CAJ | 학술논문

目的：研究颞下颌关节紊乱病（TMD）不同症状患者心理社会因素，尤其是焦虑的差别，为心理治疗对策提供试验依据。方法206例就诊于天津医科大学口腔医院的TMD患者和201名无症状志愿者，填写症状自评量表（SCL?90）和状态-特质焦虑问卷（STAI），根据患者主诉分组。采用SPSS 17.0统计软件，采用独立样本t检验和单因素方差分析对所有数据进行统计学分析。结果（1）TMD患者SCL?90量表中的躯体化、抑郁、焦虑、敌对、精神病性因子得分及总分高于无症状志愿者，差异有统计学意义（t躯体化=3.79，P躯体化=0.000；t抑郁=2.14，P抑郁=0.033；t焦虑=2.91，P焦虑=0.004；t敌对=3.93，P敌对=0.000；t精神病性=2.48，P精神病性=0.013；t总分=2.80，P总分=0.005）；女性TMD患者的状态焦虑及特质焦虑得分均高于女性无症状志愿者（t状态焦虑=3.52，P状态焦虑=0.001；t特质焦虑=4.26，P特质焦虑=0.000），两组男性之间差异无统计学意义（t状态焦虑=0.36，P状态焦虑=0.718；t特质焦虑=0.76，P特质焦虑=0.453）；（2）不同症状TMD患者在躯体化和状态焦虑方面差异有统计学意义（F躯体化=2.714，P躯体化=0.046；F特质焦虑=3.007，P特质焦虑=0.031），具有单纯疼痛症状者躯体化得分高于单纯弹响患者（P=0.005），单纯弹响及疼痛伴弹响患者的特质焦虑得分高于疼痛伴开口受限者（P=0.016）。结论 TMD患者心理健康水平比无症状人群低，主要表现在躯体化、抑郁、焦虑、敌对和精神病性方面。女性TMD患者有明显焦虑特征。单纯疼痛TMD患者躯体化比单纯弹响者更为明显。
목적：연구섭하합관절문란병（TMD）불동증상환자심리사회인소，우기시초필적차별，위심리치료대책제공시험의거。방법206례취진우천진의과대학구강의원적TMD환자화201명무증상지원자，전사증상자평량표（SCL?90）화상태-특질초필문권（STAI），근거환자주소분조。채용SPSS 17.0통계연건，채용독립양본t검험화단인소방차분석대소유수거진행통계학분석。결과（1）TMD환자SCL?90량표중적구체화、억욱、초필、활대、정신병성인자득분급총분고우무증상지원자，차이유통계학의의（t구체화=3.79，P구체화=0.000；t억욱=2.14，P억욱=0.033；t초필=2.91，P초필=0.004；t활대=3.93，P활대=0.000；t정신병성=2.48，P정신병성=0.013；t총분=2.80，P총분=0.005）；녀성TMD환자적상태초필급특질초필득분균고우녀성무증상지원자（t상태초필=3.52，P상태초필=0.001；t특질초필=4.26，P특질초필=0.000），량조남성지간차이무통계학의의（t상태초필=0.36，P상태초필=0.718；t특질초필=0.76，P특질초필=0.453）；（2）불동증상TMD환자재구체화화상태초필방면차이유통계학의의（F구체화=2.714，P구체화=0.046；F특질초필=3.007，P특질초필=0.031），구유단순동통증상자구체화득분고우단순탄향환자（P=0.005），단순탄향급동통반탄향환자적특질초필득분고우동통반개구수한자（P=0.016）。결론 TMD환자심리건강수평비무증상인군저，주요표현재구체화、억욱、초필、활대화정신병성방면。녀성TMD환자유명현초필특정。단순동통TMD환자구체화비단순탄향자경위명현。
Objective To compare the psychosocial factors especially anxiety in patients with different symptoms of temporomandibular disorders(TMD)and provide evidence for psychotherapy strategies of patients with TMD. Methods Totally 206 patients visited TMD clinic of stomatological hospital of Tianjin Medical University and 201 asymptomatic volunteers were included in this study. Symptom Checklist 90(SCL?90)and State?Trait Anxiety Inventory(STAI)were used to assess the psychological status. The patients were classified according to the chief complaints. The datas were analyzed by SPSS 17.0. Results There was a statistically significant difference(tsomatization=3.79,Psomatization=0.000;tdepres ion=2.14,Pdepres ion=0.033;tanxiety=2.91,Panxiety=0.004;thostility=3.93,Phostility=0.000;tpsychoticism=2.48,Ppsychoticism=0.013;ttotal=2.80,Ptotal=0.005)in the scores of SCL?90 between the patients and the volunteers,the patients got higher scores on the somatization,depression,anxiety,hostility,psychoticism and the total score of SCL?90. Both scores of state anxiety inventory and trait anxiety inventory in female patients were significantly higher than the female volunteers(tS?AI=3.52,PS?AI=0.001;tT?AI=4.26,PT?AI=0.000),but there was no difference between male patients and volunteers(tS?AI=0.36,PS?AI=0.718;tT?AI=0.76,PT?AI=0.453). The scores of somatization and trait?anxiety were different among patients with different TMD symptoms(Fsomatization=2.714,Psomatization=0.046;FT?AI=3.007,PT?AI=0.031). Patients with pain symptom had a higher somatization score than those with clicking symptom (P=0.005). The trait?anxiety score of patients who had clicking with or without pain were higher than those had pain with limited opening(P=0.016). Conclusions The level of psychological health of TMD patients were lower than the controls, focusing on somatization,depression,anxiety,hostility and psychoticism. The female TMD paients had the more obvious anxiety. Somatization in patients with pain were more obvious than patients with clicking.