触发点干针疗法联合超声引导下颈神经后支阻滞用于颈型颈椎病疼痛临床研究  

Application of dry needling for trigger points combined with ultrasound‑guided cervical nerve posterior branch block for pain in neck‑type cervical spondylopathy

作　　者：王佳佳 胡长馨 陈唯 孙凡 李友华 袁燕 Wang Jiajia;Hu Changxin;Chen Wei;Sun Fan;Li Youhua;Yuan Yan(School of Anesthesiology,Xuzhou Medical University,Xuzhou 221004,China;Department of Pain,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221002,China;Department of Anesthesiology,the First Affiliated Hospital of Bengbu Medical University,Bengbu 233099,China)

机构地区：[1]徐州医科大学麻醉学院,徐州221004 [2]徐州医科大学附属医院疼痛科,徐州221002 [3]蚌埠医科大学第一附属医院麻醉科,蚌埠233099

出　　处：《国际麻醉学与复苏杂志》2024年第9期956-961,共6页International Journal of Anesthesiology and Resuscitation

基　　金：徐州医科大学麻醉学院临床科研项目(XYMZ2023007)。

摘　　要：目的比较触发点干针疗法联合颈神经阻滞与单纯颈神经阻滞治疗对颈型颈椎病(NTCS)疼痛的影响。方法选取2023年8月至2023年10月于徐州医科大学附属医院疼痛科就诊的NTCS患者68例,按随机数字表法分为联合治疗组(试验组)和神经阻滞组(对照组),每组34例。试验组行触发点干针疗法联合颈神经后支阻滞治疗,对照组行颈神经后支阻滞治疗。进行两次操作为1个治疗周期,两次治疗间隔6 d。记录两组患者性别、体重指数(BMI)、年龄及病程等一般资料。记录分析两组患者治疗前与治疗后1 d、1周、4周、12周的数字分级评分法(NRS)疼痛评分、颈痛量表(NPQ)评分,治疗前、治疗后4周匹兹堡睡眠质量指数量表(PSQI)评分,治疗前、治疗后1 d的颈部关节活动度(CROM)(屈伸、侧弯、旋转);同时记录在院期间补救药物使用率和不良反应发生情况。结果与治疗前比较,两组患者治疗后各时点NRS疼痛评分、NPQ评分均降低(均P<0.05),治疗后4周PSQI评分均降低(均P<0.05),治疗后1 d CROM(侧弯、旋转)均增加(均P<0.05)。与对照组比较,试验组治疗后4周、12周的NRS疼痛评分及NPQ评分均较低(均P<0.05),治疗后4周PSQI评分较低(P<0.05),治疗后1 d CROM(侧弯、旋转)均较大(均P<0.05)。其余指标差异均无统计学意义(均P>0.05)。结论触发点干针疗法联合超声引导下颈神经后支阻滞治疗NTCS疗效显著,优于单纯神经阻滞治疗。Objective To compare the effects of dry needling for trigger points with cervical nerve block versus cervical nerve block alone on the pain of neck‑type cervical spondylopathy(NTCS).Methods A total of 68 NTCS patients who were admitted to De‑partment of Pain Management,the Affiliated Hospital of Xuzhou Medical University from August 2023 to October 2023 were selected.According to the random number table method,they were divided into two groups(n=34):a combined treatment(experimental)group and a nerve block(control)group.The experimental group underwent dry needling for trigger points combined with cervical nerve posterior branch block,while the control group received cervical nerve posterior branch block alone.One treatment cycle consisted of two proce‑dures,with a 6 d interval between treatments.The general information such as gender,body mass index(BMI),age and course of dis‑ease of the two groups were recorded.Then,the Numerical Rating Scale(NRS)scores,and Northwick Park Neck Pain Questionnaire(NPQ)scores were analyzed before treatment and day 1,weeks 1,4 and 12 after treatment.The Pittsburgh Sleep Quality Index(PSQI)scores were recorded before and 4 weeks after treatment.The cervical range of motion(CROM)(flexion/extension,lateral bending,and rotation)was measured before and day 1 after treatment.Meanwhile,the use of rescue medication and the incidences of adverse reactions during hospitalization were recorded.Results Compared with those before treatment,NRS pain scores and NPQ scores de‑creased at all time points after treatment in both groups(all P<0.05),PSQI scores decreased 4 weeks after treatment(all P<0.05),and CROM(lateral bending,rotation)increased day 1 after treatment(all P<0.05).Compared with the control group,the experimental group showed decreases in NRS pain scores and NPQ scores 4 and 12 weeks after treatment(all P<0.05);decreases in PSQI scores 4 weeks after treatment(P<0.05);and increases in CROM(lateral bending,and rotation)day 1 after treatment(all P<0.05).There were no statis‑t

关 键 词：颈型颈椎病 肌筋膜触发点 干针 神经阻滞 

分 类 号：R614[医药卫生—麻醉学]