口服度洛西汀联合局部内热针治疗慢性颈肩背部肌筋膜疼痛综合征的疗效  

Clinical efficacy of oral duloxetine combined with local internal heated needle in the treatment of patients with neck-shoulder-back myofascial pain syndrome

作　　者：汤达承 李晓宏[1] 黄翔[1] 陈盼 邓翠芬[1] Tang Dacheng;Li Xiaohong;Huang Xiang;Chen Pan;Deng Cuifen(Department of Pain Management,First People's Hospital of Foshan City,Guangdong Province 528000,China)

机构地区：[1]佛山市第一人民医院疼痛科,广东省佛山市528000

出　　处：《中华疼痛学杂志》2020年第6期485-490,共6页Chinese Journal Of Painology

摘　　要：目的探讨度洛西汀联合内热针治疗慢性颈肩背部肌筋膜疼痛综合征(MPS)的临床疗效。方法收集2018年12月至2019年9月就诊于佛山市第一人民医院疼痛科的慢性颈肩背部MPS患者46例,性别、年龄不限,随机分为内热针组(内热针治疗)与联合组(度洛西汀联合内热针治疗组)。治疗前及治疗后1周、1个月和3个月时两组均采用数字疼痛评分法(NRS)和贝克抑郁自评量表-Ⅱ(BDI-Ⅱ)评分进行疼痛程度评分及抑郁状态评估,同时观察不良反应。结果本研究入组患者中女34例,男12例,年龄33~78岁;两组患者一般资料比较差异无统计学意义(P均>0.05)。内热针组和联合组治疗后1周、1个月、3个月NRS评分[内热针组(2.0±0.9)、(2.5±1.5)、(2.3±1.4)分;联合组(1.3±1.0)、(1.5±1.2)、(1.3±1.3)分]和BDI-Ⅱ评分[内热针组(4.5±3.0)、(5.1±3.6)、(5.0±3.3)分;联合组(3.9±3.2)、(3.3±2.3)、(3.0±2.8)分]均较治疗前降低[内热针组NRS(5.6±1.1)分,联合组NRS(5.4±0.9)分;内热针组BDI-Ⅱ(7.5±5.9)分,联合组BDI-Ⅱ(7.2±4.7)分;P均<0.05],且联合组治疗后1周、1个月、3个月时NRS评分及治疗后1个月、3个月时BDI-Ⅱ评分均明显低于内热针组(P均<0.05)。两组均未见严重不良反应。结论口服度洛西汀联合局部内热针法或单纯内热针法均可有效治疗慢性颈肩背部肌筋膜疼痛综合征,联合治疗疗效优于单纯内热针治疗。Objective To evaluate the clinical efficacy of duloxetine combined with internal heat needle on patients with neck-shoulder-back myofascial pain syndrome(MPS).Methods Fourty-six patients with neck-shoulder-back MPS,in Department of Pain Management,First People's Hospital of Foshan City between December 2018 to September 2019,regardless of age and gender,were randomly divided into the controlled group given internal heat needle treatment and the treatment group received duloxetine combined with internal heat needle treatment.Numerical rating scale(NRS)and Beck depression inventory-Ⅱ(BDI-Ⅱ)were evaluated,and the adverse reactions were also observed before the treatment and 1 week,1 month and 3 months after the treatment.Results There were 34 females and 12 males enrolled in this study,aged from 33 to 78 years old.There was no significant difference in general data between the two groups(all P>0.05).The NRS was(5.6±1.1),(2.0±0.9),(2.5±1.5),(2.3±1.4)in the controlled group before the treatment and 1 week,1 month and 3 months after the treatment respectively,while it was(5.4±0.9),(1.3±1.0),(1.5±1.2),(1.3±1.3)in the treatment group respectively.The BDI-Ⅱscore was(7.5±5.9),(4.5±3.0),(5.1±3.6),(5.0±3.3)before the treatment and 1 week,1 month and 3 months after the treatment in the control group respectively,while it was(7.2±4.7),(3.9±3.2),(3.3±2.3),(3.0±2.8)in the treatment group respectively.The NRS and BDI-Ⅱscores were significantly decreased in the two groups after the treatment,compared with that before the treatment(all P<0.05).Compared with the control group,NRS was significantly lower at 1 week,1 month,and 3 months after the treatment in the treatment group(all P<0.05),and BDI-Ⅱscore was significantly lower at 1 month and 3 months after the treatment in the treatment group(all P<0.05).No significant adverse reactions were found in both groups.Conclusion Oral duloxetine combined with local internal heat needle or internal heat needle can effectively relieve the pain in the neck-shoulder-ba

关 键 词：肌筋膜疼痛综合征 度洛西汀 内热针 

分 类 号：R686[医药卫生—骨科学]