颞下颌关节上下腔注射富血小板血浆或透明质酸治疗颞下颌关节骨关节炎的疗效比较-- 实验原始数据 Original data of "Comparison of Temporomandibular Joint Osteoarthritis Treatment Efficacy of Platelet-rich Plasma and Hyaluronic Acid Injection in Upper or Lower TMJ Space".xlsx

The original data of the research "Comparison of Temporomandibular Joint Osteoarthritis Treatment Efficacy of Platelet-rich Plasma and Hyaluronic Acid Injection in Upper or Lower TMJ Space"Objective To compare the efficacy of temporomandibular joint (TMJ) osteoarthritis (OA) treatment efficacy of the platelet-rich plasma (PRP) and hyaluronic acid (HA) injection in upper or lower TMJ space. Methods A total of 60 TMJ-OA patients were randomly assigned to four groups: HA injection in upper TMJ space(n=20); HA injection in the lower-TMJ space (n=20); PRP injection in upper-TMJ space (n=10); PRP injection in lower-TMJ space (n=10). All patients were injected with HA or PRP 3 times at 2-week intervals of each injection. After the first injection, all participants received 750 mg of glucosamine hydrochloride, twice a day for 1.5 months, and wore a stabilization splint for 10 h a day for 2.5 months. The Helkimo Anamnestic index (Ai) and Clinical dysfunction index (Di) were used to evaluate clinical symptoms and condylar healing morphology was assessed by Cone beam Computer Tomography (CBCT) imaging. Results The Helkimo index significantly decreased in all groups at the 3-month follow-up compared to before the treatment. PRP injection in the lower-TMJ space exhibited better improvement in the Helkimo index compared with HA injection in the upper-TMJ space (P < 0.05). PRP injection in the lower-TMJ space showed a better maximum active mouth opening (MMO) improvement than the HA injection in the lower-TMJ space (P < 0.05). Regarding both the Helkimo index and MMO improvement, PRP or HA injection in lower space showed better results compared with PRP or HA injection in upper space. There were no statistically significant differences in TMJ subchondral bone parameters improvement scores among the groups. Conclusion In patients with TMJ-OA, injection of HA or PRP in the lower-TMJ space was more effective in alleviating clinical symptoms than injection into the upper-TMJ space. The combination of HA/PRP injection, glucosamine hydrochloride, and stabilization splint proved to be an effective combination therapy. Furthermore, PRP injection demonstrated slightly better results than HA in terms of clinical symptoms and MMO recovery. PRP injection could be a promising therapeutic approach for TMJ-OA.

本研究数据源自题为《富血小板血浆与透明质酸分别注射于颞下颌关节上下腔治疗颞下颌关节骨关节炎的疗效对比研究》的科研课题。目的：对比富血小板血浆（Platelet-rich Plasma, PRP）与透明质酸（Hyaluronic Acid, HA）分别注射于颞下颌关节（Temporomandibular Joint, TMJ）上下腔治疗颞下颌关节骨关节炎（Osteoarthritis, OA）的临床疗效。方法：共纳入60例颞下颌关节骨关节炎患者，采用随机分组法将其分为四组：颞下颌关节上腔透明质酸注射组（n=20）、颞下颌关节下腔透明质酸注射组（n=20）、颞下颌关节上腔富血小板血浆注射组（n=10）以及颞下颌关节下腔富血小板血浆注射组（n=10）。所有患者均接受3次HA或PRP注射，每次注射间隔2周。首次注射后，所有受试者每日口服2次盐酸氨基葡萄糖，每次750mg，持续1.5个月；同时每日佩戴稳定性咬合板10小时，持续2.5个月。采用Helkimo记忆指数（Helkimo Anamnestic Index, Ai）与临床功能障碍指数（Clinical Dysfunction Index, Di）评估临床症状，并通过锥形束计算机断层扫描（Cone beam Computer Tomography, CBCT）成像评估髁突愈合形态。结果：与治疗前相比，所有受试者在3个月随访时的Helkimo指数均显著降低。颞下颌关节下腔PRP注射组的Helkimo指数改善效果优于颞下颌关节上腔HA注射组（P<0.05）。颞下颌关节下腔PRP注射组的最大主动张口度（Maximum Active Mouth Opening, MMO）改善效果优于颞下颌关节下腔HA注射组（P<0.05）。在Helkimo指数与MMO改善方面，颞下颌关节下腔注射HA或PRP的效果均优于上腔注射组。各组间颞下颌关节软骨下骨参数改善评分的统计学差异无显著性。结论：对于颞下颌关节骨关节炎患者，于颞下颌关节下腔注射HA或PRP缓解临床症状的效果优于上腔注射。联合使用HA/PRP注射、盐酸氨基葡萄糖与稳定性咬合板的综合治疗方案疗效确切。此外，在临床症状改善与MMO恢复方面，PRP注射的效果略优于HA注射。PRP注射有望成为颞下颌关节骨关节炎的一种极具前景的治疗手段。