基于“以痛为输”探讨针刺激痛点治疗肌筋膜疼痛综合征镇痛效应机制  

Analgesic Mechanism of Needling MTrPs in the Treatment of MPS Based on“Pain-point Needling”

作　　者：马俊杰 胡哲 陈怡然[1,2] 刘玉丽 王树东[1,2] 张淑慧 于嘉祥[1,2] 李冰倩 姚远 王列 马铁明 MA Junjie;HU Zhe;CHEN Yiran;LIU Yuli;WANG Shudong;ZHANG Shuhui;YU Jiaxiang;LI Bingqian;YAO Yuan;WANG Lie;MA Tieming(Liaoning University of Traditional Chinense Medicine,Shenyang 110847,Liaoning,China;Key Laboratory of Acupuncture and Moxibustion Health and Rehabilitation in Liaoning Province,Shenyang 110847,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁省针灸养生康复重点实验室,辽宁沈阳110847

出　　处：《辽宁中医药大学学报》2024年第6期162-165,共4页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：辽宁省自然科学基金计划项目-博士科研启动基金计划项目(2023-BS-137);辽宁省科学技术计划项目-自然基金指导计划项目(2019-ZD-0947);辽宁省“兴辽英才计划”项目-科技创新领军人才(XLYC1902004);辽宁省教育厅基本科研项目(青年项目)(LJKQZ2021066)。

摘　　要：肌筋膜疼痛综合征(myofascial pain syndrome,MPS)已成为一种全球多发病,疼痛是MPS患者最常见的主诉症状。激痛点(myofascial trigger points,MTrPs)实质为挛缩的肌小节,利用体格检查或生物化学检测可以确定MTrPs在骨骼肌中的位置,它是引发肌肉紧绷疼痛的主要原因之一,亦为肌骨疼痛疾病尤其是MPS的有效治疗部位。这与《灵枢·经筋》“以痛为输”理论高度契合。“以痛为输”重点关注患者软组织损伤的疼痛部位和医者触诊到的压痛点,是针刺治疗经筋病的基本取穴原则,已被沿用二千余年,但其作用机制尚不清楚。国内外已开展大量研究探查针刺MTrPs治疗MPS作用机制,基于其与“以痛为输”的相似性,该文就MTrPs实质、MPS疼痛发病机制及针刺MTrPs治疗MPS抗炎镇痛机制等方面进行探讨,以期丰富“以痛为输”理论的科学内涵。Myofascial pain syndrome(MPS)has become a global common disease,and pain is the most common complaint among MPS patients.Myofascial trigger points(MTrPs)are essentially contracted muscle segments.Physical examination or biochemical testing can determine the location of MTrPs in skeletal muscles,which is one of the main causes of muscle tension pain and an effective treatment site for musculoskeletal pain diseases,especially MPS.Acupuncture at the painful point is highly coincident with the theory of“pain-point needling”in Jingjin·Lingshu.The principle of“pain-point needling”focuses on the pain areas of patients with soft tissue injuries and the pain points palpated by doctors.It is the basic acupoint selection principle for acupuncture treatment of meridian diseases and has been used for more than two thousand years,but its mechanism of action is still unclear.A large amount of research has been conducted both domestically and internationally to explore the mechanism of acupuncture MTrPs in treating MPS.Based on its similarity with“pain-point needling”,this article explores the pathogenesis of substantial MPS pain in MTrPs and the anti-inflammatory and analgesic mechanisms of acupuncture MTrPs in treating MPS,in order to enrich the scientific connotation of the theory of“pain-point needling”.

关 键 词：以痛为输 激痛点 肌筋膜疼痛综合征 针刺 

分 类 号：R245.31[医药卫生—针灸推拿学]