应用腰方肌筋膜触发点疼痛理论综合治疗腰腿痛:68例分析

Combined therapy for low back pain based on the theory about quadratus lumborum myofascial trigger point pain:an analysis in 68 cases

目的:观察牵张和药物综合治疗改善腰方肌筋膜触发点疼痛患者症状的效果。方法:选自 2003-03/2004-01云南省玉溪市中医院民族科收治的腰方肌触发点疼痛患者 68例,随机分成两组,治疗组 35例,应用手法压榨和牵张受累肌肉,牵张前注射当归注射液于触发点处镇痛,同时给予改善周围循环的药物如三七、复方丹参片及少腹逐瘀汤加减口服等综合疗法治疗;对照组 33例,应用牵张前注射 10g/L 利多卡因于触发点处镇痛。两组治疗后教会患者在家做自我牵张疗法并进行随访,对治疗前后的疼痛作自拟评分。结果:治疗组治疗前自拟评分总分为(3.54±1.19)分;治疗后为 分 0 25例,1分 5例,2分 5例;治愈 25例,显效 5例,好转 5例。对照组治疗前自拟评分总分为(3.55±1.08)分;治疗后为 0分 20例,1分 3例,2分 2例,3分 例;治愈 8 20例,显效 3例,好转 2例和无效 8例。两组比较差异有显著性意义(χ 2 =5.5284,P <0.05)。结论:综合疗法治疗腰方肌筋膜触发点疼痛,可以改善疼痛症状,增强肌肉力量,促进炎症吸收。

AIM:To observe the effect of combined therapy with stretch and drugs in relieving quadratus lumborum myofascial trigger point pain of patients. METHODS:Sixty-eight patients with quadratus lumborum myofascial trigger point pain were selected form inpatients in the Department for Nationalities,Yuxi Hospital of Traditional Chinese Medicine,Yunnan Province.The selected patients were divided into treatment group(n=35) and control group(n=33) randomly.In the treatment group,patients undertook manipulation of squeeze and stretch on involved muscles;Before stretch,trigger point was injected Chinese angelica parenteral solution,and meanwhile Chinese drugs that can improve peripheral circulation,such as radix notoginseng,compound radix salviae miltiorrhizae and shaofu zhuyu tang were taken orally.In the control group,the trigger points of the patients were injected 10 g/L anestacon before stretch.After treatment,the patients were taught to self-stretch at home,and then followed up.Pain scale was self-drafted before and after treatment. RESULTS:The drafted pain scale of patients in the treatment group was (3.54±1.19) points before treatment.After treatment,25 cases had 0 point,5 had 1 point and 5 had 2 points;25 cases were cured,5 were effectively improved and 5 were improved.The drafted pain scale of patients in the control group was (3.55±1.08) points before treatment.After treatment,20 cases had 0 point,3 had 1 point,2 had 2 points and 8 had 3 points;20 cases were cured,3 were effectively improved,5 were improved and 8 were ineffectively treated.There was significant difference in the curative effect between the two groups. CONCLUSION:The combined therapy for quadratus lumborum myofascial trigger point pains is effective in improving pain,strengthening muscle and promoting inflammatory absorption.