不同疗法对肌筋膜疼痛病人的自主神经功能的影响  

The influence of Autonomic Nerve System by Different Therapy on Patients with Myofascial Pain Syndrome.

作　　者：齐峰[1] 韩梅[2] 舒雅[1] 於金贵[1] 类维富[1] 

机构地区：[1]山东大学齐鲁医院,中国济南250012 [2]山东大学第二医院

出　　处：《中国麻醉与镇痛》2007年第1期51-54,共4页China Anesthesia and Analgesia

摘　　要：目的：本研究的目的是观察注射疗法及复合小针刀疗法治疗肌筋膜疼痛综合征对自主神经系统功能的影响。方法：选择40例诊断明确的肌筋膜疼痛病人，随机分为两组，每组20例。Ⅰ组：采用注射疗法治疗；IS组：采用注射疗法加小针刀治疗。观察两组病人治疗前后心率变异（HRV）的频域变化，低频LF、超低频LLF、高频HF、低高频比LF／HF及心率变异指数HR-Ⅵ；用视觉模拟评分法（VAS）评定治疗前后疗效并随访观察其远期疗效。结果：①HRV频域指标组内比较：LF、LLF、HF以及HRVI治疗前舆治疗后1min比较有显着性差异（P〈0．05），与5min、10min比较有非常显着性差异（P〈0．01）。LF／HF治疗前与治疗后5min、10min比较有显着性差异（P〈0．05）。组间治疗后1、5、10min，两两比较无显着性差异。②组间比较：病人治疗后临床症状、VAS评分均较治疗前降低．治疗前后IS组有非常显着性差异（P〈0．01）。两组VAS降低率有非常显着性差异（P〈0．01）。③回访病例中，两组治疗有效率比较有显着性差异（P〈0．05）。结论：注射疗法以及复合小针刀疗法均可有效改善肌筋膜疼痛病人的自主神经功能，其机制可能是通过调节、稳定自主神经系统功能达到缓解疼痛。注射疗法复合小针刀疗法的远期疗效优于单纯注射疗法。Objective Many patients with myofascial pain syndrome were caused by trigger points. Acupotomy and point injection were effective treatment for these patients. The aim of our study was to observe the autonomic nerve system change by point injection alone or combined with acupotomy on patients with myofascial pain syndrome. Methods 40 patients with myofascial pain syndrome were divided into two groups randomly, underwent point injection alone or combination with acupotomy therapy respectively. The heart rate variability index （HRVI）, low frequency （LF）, LLF, high frequency（HF）, HHF, LF/HF were measured to observe the function and stability of autonomic nerve system （ANS） before and after treatment. VAS was used to assess the clinical efficacy. All patients were given a followed up st, ldy for three to six months. Results （1） HRV frequency-domain analysis showed： LF. LLF . HF and HRVI were significantly decreased post-treatment 1 min（P〈0.05）, 5min, 10rain compared to pre-treatment （P〈0. 01 ,respectively）. And the LF/HF decreased, post-treatment 5min and 10min compared to pre-treatment and （P〈0. 05, respectively）. There was no difference between two groups. （2） VAS was decreased significantly post-treatment compared to pre treatment （P〈0. 01）. （3）In a following-up study, the clinical efficacy of two methods had a significant difference （P〈0. 05）. Conclusion The results imply the autonomic nerve system change on myofascial pain syndrome patients by point injection alone or combined with acupotomy. The mechanism of pain relief is probably by regulation the balance of autonomic nerve system. The follow-up study indicates that acupotomy provides more effective treatment than point injection alone.

关 键 词：肌筋膜疼痛综合征 注射疗法 小针刀疗法 自主神经 心率变异指数 

分 类 号：R686.3[医药卫生—骨科学]