• 1. 四川大學華西口腔醫(yī)院,成都,6100412. 中國醫(yī)學科學院北京協(xié)和醫(yī)院口腔科,北京,100032;

目的 　評價關(guān)節(jié)內(nèi)注射透明質(zhì)酸鈉治療顳下頜關(guān)節(jié)紊亂病的效果.
方法 　檢索多種數(shù)據(jù)庫,手檢15種中國口腔醫(yī)學雜志,納入應用隨機或半隨機對照試驗設計的有關(guān)關(guān)節(jié)內(nèi)注射透明質(zhì)酸鈉治療顳下頜關(guān)節(jié)紊亂病的文獻摘要及全文,嘗試追尋未發(fā)表文獻.資料提取、評價、薈萃分析方法參照Cochrane指導原則進行.
結(jié)果 　通過廣泛文獻檢索,共發(fā)現(xiàn)關(guān)節(jié)內(nèi)注射透明質(zhì)酸鈉治療顳下頜關(guān)節(jié)紊亂病隨機對照試驗文獻12篇,半隨機對照試驗2篇,治療類風濕顳下頜關(guān)節(jié)炎隨機對照試驗1篇,其中10篇符合納入標準.除了71例僅有定性資料描述,余490例有定量資料描述,可進行Meta-分析.277例應用透明質(zhì)酸鈉,113例應用安慰劑或無治療,100例應用糖皮質(zhì)激素關(guān)節(jié)內(nèi)注射.與安慰劑組相比較,透明質(zhì)酸鈉對減輕短期及長期癥狀,改善疼痛未達到統(tǒng)計學顯著水平,但可顯著減輕短期及長期臨床體征,顯著增加張口度.敏感分析發(fā)現(xiàn),與安慰劑相比對臨床體征可短期改善的結(jié)論不穩(wěn)定.透明質(zhì)酸鈉不良反應多為輕微一過性.
結(jié)論 　關(guān)節(jié)內(nèi)注射透明質(zhì)酸鈉可能改善短期及長期顳下頜關(guān)節(jié)紊亂病臨床體征,不良反應輕微一過性,但需要更多設計良好的隨機對照試驗證實其治療效果.

引用本文： 史宗道,郭春嵐,陳娥. 關(guān)節(jié)內(nèi)注射透明質(zhì)酸鈉治療顳下頜關(guān)節(jié)紊亂病效果的系統(tǒng)評價. 中國循證醫(yī)學雜志, 2004, 04(6): 368-376. doi: 復制

1. ［1］Rugh JD, Solberg WK. Oral health status in the United States: temporomandibular disorders[J]. J Dent Edu., 1985;49(6) :398-405.
2. ［2］Solberg WK, Woo MW, Houston JB. Prevalence of mandibular dysfunction in young adults[J]. JADA,1979; 98(1): 25-34.
3. ［3］Wanman A, Agerberg G. Mandibular dysfunction in adolescent[J]. Acta Odont Scand, 1986; 44(1): 45-73.
4. ［4］Xu YH, Yi XZ, Luo ZH. An epidemiologic study of temporomandibular joint dysfunction in young people [J ]. Chin J Stomatol, 1989 (3) ;24,249-252.
5. 徐櫻華,易新竹,羅宗賚,任平惠.顳下頜關(guān)節(jié)紊亂綜合征在青年學生中的流行病學調(diào)查[J].中華口腔醫(yī)學雜志1989;24(3):249-52.
6. ［5］Stegenga B, de Bont LGM, Boering G. Osteoarthrosis as the cause of craniomandibular pain and dysfuction, A unifying concept[J]. J Oral Maxillofac Surg, 1989;47(3) :249-256.
7. ［6］Stegenga B, de Bont LGM, van der Kuijl B, Boering G. Classification of temporomandibular joint osteoarthrosis and internal derangement. Part I: Diagnostic significance of clinical and radiographic symptoms and signs[J]. J Cranio-mandibul Pract, 1992;10(2) :96-106.
