推拿治疗肌筋膜疼痛综合征机制研究进展  

Research progress on the mechanism of tuina in the treatment of myofascial pain syndrome

作　　者：李彦龙 张增乔 倪亦铭 朱澳琳 孙武权[1] LI Yanlong;ZHANG Zengqiao;NI Yiming;ZHU Aolin;SUN Wuquan(Department of Tuina,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院推拿科,200437 [2]上海中医药大学岳阳临床医学院

出　　处：《环球中医药》2025年第4期850-856,共7页Global Traditional Chinese Medicine

基　　金：国家中医药管理局高水平中医药重点学科(ZYYZDXK-2023061)。

摘　　要：肌筋膜疼痛综合征(myofascial pain syndromes,MPS)特点是非关节性肌肉骨骼慢性疼痛。推拿作为中医外治疗法的重要组成部分,针对MPS的手法多样且疗效确切。随着研究技术的发展,近年来对推拿治疗MPS的机制研究取得了明显的突破。推拿对MPS的治疗机制可体现在多个层面。在细胞层面,推拿手法可以促进细胞呼吸作用产生三磷酸腺苷,改善肌细胞的能量供应;推拿能够改善肌细胞收缩,抑制胶原纤维生成,促进肌细胞修复,防止纤维化。在组织层面,推拿能够促进炎症因子的代谢,调节炎症相关信号通路,改善组织间隙炎症内环境。在系统层面,推拿可以作用于自主神经系统,抑制交感神经,兴奋副交感神经;推拿能够调节条件性痛觉调制,影响中枢的疼痛调节,改善中枢敏化;推拿可以通过抑制前额叶皮层的活动,影响自主神经并抑制疼痛信息处理。但对于推拿治疗MPS的作用机制研究尚处于起步阶段,今后仍需利用更加优秀的技术,推进治疗的标准化及多层次、多学科交叉的深入研究,为临床推拿治疗提供有力的理论依据。Myofascial pain syndrome(MPS)is a type of chronic non-articular musculoskeletal pain.As an important part of external treatment of traditional Chinese medicine,tuina has various techniques for MPS and has significant curative effect.With the development of research technology,the mechanism of tuina therapy for MPS has made significant progress in recent years.The therapeutic mechanism of tuina for MPS can be manifested in multiple aspects.At the cellular level,tuina can promote cell respiration to produce ATP,improve the energy demand of muscle cells;tuina can improve muscle cell contraction,inhibit collagen fiber generation,promote muscle cytothesis,and prevent fibrosis.At the tissue level,tuina can promote the metabolism of inflammatory factors,regulate inflammation-related signaling pathways,inhibit inflammation and improve the internal environment.At the system level,tuina can act on the autonomic nervous system,inhibit the sympathetic nerve and excite the parasympathetic nerve;tuina can regulate conditioned pain modulation,affect central pain regulation,improve central sensitization;tuina can also inhibit pain information processing by inhibiting activity in the prefrontal cortex,affecting the autonomic nerve.The study on the mechanism of MPS in tuina therapy is still deficiency.It is necessary to use more excellent technologies in the future to promote the standardization of treatment and multi-level and multidisciplinary in-depth research,so as to provide a strong theoretical basis for clinical tuina therapy.

关 键 词：肌筋膜疼痛综合征 肌筋膜触发点 推拿 临床概述 作用机制 细胞 组织 系统 

分 类 号：R244.1[医药卫生—针灸推拿学]