针刺肌筋膜疼痛激痛点治疗髌股疼痛综合征的疗效：随机对照试验  

EFFECT OF ACUPUNCTURE ON MYOFASCIAL TRIGGER POINTS IN THE TREATMENT OF PATELLOFEMORAL PAIN SYNDROME: A RANDOMIZED CONTROLLED TRIAL

作　　者：马彦韬 赵佳敏 黄强民[1] 李丽辉[1] 徐安乐 庞博 郑拥军 MA Yan-Tao;ZHAO Jia-Min;HUANG Qiang-Min;LI Li-Hui;XU An-Le;PANG Bo;ZHENG Yong-Jun(Shanghai University of Sports,Shanghai 200438;Department of Pain Management,Huadong Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]上海体育学院,上海200438 [2]复旦大学附属华东医院疼痛科,上海200040

出　　处：《中国疼痛医学杂志》2019年第12期919-923,共5页Chinese Journal of Pain Medicine

基　　金：国家自然科学基金面上项目(81470105);上海市人体运动能力开发与保障重点实验室(上海体育学院)(11DZ 2261100)

摘　　要：目的:观察针刺股四头肌激痛点结合静态拉伸股四头肌治疗髌股疼痛综合征的临床疗效。方法:50例髌股疼痛综合征(patellofemoral pain syndrome,PFPS)病人,随机分为两组(n=25):实验组采用针刺股四头肌激痛点结合股四头肌拉伸。对照组采用安慰剂针法,拉伸和实验组相同,两组均每周针刺1次,拉伸每日3次,每次1 min,持续6周。于治疗前、治疗3周和6周后和治疗结束后3个月,分别采用疼痛数字评价量表(numberical rating scale,NRS)、膝关节主动屈膝活动度(active range of motion,AROM)和膝关节Lysholm评分进行疗效观察。结果:两组病人一般资料无显著性差异,两组NRS在治疗3周、6周后,较治疗前均有显著性下降,但3个月随访时,对照组较治疗前无显著性差异;两组治疗后的膝关节AROM较治疗前均有显著性提高,但是在治疗6周后,实验组显著高于对照组;两组膝关节Lysholm评分治疗后较治疗前均有显著性提高,但是在治疗6周后和3个月随访,实验组显著高于对照组。结论:针刺激痛点与安慰针疗法结合静态拉伸均可在短期内有效缓解疼痛及改善膝关节活动度,但前者长期效果更佳。Objective:To observe the efficacy of acupuncture on quadriceps trigger points and the static stretch quadriceps for the treatment of patellofemoral pain syndrome(PFPS).Methods:Fifty patients with PFPS were randomly divided into two groups(n=25):In the test group,the trigger points of the oblique,femoral lateral and rectus femoris muscles were acupunctured,and static quadriceps stretching was performed after acupuncture.The placebo acupuncture was used in the control group.The quadriceps muscles were statically stretched in the same way as the test group.The two groups were acupunctured once a week.The quadriceps muscles were statically stretched for 6 weeks,3 times a day for 1 minute.Before treatment,after 3 and 6 weeks of treatment,and 3 months after the end of treatment,the numberical rating scale(NRS),knee active range of motion(AROM)and knee Lysholm score were used for efficacy observation.Results:There was no significant difference in general data between the two groups.The NRS in the test group decreased significantly after 3,6 weeks,and 3 months after treatment compared with NRS before treatment.The NRS in the control group had a significant decrease after 3 and 6 weeks of treatment compared with NRS before treatment.However,there was no significant difference in 3 months follow-up compared with NRS before treatment.The knee active range of motion(AEMG)of the test group and the control group were increased after treatment,but after 6 weeks of treatment,the test group was significantly higher than that of the control group.Lysholm scores in the test and control groups were significantly higher than before treatment,but after 6 weeks and 3 months of follow-up,the test group was sig-nificantly higher than the control group.Conclusion:Both acupuncture trigger points and placebo acupuncture combined with static stretching can effectively relieve pain and improve knee joint motion in a short period of time,but the former has better long-term effects.

关 键 词：髌股疼痛综合征 激痛点 针刺 拉伸 

分 类 号：R246.9[医药卫生—针灸推拿学]