8. ［7］Toller PA. Use and misuse of intra-articular corticosteroids in treatment of temporomandibular joint pain. Proceedings of the Royal Society of Medicine[J], 1977; 70(7) :461-463.
9. ［8］Kopp S, Wenneberg B. Effects of occlusal treatment and intraarticular injections on temporomandibular joint pain and dysfunction. Acta Odontolog Scandinavica, 1981 ;39(2) :87-96.
10. ［9］Zhang XN, Zhang ZK. Effect of intra-articular injection of prednisolone in treating organic destrucion of the TMJ disturbance syndrome[J]. Chin J Stomatol,1985 ;20(2) :93-95.
11. 張熙恩,張震康.關(guān)節(jié)下腔注射醋酸強的松龍治療顳下頜關(guān)節(jié)紊亂綜合征器質(zhì)性破壞期的近期療效觀察[J].中華口腔醫(yī)學雜志,1985;20(2):93-95.
12. ［10］Wenneberg B, Kopp S, Grondahl HG. Long-term effect of intra-articular injections of a glucocorticosteroid into the TMJ:a clinical and radiographic 8-year follow-up[J]. J Craniomandibul Disord: Facial & Oral Pain,1991; 5(1) :11-18.
13. ［11］Kikiewicz D. Effect of hydrocortisone on experimental necrosis of cartilage of the temporomandibular joint in guinea pigs [ J ]. Annales Academiae Medicae Stetinensis in Polish,1985; 31:185-196.
14. ［12］Gu ZY, Cai ZQ, Wu QL. The effects ofprednisolone on rabbit temporomandibular joints[J]. J Oral Maxillofac Surg,1993:3(4) :218-220.
15. 谷志遠,曹志強,吳求亮,.醋酸強的松龍對兔顳下頜關(guān)節(jié)的影響[J].口腔頜面外科雜志,1993;3(4):218-220.
16. ［13］Hu B, Wang DH, Preliminary study on effects ofintraarticular injection of prednisolone on temporomandibular joint [ J ]. J Comprehensive Stomatol, 1995; 11 ( 2 ): 86-88.
17. 胡波,王大章.醋酸強的松龍關(guān)節(jié)內(nèi)注射對顳下頜關(guān)節(jié)影響的初步研究[J]口腔醫(yī)學縱橫雜志,1995;11(2):86-88.
18. ［14］Shi ZD, Yang F, He ZX, Shi B, Yang MZ. Comparative study on effects of sodium hyaluronate and prednisolone injecions on experimental temporomandibular joint osteoarthritis of rabbits[J]. Chin J Reparat and Reconstruct Surg, 2002; 16(1) :5-10.
19. 史宗道,楊峰,何志秀,史冰,楊名仲透明質(zhì)酸鈉與強的松龍治療兔實驗性顳頜關(guān)節(jié)骨關(guān)節(jié)炎的對照研究[J].中國修復重建外科雜志,2002;16(1):5-10.
20. ［15］Chandler GN,Wright V.Deleterious effect ofintra-articular hydrocorrisone[J]Lancet,1958;2(7048):661-663.
21. ［16］Fu K,Ma X,Zheng Z.Pathologic study on synovialfluid after intra-articular corticosteroid therapy in temporomandibular jomt disorders[J].Chin J Stomatol 1999;34(1):55-57.
22. 傅開元,馬緒臣,張震康,孫開華,魏明潔.顳下頜關(guān)節(jié)紊亂病關(guān)節(jié)腔注射糖皮質(zhì)激素后關(guān)節(jié)液病理分析[J]中華口腔醫(yī)學雜志,1999;34(1):55-57.
23. ［17］Abatangelo G, Botri P, Bue D. Intrarticular sodium hyaluronate injections in the Pond-Nuki experimental model of osteoarthritis in dogs [ J ]. Clin Orthop Relat Res, 1989;241:286-99.
24. ［18］Galateo D, Schiavinato A, Lini E, Guidolin D. Intrarticular sodium hyaluronate injections in the Pond-Nuki experimental model of osteoarthritis in dogs[J]. Clin J Orthop, 1989 ;241:286-299.
