基于肌筋膜触发点的干针疗法治疗颈肩肌筋膜疼痛综合征临床研究  

Clinical Study on Dry Needling Therapy Based on Myofascial Trigger Points for Neck-Shoulder Myofascial Pain Syndrome

作　　者：罗登攀[1] 黄节 赵宁[1] LUO Dengpan;HUANG Jie;ZHAO Ning

机构地区：[1]郑州市第三人民医院疼痛科,河南郑州450000 [2]郑州市惠济区第二人民医院妇科,河南郑州450000

出　　处：《新中医》2022年第5期205-210,共6页New Chinese Medicine

摘　　要：目的:观察基于肌筋膜触发点的干针疗法对颈肩肌筋膜疼痛综合征患者的临床疗效。方法:选取86例颈肩肌筋膜疼痛综合征患者进行前瞻性研究,按随机数字表法将其分为研究组与对照组各43例,对照组采取常规电针疗法,研究组采取基于肌筋膜触发点的干针疗法,2组均连续治疗3个月。观察2组临床疗效,比较2组治疗前后中医证候评分、颈椎活动度(CROM)、疼痛程度[McGill疼痛问卷评分量表(SF-MPQ)]、血清[肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-β)以及β-内啡肽、物质-P水平]变化。结果:研究组临床疗效总有效率为95.35%,对照组为81.40%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组中医证候疼痛、压痛、肿胀、功能障碍、瘀斑、舌象、脉象及总分均较治疗前下降(P<0.05),研究组上述各项中医证候评分及总分均低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组前屈、后伸、左侧侧屈、右侧侧屈CROM水平均较治疗前升高(P<0.05),研究组前屈、后伸、左侧侧屈、右侧侧屈CROM水平均高于对照组,差异均有统计学意义(P<0.05)。治疗后,2组SF-MPQ评分均较治疗前下降(P<0.05),研究组SF-MPQ评分低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组血清TNF-α、IL-1β、物质-P水平均较治疗前下降,血清β-内啡肽水平均较治疗前上升,差异均有统计学意义(P<0.05);研究组血清TNF-α、IL-1β、物质-P水平均低于对照组,血清β-内啡肽水平高于对照组,差异均有统计学意义(P<0.05)。结论:基于肌筋膜触发点的干针疗法对颈肩肌筋膜疼痛综合征患者的疗效较好,可有效减轻疼痛、肿胀程度,提高颈椎活动度。Objective:To observe the clinical effect of dry needling therapy based on myofascial trigger points for neckshoulder myofascial pain syndrome.Methods:A total of 86 cases of patients with neck-shoulder myofascial pain syndrome were selected for prospective study,and were divided into the study group and the control group according to the random number table method,with 43 cases in each group.The control group was given routine electroacupuncture,and the study group was given dry needling therapy based on myofascial trigger points.Both groups were treated for three months.The clinical effects in the two groups were observed.Before and after treatment,the changes in Chinese medicine syndrome scores,cervical range of motion(CROM),the pain degree in McGill Pain Questionnaire Scale(SF-MPQ),the levels of tumor necrosis factor-α(TNF-α),interleukin 1β(IL-1β)andβ-endorphin and substance-P in serum in the two groups were compared.Results:The total clinical effective rate was 95.35%in the study group and 81.40%in the control group,the difference being significant(P<0.05).After treatment,the scores of Chinese medicine syndromes including pain,tenderness,swelling,dysfunction,stasis macules,tongue manifestation and pulse manifestation as well as the total scores in the two groups were decreased when compared with those before treatment(P<0.05),and the scores of Chinese medicine syndromes as well as the total score in the study group were lower than those in the control group,differences being significant(P<0.05).After treatment,CROM levels of anteflexion,posterior extension,left lateral flexion and right lateral flexion in the two groups were increased when compared with those before treatment(P<0.05),and the above CROM levels in the study group were higher than those in the control group,differences being significant(P<0.05).After treatment,SF-MPQ scores in the two groups were decreased when compared with those before treatment(P<0.05),and the SF-MPQ score in the study group was lower than that in the control group,differ

关 键 词：肌筋膜疼痛综合征 肌筋膜触发点 干针疗法 炎症反应 颈椎活动度 

分 类 号：R246.9[医药卫生—针灸推拿学]