Abstract：
Temporomandibular disorder (TMD) is a common condition disabling people and bringing up costs. The aim of this study was to investigate the effects of manual therapy on pain intensity, maximum mouth opening (MMO) and disability. Searches were conducted in six databases for randomised controlled trials (RCTs). Selection of trials, data extraction and methodological quality assessment were conducted by two reviewers with discrepancies resolved by a third reviewer. Estimates were presented as mean differences (MDs) or standardized mean differences (SMDs) with 95% confidence intervals (CIs). Quality of the evidence was assessed using the GRADE approach. Twenty trials met the eligibility criteria and were included. For pain intensity, high and moderate quality evidence demonstrated the additional effects of manual therapy at short- (95% CI -2.12 to -0.82 points) and long-term (95% CI -2.17 to -0.40 points) on the 0-10 points scale. For MMO, moderate to high quality evidence was found in favour of manual therapy alone (95% CI 0.01 to 7.30 mm) and its additional effects (95% CI 1.58 to 3.58 mm) at short- and long-term (95% CI 1.22 to 8.40 mm). Moderate quality evidence demonstrated an additional effect of manual therapy for disability (95% CI = -0.87 to -0.14). Evidence supports manual therapy as effective for TMD.
摘要：
颞下颌关节紊乱病（TMD）是一种常见的疾病，使人致残并增加费用。这项研究的目的是研究手动治疗对疼痛强度的影响，最大张口（MMO）和残疾。在六个数据库中进行了随机对照试验（RCT）的搜索。选择试验，数据提取和方法学质量评估由两名评审员进行,差异由第三名评审员解决.估计值表示为具有95％置信区间（CI）的平均差（MD）或标准化平均差（SMD）。使用GRADE方法评估证据质量。20项试验符合资格标准并被纳入。对于疼痛强度，高质量和中等质量证据表明,在0~10分量表中,短期(95%CI-2.12~-0.82分)和长期(95%CI-2.17~-0.40分)手动治疗具有额外效果.对于MMO，在短期和长期(95%CI1.22~8.40mm),发现中等至高质量的证据支持单纯手动治疗(95%CI0.01~7.30mm)及其附加效应(95%CI1.58~3.58mm).中等质量的证据表明，手动治疗对残疾有额外的影响（95％CI=-0.87至-0.14）。证据支持手动治疗对TMD有效。