25. ［19］Kitoh Y, Katsuramaki T, Tanaka H. Effect ofSL-1010 (sodium hyaluronate with high molecular weight) on experimental osteoarthritis induced by intra-articularly applied papain in rabbits[J]. Nippon Yakurigaku Zasshi,1992 ;100( 1 ) :67-76.
26. ［20］Neo H, IsmimaruJI, Kurita K, Goss AN. The effect ofhyaluronic acid on experimental temporomandibular joint osteoarthrosis in the sheep[J]. J Oral Maxillofac Surg, 1997; 55(10):1 114-1 119.
27. ［21］Zhang SZ; Wu YH. The effect of sodium hyaluronate on the rabbit osteoarthrosis[J]. Shanghai J Stomatol, 2003; 12 (3):187-190.
28. 張世周,吳益華.透明質(zhì)酸鈉對兔顳下頜關(guān)節(jié)骨病的作用[J].上海口腔醫(yī)學,2003;12(3):187-190.
29. ［22］Rydel NW, Butler J, Balazs EA. Hyaluronic acid in synovial fluid VI. Effect of intra-articular injection of hyaluronic acid on the clinical symptoms of arthritis in track horses[J]. Acta Veterinaria Scandinavica, 1970(2) ;11:139-155.
30. ［23］Peyron JG, Balazs EA. Preliminary clinical assessment of Nahyaluronate injection into human arthritic joints [ J ]. Pathologieet Biologie, 1974 ;22 (8) :731.
31. ［24］Kopp S, Wenneberg B. Injektion av healonid i kakled-En prelininar rapport [ M ]. Report Series, Department of Stomatognathic Physiology, Goteborg University, 1979.
32. ［25］Kopp S, Wenneberg B, Haraldson T, Carlsson GE. The short-term effect of intra-articular injections of sodium hyaluronate and corticosteroid on temporomandibular joint pain and dysfunction [ J ]. J Oral Maxillofac Surg, 1985;43(6) :429-35.
33. ［26］Kopp S, Carlsson GE, Haraldson T, Wenneberg B. Longterm effect of intra-articular injecttion of sodium hyaluronate and corticosteroid on temporomandibular joint arthritis[J]. J Oral Maxillofa Surg,1987 ;45(11 ) :929-935.
34. ［27］McCanin JP, Balazs EA, de la Rua H. Preliminary studies on the use of a viscoelastic solution in arthroscopic surgery of the terporomandibular joint[J ]. J Oral Maxillofac Surg, 1989;47:1 161-1 168.
35. ［28］Kopp S, Akerman S, Nilner M. Short-term effects of intra-articular sodium hyaluronate, glucocorticoid, and saline injectious on rheumatoid arthritis [ J ]. J Craniomandibul Disord :Facial & Oral Pain,1991 ;5:231-8.
36. ［29］Bertolari CN, Gay T, Clark GT, Rendell J, Shetty V, Liu C, Swann DA. Use of sodium hyaluronate in treating temporomandibular joint disorders: a randomized, double-blind,placebo controlled clinical trial [ J ]. J Oral and Maxillofac Surg, 1993 ;51 (3) ;232-242.
37. ［30］Gu ZY, GuoQ, Wu QL, Xie ZJ. The effect of sodiur hyaluronate in treating temporomandibuiar joint disturbance syndrome[J]. Chin J Dental Material and Devices,1997; 6(2):58-9.
38. 谷志遠,郭琦,吳求亮,謝志堅.透明質(zhì)酸鈉在治療顥下頜關(guān)節(jié)紊亂綜合征中的作用[J].口腔材料器械雜志1997;6(2):58-59.
39. ［31］Gu Z, Wu Q, Zhang Y, Zhang Z, Sun K. Visco-supplementation therapy in internal derangement of temporomandibular joint[J]. Chin Med J (Eng),1998; 111(7) :656-9.
40. ［32］Qian DY. Hyaluronase in treating temporomandibular joint disorders [ J ]. JHengyang Medical College, 1999; 27(2) :139-140.
41. 蹇敦羽.透明質(zhì)酸治療顳下頜關(guān)節(jié)紊亂綜合征[J]衡陽醫(yī)學院學報1999;27(2):139-140.
