放散式冲击波循经取穴对慢性颈部疼痛表面肌电图及疼痛递质的影响

Effects of dispersive shock wave meridian retrieval on surface electromyography and pain mediators in chronic neck pain

目的 探讨放散式冲击波循经取穴对慢性颈部疼痛(CNP)的应用价值。方法 选取2020年2月至2022年1月右江民族医学院附属医院60例CNP病人,简单随机化法分为对照组(n=30)和观察组(n=30),分别采取放散式冲击波治疗、放散式冲击波穴位点治疗,连续治疗8周。治疗8周后,统计两组临床疗效、视觉模拟评分法(VAS)、表面肌电图指标[中位频率值(MF)、均方根值(RMS)]、颈椎功能障碍指数(NDI)、颈椎活动度(左旋、右旋、前屈、后伸)、疼痛递质[前列腺素E(PEG2)、神经生长因子(NGF)、缓激肽(BK)]。结果 治疗4、8周后,观察组治疗总有效率90.00%高于对照组66.67%(P<0.05);治疗4、8周后观察组VAS、NDI评分低于对照组(P<0.05);治疗4、8周后观察组颈后伸肌、胸锁乳突肌MF、RMS高于对照组,右旋、后伸、前驱、左旋高于对照组(P<0.05);治疗4、8周后观察组血清PEG2、NGF、BK水平低于对照组(P<0.05)。结论 放散式冲击波循经取穴治疗CNP效果确切,可调节疼痛递质,改善颈部肌群疲劳程度,扩大颈椎活动度。

Objective To investigate the value of dispersive shock wave meridian retrieval for patients with chronic neck pain(CNP).Methods A total of 60 CNP patients in Affiliated Hospital of Youjiang Medical College for Nationalities from February 2020 to Janu⁃ary 2022 were selected and divided into the control group(n=30)and the observation group(n=30)by simple randomization.They were treated with radiated shock wave therapy and radiated shock wave respectively.Acupoint treatment,continuous treatment for 8 weeks.After 8 weeks of treatment,the 2 groups of clinical efficacy,visual analogue scoring(VAS),surface electromyography indicators[medi⁃an frequency(MF),root mean square(RMS)],cervical spine dysfunction index(NDI),Cervical spine mobility(left-handed,right-hand⁃ed,forward,backward extension),pain mediators[prostaglandin E(PEG2),nerve growth factor(NGF),bradykinin(BK)],self-conscious function scale(PSFS),European five Dimension scale(ED-5Q).Results After 4 weeks and 8 weeks of treatment,the total effective rate of treatment in the observation group was 90.00%higher than that in the control group(66.67%,P<0.05).VAS and NDI scores in the observation group were lower than the control after 4 weeks and 8 weeks of treatment Group(P<0.05).After 4 weeks and 8 weeks of treatment,the MF and RMS of posterior cervical extensor and sternocleidomastoid muscles in the observation group were higher than those in the control group,and right-handedness,back-extension,prodration and left-handedness were higher than those of the control group Group(P<0.05).Serum PEG2,NGF,BK levels in the observation group after 4 weeks of treatment and 8 weeks later were lower than those of the control group(P<0.05).ED-5Q scores of the 2 groups after 8 weeks of treatment Lower than before treatment,PSFS score was higher than before treatment(P<0.05).Conclusion Discharge shock wave following the meridian and acupuncture points is effective in treating CNP,regulating pain mediators,improving the degree of fatigue of the cervical muscles and expanding the mobility of the cervical spine.