浮针治疗颈肩部肌筋膜疼痛综合征应用效果、肌张力指标及超声弹性成像指标的研究  

Effect of Fu’s Subcutaneous Needling in Treating Cervical and Shoulder Myofascial Pain Syndrome and Its Influence to Indexes of Muscular Tension and Ultrasound Elastography

作　　者：张广防 彭雄强 郭玲崧 黎玉明 鞠佳俊 肖建斌 ZHANG Guangfang;PENG Xiongqiang;GUO Lingsong;LI Yuming;JU Jiajun;XIAO Jianbin(The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China)

机构地区：[1]广州中医药大学第二附属医院,广东广州510120

出　　处：《针灸临床杂志》2021年第10期33-38,共6页Journal of Clinical Acupuncture and Moxibustion

基　　金：广东省中医药局科研项目,编号:20201139。

摘　　要：目的:观察浮针治疗颈肩部肌筋膜疼痛综合征的应用效果,分析其对患者肌张力及超声弹性成像指标的影响。方法:选取2018年3月—2019年12月在本院接受治疗的70例颈肩部肌筋膜疼痛综合征患者作为研究对象,通过随机数字表法将患者分为对照组与研究组,各35例。对照组采用针灸疗法联合肌肉能量技术(MET)治疗,研究组在此基础上采用浮针治疗,两组患者均连续治疗2周。治疗前后,采用视觉疼痛模拟量表(VAS)评估患者颈肩部疼痛程度,颈部功能障碍指数(NDI)评估患者颈部功能障碍,并对两组患者疗效情况、肌力变化、关节活动度、超声弹性成像指标、血清5-羟色胺(5-HT)和β-内啡肽(β-EP)水平进行分析比较。结果:研究组治疗总有效率为91.43%(32/35),明显高于对照组的71.43%(25/35),差异具有统计学意义(P<0.05);治疗后,研究组VAS评分、NDI评分均明显低于对照组,差异具有统计学意义(P<0.05);研究组双侧肌张力均明显大于对照组,差异具有统计学意义(P<0.05);研究组关节活动度明显优于对照组,差异具有统计学意义(P<0.05);研究组超声弹性成像指标弹性评分、杨氏模量值均明显低于对照组,差异具有统计学意义(P<0.05);研究组血清5-HT水平明显低于对照组,差异具有统计学意义(P<0.05),β-EP水平明显高于对照组,差异具有统计学意义(P<0.05)。结论:浮针治疗可以有效缓解颈肩部肌筋膜疼痛综合征患者颈肩部肌肉疼痛,提高颈肩部双侧肌力与关节活动度,调节血清5-HT、β-EP水平,改善颈椎功能障碍,值得临床推广。Objective:To observe the efficacy of Fu’s subcutaneous needling in the treatment of cervical and shoulder myofascial pain syndrome and to analyze its influence to muscular strength and ultrasound elastography.Methods:70 cases of cervical and shoulder myofascial pain syndrome were randomly divided into the control group and the study group,with 35 cases in each group.The control group was treated with acupuncture combined with muscle energy technology(MET);on which basis,the study group was also treated with Fu’s subcutaneous needling.Both groups were treated for 2 weeks.The scores of VAS and NDI,the changes of muscular strength,joint motility,indexes of ultrasonic elastography,the serum levels of 5-HT andβ-endorphin(β-EP),as well as the therapeutic effect were compared between the two groups after the treatment.Results:The total effective rate was 91.43%(32/35)in the study group,which was significantly higher than 71.43%(25/35)in the control group(P<0.05).The scores of VAS and NDI were significantly lower in the study group than those in the control group(P<0.05).The bilateral muscular strength was significantly greater in the study group than that in the control group(P<0.05).The joint motility of the study group was superior to that in the control group(P<0.05).The indexes of ultrasonic elastography and the value of Young’s modulus were significantly lower in the study group than those in the control group(P<0.05).The serum level of 5-HT was significantly lower(P<0.05),and the level ofβ-EP was significantly higher in the study group than those in the control group(P<0.05).Conclusion:Fu’s subcutaneous needling can effectively relieve cervical and shoulder muscle pain in patients with cervical myofascial pain syndrome,it can improve bilateral cervical muscular strength and joint motility,regulate serum levels of 5-HT andβ-EP,as well as improve cervical dysfunction,which is worthy of clinical promotion.

关 键 词：浮针 肌筋膜疼痛综合征 肌张力 超声弹性成像 5-羟色胺 Β-内啡肽 

分 类 号：R246.2[医药卫生—针灸推拿学]