42. ［33］Chu JQ, Hu QG. Using arthrocentesis and hyaluronate to treat non-reducing disc displacement of the temporomandibular joint [ M ] . in: Group of Temporomandibular Diseases, Chinese Association of Stomatology. Preceedings of the Third National Symposium on Advancement of Basic R. esearch and Clinical Studies on Temporomandibular Diseases, Xiamen,China, 2001:73.
43. 儲嘉琪,胡勤鋼.顳頜關(guān)節(jié)灌洗加透明質(zhì)酸治療不可復性盤前移[M].見:中華口腔醫(yī)學顳下頜關(guān)節(jié)病學組.全國第三屆顳下頜關(guān)節(jié)紊亂病專題研討會顳下頜關(guān)節(jié)病基礎與臨床進展論文匯編.廈門,2001:73.
44. ［34］Qi DY, Pan JL, Liu CH. Effect of intraarticular injection of hyaluronate on nonreducing disc displacement of the temporomandibular disorders [ M ]. in: Group of Temporomandibular Diseases, Chinese Association of Stomatology. Proceedings of the Third National Symposium on Advancement of Basic Research and Clinical Studies on Temporomandibular Diseases, Xiamen, China, 2001:73.
45. 齊東元,潘巨利,劉成海.透明質(zhì)酸鈉關(guān)節(jié)腔注射治療關(guān)節(jié)盤不可復性前移位[M].見:中華口腔醫(yī)學顳下頜關(guān)節(jié)病學組.全國第三屆顳下頜關(guān)節(jié)紊亂病專題研討會顳下頜關(guān)節(jié)病基礎與臨床進展論文匯編.廈門,2001:73.
46. ［35］Alpaslan GH, Alpaslan C. Efficacy of temporomandibular joint arthrocentesis with and without injection of sodium hyaluronate in treatment of internal derangements[J]. J Oral and Maxillofac Surg, 2001 ;59(6) :613-618.
47. ［36］Hepguler S, Akkoc YS, Pehlivan M, Ozturk C, Celebi G,Saracoglu A, Ozpinar B. The efficacy of intra-articular sodium hyaluronate in patients with recucing displaced disc [J ]. J Oral Rehabil, 2002 ;29 ( 1 ) :80-86.
48. ［37］Shi ZD, Yang F, Zhang JY, Shi B. Randomized controlled trial of sodium hyaluronate for degenerative disorders of the temporomandibular joint. Chinese Journal of Reparative and Reconstructive Surgery. 2002; 16 ( 1 ): 11-15.
49. 史宗道,楊峰,張靜儀,史冰透明質(zhì)酸鈉治療顳頜關(guān)節(jié)退行性關(guān)節(jié)病臨床隨機對照研究[J].中國修復重建外科雜志,2002;16(1):11-15.
50. ［38］Qi DY, Pan JL, Liu CH. Effect of intraarticular injection of hyaluronate on nonreducing disc displacement of the temporomandibular disorders[ J ] . J Modern Stomatol, 2003;17(1) :91.
51. 齊東元,潘巨利,劉成海.透明質(zhì)酸鈉關(guān)節(jié)腔注射治療顙下頜關(guān)節(jié)盤不可復性前移位.現(xiàn)代口腔醫(yī)學雜志2003;17(1):91.
52. ［39］Peng GG, LiJP, WuJW, Lin M, ChenJF, Li J,Xian D, He GY, Fu Z, Wang WH. The short-term effect of intra-articular injections of sodium hyaluronate on temporomandibular joint interal derangement [ J ]. J Clin Stomatol, 2002 ;18 (5) :372-373.
53. 彭國光,李嘉朋,吳俊偉,林銘,陳巨峰,李捷,冼淡,何國燕,傅忠,王維煥.關(guān)節(jié)上腔留注透明質(zhì)酸鈉治療TMJID的療效觀察[J].臨床口腔醫(yī)學雜志2002;18(5):372-373.
