推拿手法联合药物治疗肌筋膜疼痛综合征60例临床研究  

Clinical Study on 60 Cases of Tuina Manipulation Combined with Medicine for Myofascial Pain Syndrome

作　　者：梅胜利[1] MEI Shengli

机构地区：[1]郑州大学第二附属医院(南阳路院区)康复科,河南郑州450002

出　　处：《新中医》2020年第9期132-134,共3页New Chinese Medicine

摘　　要：目的:观察推拿手法联合药物治疗肌筋膜疼痛综合征的效果。方法:纳入120例肌筋膜疼痛综合征患者,利用随机数字表法分为2组各60例,2组均服用腰痛胶囊和外用吡罗昔康凝胶,观察组加用腰部斜扳法、穴位按摩、理筋等推拿手法治疗。2组疗程均为1个月。治疗前后应用简化Mc Gill疼痛量表评估疼痛程度[包括疼痛分级指数(PRI)、视觉模拟评定法(VAS)评分、现时疼痛强度(PPI)],应用彩色多普勒超声诊断仪测量患侧腰大肌和腰方肌的肌肉厚度,并对整体疗效进行评价。结果:治疗1个月后,2组PRI、PPI、VAS分值均较治疗前下降(P<0.05),观察组3项评分均低于对照组(P<0.05)。2组腰大肌、腰方肌的肌肉厚度值均较治疗前升高(P<0.05),且观察组2项肌肉厚度值均高于对照组(P<0.05)。对照组临床疗效总有效率81.67%,观察组96.67%,2组比较,差异有统计学意义(P<0.05)。结论:在药物基础上加用腰部斜扳法、穴位按摩、理筋等推拿手法治疗肌筋膜疼痛综合征患者具有更优秀的治疗优势,可有效改善疼痛等临床症状和体征,增强肌肉功能,提高临床疗效。Objective:To observe the effect of tuina manipulation combined with medicine for myofascial pain syndrome.Methods:Enrolled 120 cases of patients with myofascial pain syndrome,and divided them into two groups according to random number table,60 cases in each group.Both groups received the oral administration of Yaotong capsules and the external application of piroxicam gel,while the observation group additionally received tuina manipulation such as oblique pulling in waist,acupoint massage and tendon regulation.The courses of treatment in both groups lasted for one month.Before and after treatment,evaluated the degree of pain[Pain Rating Index(PRI),the scores of Visual Analogue Scale(VAS)and Present Pain Intensity(PPI)]via the simplified Mc Gill Scale,measured the muscle thickness of psoas major and quadratus lumborum in the affected side via Color Doppler ultrasonic diagnostic apparatus,and evaluated the overall therapeutic effect.Results:After one month of treatment,the scores of PRI,PPI,and VAS in both groups were respectively lower than those before treatment(P<0.05),and the three scores above in the observation group were lower than those in the control group(P<0.05).The muscle thickness values of psoas major and quadratus lumborum in both groups were higher than those before treatment(P<0.05),and the two values of muscle thickness in the observation group were higher than those in the control group(P<0.05).The total effective rate was 81.67%in the control group and 96.67%in the observation group,difference being significant(P<0.05).Conclusion:The additional application of tuina manipulation such as oblique pulling in waist,acupoint massage and tendon regulation based on medicine has better therapeutic advantage in treating patients with myofascial pain syndrome,which can effectively improve clinical symptoms like pain and signs,enhance muscle function and increase clinical effect.

关 键 词：肌筋膜疼痛综合征 中西医结合疗法 推拿手法 腰部斜扳法 穴位按摩 理筋 简化Mc Gill疼痛量表 肌肉骨骼超声 

分 类 号：R686.3[医药卫生—骨科学]