摘要：

目的： 探讨自体富血小板血浆（platelet-rich plasma，PRP）联合透明质酸（hyaluronic acid，HA）注射治疗颞下颌关节骨关节炎（temporomandibular joint osteoarthritis，TMJOA）的临床疗效。方法： 选取本院于2023年3月—2024年3月收治的82例TMJOA患者，采用随机数字表法将患者分为HA组和联合组，各41例。HA组给予HA注射治疗，联合组在HA组基础上，给予PRP治疗。比较2组患者治疗前（T₀）和末次注射后1周（T₁）的最大张口度（maximum mouth opening，MMO）及MMO变化值、疼痛度及疼痛缓解度、下颌功能受限程度、颞下颌关节紊乱情况及炎症因子水平。结果： T₁时，2组患者MMO较T₀时显著增大（P<0.05），且联合组显著大于HA组（P<0.05）；联合组MMO的变化值及疼痛缓解度显著高于HA组（P<0.05）；T₁时，2组患者疼痛视觉模拟评分法（visual analogue scale，VAS）评分、下颌功能受限表（jaw functional limitation scale，JFLS）评分、颞下颌关节紊乱指数（craniomandibular index，CMI）评分、白细胞介素1β（interleukin-1β，IL-1β）、肿瘤坏死因子α（tumor necrosis factor-α，TNF-α）水平均较T₀时显著降低（P<0.05），且联合组显著低于HA组（P<0.05）。结论： PRP联合HA注射治疗TMJOA的方法可有效改善关节功能和缓解关节疼痛，具有一定临床参考价值。

关键词: 自体富血小板血浆, 透明质酸, 颞下颌关节骨关节炎, 临床疗效

Abstract:

Objective: To investigate the clinical efficacy of autologous platelet-rich plasma (PRP) combined with hyaluronic acid (HA) injection in the treatment of temporomandibular joint osteoarthritis (TMJOA). Methods: Eighty-two TMJOA patients admitted to our hospital from March 2023 to March 2024 were enrolled and randomly assigned to either the HA group or the combination group (n=41 per group) using a random number table. The HA group received HA injection, while the combination group received PRP in addition to HA. The following parameters were compared between the two groups before treatment (T₀) and one week after the final injection (T₁): maximum mouth opening (MMO), change in MMO, pain intensity and pain relief, degree of mandibular functional limitation, status of temporomandibular joint disorders, and levels of inflammatory factors. Results: At T₁, the MMO in both groups had increased significantly compared to T₀ (P<0.05), and the MMO in the combination group was significantly higher than that in the HA group (P<0.05). The change in MMO and pain relief in the combination group were significantly greater than those in the HA group (P<0.05). At T₁, visual analogue scale (VAS) scores, jaw functional limitation scale (JFLS) scores, craniomandibular index (CMI) scores, interleukin-1β (IL-1β) levels, and tumor necrosis factor-α (TNF-α) levels were significantly reduced in both groups compared to T₀ (P<0.05), and these values in the combination group were significantly lower than those in the HA group (P<0.05). Conclusion: PRP combined with HA injection is an effective treatment for TMJOA, as it significantly improves joint function and alleviates pain, providing a reference for clinical practice.

Key words: autologous platelet-rich plasma, hyaluronic acid, temporomandibular joint osteoarthritis, clinical efficacy

中图分类号: 

• 自体富血小板血浆

• 透明质酸

• 颞下颌关节骨关节炎

• 临床疗效

• autologous platelet-rich plasma

• hyaluronic acid

• temporomandibular joint osteoarthritis

• clinical efficacy