54. ［40］Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique [ J ]. J Craniomandibul Disorders:Facial & Oral Pain, 1992;6(4) :301-355.
55. ［41］Stegenga B, de Bont LG, Boering G. Classification of temporomandibular joint osteoarthrosis and internal derangement. 2 Specific diagnostic criteria[J]. Cranio,1992;10(2):107-116.
56. ［42］List T, Dworkin SF. Research diagnostic criteria for TMJ guidelines[J]. J Orofac Pain, 1996; 10 ( 3 ) :240-253.
57. ［43］Clarke M, Oxman AD, editors. Assessment of study quality.Cochrane Reviewers’ Handbook 4.0 [ updated July 1999 ]Review Manager ( RevMan) [ Computer Program]. Version 4.0. Oxford, England: The Cochrane Collaboration, 1999.
58. ［44］Balazs EA. Analgesic effect of elastoviscous hyaluronan solutions and the treatment of arthritic pain [ J ]. Cells Tissues Organs, 2003;174(1-2) :49-62.
  1. 1. ［1］Rugh JD, Solberg WK. Oral health status in the United States: temporomandibular disorders[J]. J Dent Edu., 1985;49(6) :398-405.
  2. 2. ［2］Solberg WK, Woo MW, Houston JB. Prevalence of mandibular dysfunction in young adults[J]. JADA,1979; 98(1): 25-34.
  3. 3. ［3］Wanman A, Agerberg G. Mandibular dysfunction in adolescent[J]. Acta Odont Scand, 1986; 44(1): 45-73.
  4. 4. ［4］Xu YH, Yi XZ, Luo ZH. An epidemiologic study of temporomandibular joint dysfunction in young people [J ]. Chin J Stomatol, 1989 (3) ;24,249-252.
  5. 5. 徐櫻華,易新竹,羅宗賚,任平惠.顳下頜關(guān)節(jié)紊亂綜合征在青年學生中的流行病學調(diào)查[J].中華口腔醫(yī)學雜志1989;24(3):249-52.
  6. 6. ［5］Stegenga B, de Bont LGM, Boering G. Osteoarthrosis as the cause of craniomandibular pain and dysfuction, A unifying concept[J]. J Oral Maxillofac Surg, 1989;47(3) :249-256.
  7. 7. ［6］Stegenga B, de Bont LGM, van der Kuijl B, Boering G. Classification of temporomandibular joint osteoarthrosis and internal derangement. Part I: Diagnostic significance of clinical and radiographic symptoms and signs[J]. J Cranio-mandibul Pract, 1992;10(2) :96-106.
  8. 8. ［7］Toller PA. Use and misuse of intra-articular corticosteroids in treatment of temporomandibular joint pain. Proceedings of the Royal Society of Medicine[J], 1977; 70(7) :461-463.
  9. 9. ［8］Kopp S, Wenneberg B. Effects of occlusal treatment and intraarticular injections on temporomandibular joint pain and dysfunction. Acta Odontolog Scandinavica, 1981 ;39(2) :87-96.
  10. 10. ［9］Zhang XN, Zhang ZK. Effect of intra-articular injection of prednisolone in treating organic destrucion of the TMJ disturbance syndrome[J]. Chin J Stomatol,1985 ;20(2) :93-95.
  11. 11. 張熙恩,張震康.關(guān)節(jié)下腔注射醋酸強的松龍治療顳下頜關(guān)節(jié)紊亂綜合征器質(zhì)性破壞期的近期療效觀察[J].中華口腔醫(yī)學雜志,1985;20(2):93-95.
  12. 12. ［10］Wenneberg B, Kopp S, Grondahl HG. Long-term effect of intra-articular injections of a glucocorticosteroid into the TMJ:a clinical and radiographic 8-year follow-up[J]. J Craniomandibul Disord: Facial & Oral Pain,1991; 5(1) :11-18.
  13. 13. ［11］Kikiewicz D. Effect of hydrocortisone on experimental necrosis of cartilage of the temporomandibular joint in guinea pigs [ J ]. Annales Academiae Medicae Stetinensis in Polish,1985; 31:185-196.
