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Jingdong book

颞下颌紊乱病手册

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Jingdong book

颞下颌紊乱病手册

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《颞下颌紊乱病手册》是作者遵循循证医学方面的原则，运用其知识对我的TMD治疗临床经验总结的结果。本书在科学文献、实验成果及临床经验的基础上，力图简化TMD的复杂性，以达到临床实用时易理解、好应用的目的。本书还尽可能地做到适合普通的牙科医师阅读，为他们提供一个系统的、关于如何高效地诊断和处理不同类型的TMD的思维方法。
《颞下颌紊乱病手册》旨在探讨如何通过问诊和检查获得信息，并根据这些信息选择最有效的循证治疗方法，从而使每一个病人都能获得长期的症状改善。
Author Description

蒋泽先，南昌大学第一附属医院教授，主任医师，硕士生导师。从事医学临床、教学、科研四十余年，乐在手术刀与笔墨间行走。撰写、主编医学专著三种，其中《现代手术并发症学》2007年获首届中国出版政府奖提名奖。撰写、主编《健康决定竞争力》《习惯决定健康》《常见病家庭指南丛书》《百姓健康丛书》等医学科普著作五十余种。另撰写有报告文学、社会学著作近三十种，其中《中国农民生死报告》被推荐参评2007年鲁迅文学奖，入围前二十名。人生宗旨是：生命不息，工作不止，笔耕不辍，乐在其中。
Catalogue

导论
第一部分 初诊评估
第一章 接诊病人
第二章 “初诊病人问卷”的回顾
第三章 临床检查
第四章 影像学检查
第五章 TMD诊断的分类
第六章 致病因素

第二部分 常见急性TMD症状和治疗
第七章 创伤继发TMD
第八章 牙科治疗所致的TMD
第九章 翼外肌痉挛
第十章 急性颞下颌关节不可复性关节盘前移位
第十一章 颞下颌关节脱位

第三部分 垫治疗
第十二章 稳定垫
第十三章 前置垫

第四部分 多学科综合疗法治疗TMD
第十四章 自我疗法
第十五章 物理治疗
第十六章 认知行为干预
第十七章 药物治疗
第十八章 其他的牙科治疗
第十九章 多学科综合治疗

第五部分 典型病例
病例1：牙髓病类似TMD症状的鉴别
病例2：慢性副鼻窦炎
病例3：源于颈部的放射性慢性前额疼痛
病例4：夜间不良习惯所致的面肌疼痛
病例5：牙磨损——无痛
病例6：白天不良习惯所致的面肌疼痛
病例7：紧张、抑郁、失眠的致病因素
病例8：纤维性肌痛的致病因素
病例9：无痛的TMJ盘移位的治疗
病例10：TMJ炎症
病例11：间断的急性不可复性TMJ关节盘移位
病例12：急性不可复性TMJ关节盘移位——绞锁
病例13：急性不可复性TMJ关节盘移位——没有绞锁
病例14：边缘性骨髓炎所致的张口受限
病例15：翼外肌痉挛
病例16：TMD急性发作
病例17：冠修复后多种形式的头颈痛
病例18：使髁状突处在“合适位置”的稳定耠垫
附录
附录1：初诊病人问卷表
附录2：颞下颌关节关节盘移位
附录3：TMD自我治疗
附录4：耠垫保养说明
附录5：下颌肌肉伸展运动
附录6：姿势改善训练
附录7：技工室骀垫制作说明
附录8：口腔病历记录范例
附录9：理疗会诊病例指导
附录10：心理咨询联系范例
附录11：与保险公司工作的关系
附录12：TMD信息来源
术语表（Glossary）
Book Abstract

近年来，对于TMD的了解一直在加深，一般来说，其治疗原则已从机械的牙科治疗模式发展到生物一社会一心理的治疗模式，与机体其他关节和肌肉疾病的治疗相一致。
在19世纪早期。已经有关于耠垫治疗及关节盘复位术的报道。与此同时，随着天然牙修复技术的发展，人们越深刻的了解到咬合协调对于维持咀嚼肌及双侧颞下颌关节的健康的重要性。随着人们对于最佳的健康、功能状态的理解与需要，保持天然牙列自然的概念也越来越普及。
早在1930年，耳鼻喉科医生JamesCosten发现该病与咬合异常相关并向内科和牙科医师作了报道，至今仍可见到有TMD被称为Costen（柯斯顿）综合征的命名，Costen医生认为TMD的疼痛和非耳部症状可以通过改变咬合状态获得改善。TMD是一种多因素疾病（存在多种病因）。许多治疗方法都有一定的积极作用。在20世纪，多种治疗方法已被肯定为有效的疗法。全科医生、理疗医生、按摩医生、推拿医生及其他治疗肌肉和（或）颈部疾病的医生。均曾报道过不同的治疗TMD的有效方法。应用松弛疗法、减压疗法和认知一行为疗法进行治疗的心理学家及其他心理治疗医师也曾报道，应用他们的治疗方法治疗TMD取得良好效果。
Introduction

在给硕士和住院医师讲授颞下颌紊乱病（TMD）时，我经常听到有人抱怨没有既较为实用、又具有临床指导意义的TMD方面的专著。这本书应该是：（a）适合于普通水平的牙科医生或学生阅读；（b）针对大多数颞下颌紊乱病（TMD），遵循循证医学的原则，对疾病进行诊断和采用多学科治疗方法；（c）论述如何鉴别类似TMD的疾患和如何识别致病的因素；（d）如何鉴别超出多数牙科医师知识范围的复杂的TMD。
我编写此书的动力就是源于上述要求。本书是我遵循循证医学方面的原则，运用其知识对我的TMD治疗临床经验总结的结果。本书在科学文献、实验成果及临床经验的基础上。力图简化TMD的复杂性，以达到临床实用时易理解、好应用的目的。本书还尽可能地做到适合普通的牙科医师阅读，为他们提供一个系统的、关于如何高效地诊断和处理不同类型的TMD的思维方法。
本书旨在探讨如何通过问诊和检查获得信息，并根据这些信息选择最有效的循证治疗方法.从而使每一个病人都能获得长期的症状改善。如果无法获取诊断依据，我则尽量提供一些建立在大量经验和疾病分析的基础之上的治疗方案和自我治疗建议。
本书并非关于TMD的全面的教科书，因而我们还将定期介绍超出本书范围的某些罕见疾患的症状特征等内容。我建议临床医生将那些有特殊症状的病人转给在此领域具有专长的专家进行诊治。

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