颊针疗法对慢性颈痛患者颈部肌肉弹性的影响:颊针疗法可能机制的探讨

Effect of cheek acupuncture on elasticity of affected muscles in patient with chronic cervicalgia:the possible mechanism of cheek acupuncture

目的观察颊针疗法对慢性颈痛患者疼痛的影响,应用超声弹性成像技术观察颊针治疗前后病变处肌肉弹性的变化,分析颊针对颈痛治疗可能的作用机制。方法收集2021年7月至12月北京和睦家医院麻醉疼痛科收治的颈痛患者30例,选取病变侧颈穴、上颈穴和肩胛带穴,调整进针深度,待症状、体征改善后留针30 min后拔除。记录患者治疗前、治疗完成后10 min,静息时颈部视觉模拟评分(VAS)、病变侧胸锁乳突肌和上斜方肌的厚度以及肌肉弹性Strain值。结果静息时VAS评分由(4.2±0.7)分降至治疗后的(1.0±0.6)分,差异有统计学意义(P<0.001)。治疗后中、重度颈痛的患者例数亦明显降低,由治疗前25例降至1例(P<0.001)。颊针对于慢性颈痛治疗有效率为93%(28/30例)。治疗前后胸锁乳突肌厚度分别为(8.36±0.67)mm和(8.20±0.08)mm,上斜方肌厚度分别为(10.04±1.24)mm和(9.83±1.06)mm。治疗前后病变肌肉厚度无明显差异。胸锁乳突肌和上斜方肌肌肉弹性Strain值明显增加(P<0.001)。胸锁乳突肌肌肉弹性Strain值由治疗前(0.28±0.10)增加至治疗后的(0.38±0.10),上斜方肌肌肉弹性Strain值由治疗前的(0.17±0.04)增加至治疗后的(0.24±0.05),差异均有统计学意义(P均<0.001)。结论颊针疗法可以缓解慢性颈痛患者疼痛症状,其作用原理可能是通过改善肌肉弹性、解除肌肉痉挛而实现。

Objective To observe the effect of cheek acupuncture on elasticity of affected muscles in patients with chronic cervicalgia and explore possible mechanism of cheek acupuncture.Methods Thirty patients with chronic neck pain in Department of Anesthesiology and Painology,Beijing United Family Hospital from July 2021 to December 2021,were enrolled in this study.Select acupuncture points include neck point,upper neck point and shoulder girdle point of the affected side.Adjust the depth of the needles until significant improvement in patients'symptoms and physical signs were observed for 30 minutes.Before and 10 minutes after the treatment,resting VAS were assessed.The thickness and elasticity parameter(Strain)of sternocleidomastoid muscle and upper trapezius in lesion side were measured with Sumsang ultrasound elastography.Results Resting VAS decreased after the cheek acupuncture,from(4.2±0.7)to(1.0±0.6)(P<0.001).The number of patients with moderate to severe neck pain decreased significantly(P<0.001),from 25 cases before the treatment to 1 case after the cheek acupuncture.The total effective rate was 93%and the thickness of sternocleidomastoid were(8.36±0.67)mm and(8.20±0.08)mm and the thickness of upper trapezius(10.04±1.24)mm and(9.83±1.06)mm respectively before and after the treatment.The strain of sternocleidomastoid were(0.28±0.10)and(0.38±0.10)and of upper trapezius were(0.17±0.04)and(0.24±0.05)respectively before and after the treatment.The muscle elasticity of sternocleidomastoid and upper trapezius increased significantly(P<0.001).Conclusion Cheek acupuncture could alleviate pain for patients with chronic cervicalgia and possible mechanism is the change of muscle elasticity and subsequent release of muscle spasm.