  14. 14. ［12］Gu ZY, Cai ZQ, Wu QL. The effects ofprednisolone on rabbit temporomandibular joints[J]. J Oral Maxillofac Surg,1993:3(4) :218-220.
  15. 15. 谷志遠,曹志強,吳求亮,.醋酸強的松龍對兔顳下頜關(guān)節(jié)的影響[J].口腔頜面外科雜志,1993;3(4):218-220.
  16. 16. ［13］Hu B, Wang DH, Preliminary study on effects ofintraarticular injection of prednisolone on temporomandibular joint [ J ]. J Comprehensive Stomatol, 1995; 11 ( 2 ): 86-88.
  17. 17. 胡波,王大章.醋酸強的松龍關(guān)節(jié)內(nèi)注射對顳下頜關(guān)節(jié)影響的初步研究[J]口腔醫(yī)學縱橫雜志,1995;11(2):86-88.
  18. 18. ［14］Shi ZD, Yang F, He ZX, Shi B, Yang MZ. Comparative study on effects of sodium hyaluronate and prednisolone injecions on experimental temporomandibular joint osteoarthritis of rabbits[J]. Chin J Reparat and Reconstruct Surg, 2002; 16(1) :5-10.
  19. 19. 史宗道,楊峰,何志秀,史冰,楊名仲透明質(zhì)酸鈉與強的松龍治療兔實驗性顳頜關(guān)節(jié)骨關(guān)節(jié)炎的對照研究[J].中國修復重建外科雜志,2002;16(1):5-10.
  20. 20. ［15］Chandler GN,Wright V.Deleterious effect ofintra-articular hydrocorrisone[J]Lancet,1958;2(7048):661-663.
  21. 21. ［16］Fu K,Ma X,Zheng Z.Pathologic study on synovialfluid after intra-articular corticosteroid therapy in temporomandibular jomt disorders[J].Chin J Stomatol 1999;34(1):55-57.
  22. 22. 傅開元,馬緒臣,張震康,孫開華,魏明潔.顳下頜關(guān)節(jié)紊亂病關(guān)節(jié)腔注射糖皮質(zhì)激素后關(guān)節(jié)液病理分析[J]中華口腔醫(yī)學雜志,1999;34(1):55-57.
  23. 23. ［17］Abatangelo G, Botri P, Bue D. Intrarticular sodium hyaluronate injections in the Pond-Nuki experimental model of osteoarthritis in dogs [ J ]. Clin Orthop Relat Res, 1989;241:286-99.
  24. 24. ［18］Galateo D, Schiavinato A, Lini E, Guidolin D. Intrarticular sodium hyaluronate injections in the Pond-Nuki experimental model of osteoarthritis in dogs[J]. Clin J Orthop, 1989 ;241:286-299.
  25. 25. ［19］Kitoh Y, Katsuramaki T, Tanaka H. Effect ofSL-1010 (sodium hyaluronate with high molecular weight) on experimental osteoarthritis induced by intra-articularly applied papain in rabbits[J]. Nippon Yakurigaku Zasshi,1992 ;100( 1 ) :67-76.
  26. 26. ［20］Neo H, IsmimaruJI, Kurita K, Goss AN. The effect ofhyaluronic acid on experimental temporomandibular joint osteoarthrosis in the sheep[J]. J Oral Maxillofac Surg, 1997; 55(10):1 114-1 119.
  27. 27. ［21］Zhang SZ; Wu YH. The effect of sodium hyaluronate on the rabbit osteoarthrosis[J]. Shanghai J Stomatol, 2003; 12 (3):187-190.
  28. 28. 張世周,吳益華.透明質(zhì)酸鈉對兔顳下頜關(guān)節(jié)骨病的作用[J].上?？谇会t(yī)學,2003;12(3):187-190.
  29. 29. ［22］Rydel NW, Butler J, Balazs EA. Hyaluronic acid in synovial fluid VI. Effect of intra-articular injection of hyaluronic acid on the clinical symptoms of arthritis in track horses[J]. Acta Veterinaria Scandinavica, 1970(2) ;11:139-155.
