目的 观察冲击波疗法结合康复训练治疗颞下颌关节功能紊乱的临床效果。 方法 60例颞下颌关节功能紊乱病患者分成治疗组和对照组，每组30例，治疗组给予冲击波治疗+常规康复训练，对照组给予常规康复训练。治疗2周后，应用颞下颌关节功能评价（Friction指数法）分别评定两组患者治疗前后颞下颌功能状况，目测类比法（VAS）疼痛评分评价疼痛程度，SF-36量表评估生活质量。 结果 治疗2周后，两组颞下颌关节功能评价和VAS疼痛评分均较治疗前明显下降（P<0.05），治疗组患者的下颌运动分、关节弹响、关节触压痛、肌肉触压诊分、肌肉触压痛指数、功能障碍指数及颞下颌关节紊乱指数明显低于对照组（P<0.05）。VAS疼痛评分治疗组与对照组相比差异有统计学意义（P<0.05）。SF-36量表中社会功能治疗组较对照组相比差异有统计学意义（P<0.05）。 结论 冲击波疗法结合常规康复治疗可明显改善颞下颌关节紊乱病的功能障碍。 Objective To study the therapeutic effects of extracorporeal shock wave therapy (ESWT) on temporomandibular joint disorders (TMDs). Methods Sixty patients with a temporomandibular joint disorder were randomly divided into an ESWT group and a control group, each of 30. Both groups were given routine rehabilitation training, but the treatment group additionally received ESWT for 2 weeks. Fricton′s index was used to evaluate temporomandibular joint function. The subjects used a visual analogue scale (VAS) to evaluate their pain levels. The SF-36 scale was applied to assess their life quality. Results After two weeks of treatment, the average assessment score and VAS score had decreased significantly in both groups. After treatment the average scores for mandibular movement, muscle palpation, joint noise and joint palpation, and the palpation, dysfunction and craniomandibular indexes were all significantly lower in the ESWT group than in the control group. Significant differences were also found in the average VAS scores and on the social functioning domain of the SF-36 between the ESWT group and the control group. Conclusion ESWT combined with rehabilitation training can significantly relieve the symptoms and pain of TMDs
