Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
권호 표지

Clinical Symptom of Tension-type Headache and Temporomandibular Disorders in Pain

긴장성 두통과 측두하악장애의 통증을 중심으로 한 임상적 비교

Auh, Q-Schick;Hong, Jung-Pyo;Chun, Yang-Hyunn
어규식;홍정표;전양현

  • Published : 20041200
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Abstract

The study was desiged to compare the pain characteristics in tention-type headache(TTH) and temporomandibular disorders(TMD), to understand further and to treat efficiently them in dentistry Patients with TTH(N=55) having headache and orofacial pain and patients With TMD(N=1l7) having orofacial pam were recruited at Department of Oral Medicine, Kyung Hee University Dental Hospital in two months Pam quality, pain intensity, pain laterality, and pain aggravated by physical activities were examined Statistica(Kernel release ver 55, StatSoft Inc, Tulsa OK, USA) was used for data analysis. 1. Female patients due to pain on head and orofacial region was 65.1%, male patients 34.9% Mean age was 31.3$\pm$14.1 years(male 29.7$\pm$13.7, female 32.2$\pm$14.3) Most pam was shown unilaterally, and TMD patients(82.9%) was larger than TTH patients(63.6%)(P =02) 2. Major subjective pam quality was dull pain(80.0% in TTH patients, 89.7% in TMD patients), and more prominent in TTH patients(P > 05) Subjective pain intensity is medium in TTH patients(72.7%)(P =001), and mild in TMD patients(59%)(P =02) 3. In 82.4% of TTH patients with aggravation, pam was aggravated by mastication. 91.5% of TMD patients was done(1>0.5) In 38.2% of TTH patients, pain was not changed by physical activities 29.9% of TMD patients was not changed(P > 05). Patients with TTH as well as patients with TMD had so prominent dental pain symptom characteristics Therefore, the dental evaluation and treatment must be Important necessary for patients with TTH

발생부위나 발현양상에 있어서 구강안면영역과 밀집한 관련이 있는 긴장성 두통과 주된 증상이 악관절통, 개구장애, 그러고 악관절음인 측두하악장애의 임상적 특정을 통증이라는 관점에서 새롭게 비교 분석하기 위하여, 통증을 주소로 내원한 환자 총 l72명을 대상으로 국제두통학회에서 제시한 진단기준인 통증의 형태, 통증의 강도, 통증의 양측성 유무, 그리고 일상생활시 통증의 증가유무 등을 각각 조사하여 통계처리 후 아래와 같은 성적을 얻었다. 1. 두부와 구강안면부에 통증을 주소로 내원한 환자의 성비는 남여 각각 34.9%와 65.1%로 여성에서 뚜렷하였고, 평균 연령은 3l.3$\pm$14.1세였으며, 남성 29.7$\pm$ l3.7세, 여성 32.2$\pm$14.3세였으며, 통증의 발현부위는 긴장성 두통환자군과 측두하악장애환자군 모두에서 편측성이 각각 63.6% 와 82.9%로 가장 많이 나타났고, 측두하악장애환자군에서 더욱 뚜렷하였다. 2. 주관적 통증의 형태는 긴장성두통환자군과 측두하악장애환자군 모두에서 둔통이 각각 80%와 89.7%로 가장 많이 나타났으며, 측두하악장애환자군에서 더욱 뚜렷한 경향을 보였고 (p=0.08), 주관적 통증의 강도는 긴장성두통환자군 에서 중등도가 72.7% 로 가장 많이 나타난 반면, 측두하악장애환자군에서는 경도가 59%로 가장 많이 나타났다 3. 일상생활 중 통증의 변화가 있는 경우는 긴장성두통환자군과측두하악정애환자군모두에서 저작시에 각각 82.4% 와 9l.5% 로 가장 많이 증가하였으며, 두 군간의 차이는 없었고 (p=0.l5), 일상생활 중 통증의 변화가 없는 경우는 긴장성두통환자군과 측두하악장애환자군에서 각각 38.2%와 29.9%였으며, 두 군간의 차이는 없었다 (p=0.28) 이상의 연구결과로 긴장성 두통과 측두하악장애의 임상적 양상은 주관적 통증의 형태가 둔통이었으며, 통증의 발현 부위는 편측성이었고, 일상생활 중 통증의 변화는 저작시 가장 많이 증가하는 일치된 양상을 보이기도 하였으나, 주관적 통증의 강도의 경우에는 긴장성 두통은 중등도, 측두하악장애는 경도로 나타나 일치하지 않은 양상을 보이는 부분 도 있음을 알 수 있었다. 따라서 본 연구의 결과에서는 통증의 형태, 발현부위, 그리고 일상생활 중의 변화 보다는 주관적 통증의 강도가 뚜렷하게 차이가 있었으므로, 이것이 임상적 진단 또는 감별진단이나 치료의 예후 평가에 중요한 자료가 되며, 두통에 대한 세심한 평가가 필요하리라고 판단이 된다. 그리고 긴장성 두통환자의 관측성 발현유무와 통증의 강도에 관한 추가적인 연구가 필요하며, 특히 강도의 차이에 따른 측두하악장애와 감별에 대한 부분은 보다 구체적으로 연구되어야 할 것으로 사료된다.

Keywords

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