of this study was to evaluate the differences between single and multiple diagnostic groups in TMD classification. Our study included 1201 patients who visited the TMD clinic of National Taiwan University Hospital from September 1993 to September 1995. After clinical examination, patients were classified into muscular disorder, disc displacement and arthralgia and or arthritis groups according to the defined inclusion criteria. Because no exclusion criteria were used, patients could have more than one diagnosis. The results showed that 56.9% of the patients had a single diagnosis, 41.7% had multiple diagnoses and 1.4% was not diagnosed at the first visit. Among them, 65% of patients had the diagnosis including muscular disorders, 42.4% had disc displacements, and 24.6% had arthralgia and/or arthritis. There were significantly different between single and multiple dia gnostic groups in age distribution (p<0.01), disease duration (p<0.05) and maximum mouth opening ability (p<0.05) if the diagnosis included muscular disorders or disc displacements. However in the patients with the diagnosis of arthralgia and/or arthritis, there was no statistical difference. Based on these findings we conclude that patients in a single diagnostic group derived from clear inclusion and exclusion criteria in some TMD classifications might exhibit clinical features which are different from th ose in multiple diagnostic groups. |
本系統中英文摘要資訊取自各篇刊載內容。