  30. 30. ［23］Peyron JG, Balazs EA. Preliminary clinical assessment of Nahyaluronate injection into human arthritic joints [ J ]. Pathologieet Biologie, 1974 ;22 (8) :731.
  31. 31. ［24］Kopp S, Wenneberg B. Injektion av healonid i kakled-En prelininar rapport [ M ]. Report Series, Department of Stomatognathic Physiology, Goteborg University, 1979.
  32. 32. ［25］Kopp S, Wenneberg B, Haraldson T, Carlsson GE. The short-term effect of intra-articular injections of sodium hyaluronate and corticosteroid on temporomandibular joint pain and dysfunction [ J ]. J Oral Maxillofac Surg, 1985;43(6) :429-35.
  33. 33. ［26］Kopp S, Carlsson GE, Haraldson T, Wenneberg B. Longterm effect of intra-articular injecttion of sodium hyaluronate and corticosteroid on temporomandibular joint arthritis[J]. J Oral Maxillofa Surg,1987 ;45(11 ) :929-935.
  34. 34. ［27］McCanin JP, Balazs EA, de la Rua H. Preliminary studies on the use of a viscoelastic solution in arthroscopic surgery of the terporomandibular joint[J ]. J Oral Maxillofac Surg, 1989;47:1 161-1 168.
  35. 35. ［28］Kopp S, Akerman S, Nilner M. Short-term effects of intra-articular sodium hyaluronate, glucocorticoid, and saline injectious on rheumatoid arthritis [ J ]. J Craniomandibul Disord :Facial & Oral Pain,1991 ;5:231-8.
  36. 36. ［29］Bertolari CN, Gay T, Clark GT, Rendell J, Shetty V, Liu C, Swann DA. Use of sodium hyaluronate in treating temporomandibular joint disorders: a randomized, double-blind,placebo controlled clinical trial [ J ]. J Oral and Maxillofac Surg, 1993 ;51 (3) ;232-242.
  37. 37. ［30］Gu ZY, GuoQ, Wu QL, Xie ZJ. The effect of sodiur hyaluronate in treating temporomandibuiar joint disturbance syndrome[J]. Chin J Dental Material and Devices,1997; 6(2):58-9.
  38. 38. 谷志遠,郭琦,吳求亮,謝志堅.透明質(zhì)酸鈉在治療顥下頜關(guān)節(jié)紊亂綜合征中的作用[J].口腔材料器械雜志1997;6(2):58-59.
  39. 39. ［31］Gu Z, Wu Q, Zhang Y, Zhang Z, Sun K. Visco-supplementation therapy in internal derangement of temporomandibular joint[J]. Chin Med J (Eng),1998; 111(7) :656-9.
  40. 40. ［32］Qian DY. Hyaluronase in treating temporomandibular joint disorders [ J ]. JHengyang Medical College, 1999; 27(2) :139-140.
  41. 41. 蹇敦羽.透明質(zhì)酸治療顳下頜關(guān)節(jié)紊亂綜合征[J]衡陽醫(yī)學院學報1999;27(2):139-140.
  42. 42. ［33］Chu JQ, Hu QG. Using arthrocentesis and hyaluronate to treat non-reducing disc displacement of the temporomandibular joint [ M ] . in: Group of Temporomandibular Diseases, Chinese Association of Stomatology. Preceedings of the Third National Symposium on Advancement of Basic R. esearch and Clinical Studies on Temporomandibular Diseases, Xiamen,China, 2001:73.
  43. 43. 儲嘉琪,胡勤鋼.顳頜關(guān)節(jié)灌洗加透明質(zhì)酸治療不可復性盤前移[M].見:中華口腔醫(yī)學顳下頜關(guān)節(jié)病學組.全國第三屆顳下頜關(guān)節(jié)紊亂病專題研討會顳下頜關(guān)節(jié)病基礎與臨床進展論文匯編.廈門,2001:73.
  44. 44. ［34］Qi DY, Pan JL, Liu CH. Effect of intraarticular injection of hyaluronate on nonreducing disc displacement of the temporomandibular disorders [ M ]. in: Group of Temporomandibular Diseases, Chinese Association of Stomatology. Proceedings of the Third National Symposium on Advancement of Basic Research and Clinical Studies on Temporomandibular Diseases, Xiamen, China, 2001:73.
  45. 45. 齊東元,潘巨利,劉成海.透明質(zhì)酸鈉關(guān)節(jié)腔注射治療關(guān)節(jié)盤不可復性前移位[M].見:中華口腔醫(yī)學顳下頜關(guān)節(jié)病學組.全國第三屆顳下頜關(guān)節(jié)紊亂病專題研討會顳下頜關(guān)節(jié)病基礎與臨床進展論文匯編.廈門,2001:73.
  46. 46. ［35］Alpaslan GH, Alpaslan C. Efficacy of temporomandibular joint arthrocentesis with and without injection of sodium hyaluronate in treatment of internal derangements[J]. J Oral and Maxillofac Surg, 2001 ;59(6) :613-618.
  47. 47. ［36］Hepguler S, Akkoc YS, Pehlivan M, Ozturk C, Celebi G,Saracoglu A, Ozpinar B. The efficacy of intra-articular sodium hyaluronate in patients with recucing displaced disc [J ]. J Oral Rehabil, 2002 ;29 ( 1 ) :80-86.
  48. 48. ［37］Shi ZD, Yang F, Zhang JY, Shi B. Randomized controlled trial of sodium hyaluronate for degenerative disorders of the temporomandibular joint. Chinese Journal of Reparative and Reconstructive Surgery. 2002; 16 ( 1 ): 11-15.
  49. 49. 史宗道,楊峰,張靜儀,史冰透明質(zhì)酸鈉治療顳頜關(guān)節(jié)退行性關(guān)節(jié)病臨床隨機對照研究[J].中國修復重建外科雜志,2002;16(1):11-15.
  50. 50. ［38］Qi DY, Pan JL, Liu CH. Effect of intraarticular injection of hyaluronate on nonreducing disc displacement of the temporomandibular disorders[ J ] . J Modern Stomatol, 2003;17(1) :91.
  51. 51. 齊東元,潘巨利,劉成海.透明質(zhì)酸鈉關(guān)節(jié)腔注射治療顙下頜關(guān)節(jié)盤不可復性前移位.現(xiàn)代口腔醫(yī)學雜志2003;17(1):91.
  52. 52. ［39］Peng GG, LiJP, WuJW, Lin M, ChenJF, Li J,Xian D, He GY, Fu Z, Wang WH. The short-term effect of intra-articular injections of sodium hyaluronate on temporomandibular joint interal derangement [ J ]. J Clin Stomatol, 2002 ;18 (5) :372-373.
  53. 53. 彭國光,李嘉朋,吳俊偉,林銘,陳巨峰,李捷,冼淡,何國燕,傅忠,王維煥.關(guān)節(jié)上腔留注透明質(zhì)酸鈉治療TMJID的療效觀察[J].臨床口腔醫(yī)學雜志2002;18(5):372-373.
  54. 54. ［40］Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique [ J ]. J Craniomandibul Disorders:Facial & Oral Pain, 1992;6(4) :301-355.
  55. 55. ［41］Stegenga B, de Bont LG, Boering G. Classification of temporomandibular joint osteoarthrosis and internal derangement. 2 Specific diagnostic criteria[J]. Cranio,1992;10(2):107-116.
  56. 56. ［42］List T, Dworkin SF. Research diagnostic criteria for TMJ guidelines[J]. J Orofac Pain, 1996; 10 ( 3 ) :240-253.
  57. 57. ［43］Clarke M, Oxman AD, editors. Assessment of study quality.Cochrane Reviewers’ Handbook 4.0 [ updated July 1999 ]Review Manager ( RevMan) [ Computer Program]. Version 4.0. Oxford, England: The Cochrane Collaboration, 1999.
  58. 58. ［44］Balazs EA. Analgesic effect of elastoviscous hyaluronan solutions and the treatment of arthritic pain [ J ]. Cells Tissues Organs, 2003;174(1-2) :49-62.