腰臀肌筋膜触发点疼痛和其下肢牵涉痛的诊断与治疗

The diagnoses and treatments of myofacial trigger point pains company with referred pains of leg

目的:探讨腰臀肌触发点疼痛和其腿部牵涉痛的特征,观察以反复针刺为主,受累腰臀肌牵张为辅的治疗效果。方法:研究对象为114例不同腰臀肌筋膜触发点疼痛的病例,根据诊断对这些患者以湿针刺触发点和对不同受累肌牵张疗法进行治疗。针刺触发点后,教患者在家做自我受累肌牵张和随访,并根据疼痛的程度、并发症状和体征设计和定义评分标准,对治疗前后自拟疼痛评分。本文重点描述大部分腰臀肌触发点位置和它们特定牵涉痛的范围;同时也重点描述各腰臀肌的自我牵张法和湿针刺触发点方法。结果:治疗前为4.6±1.1分,治疗后(3—6个月)为1.5±1.2分,治疗后的疼痛评分显著低于治疗前评分(P<0.001)。结论:本法对伴有腿部牵涉痛的腰臀肌触发点疼痛治疗有效,并且方便易行。

Objective: To study the characteristics of myofacial trigger point pain in lumbar and breech region with theirs referred buttock and leg pains, and to investigate the effects of repeated punctures into trigger points at involved muscles associated a stretch therapy to these muscles.Method:114 patients suffering a pain in the location around lower back, buttocks and legs, were correctly diagnosed as the myofacial trigger point pain in different lower back and buttock muscles with the feature referred pains of buttock and leg. They were treated with a wet needling combined with a stretch therapy and some medications,such as multi-vitamin etc. Methods for pain relief were applied in order to avoid the pain during puncturing.According to the level of pain,company symptom and sign,a pain scale of self-definition was made for evaluating the effect before and after treatment.Result:After 3-6 month following-up, pain scale before treatment was 4.6±1.1 and after 1.5±1.2(P<0.001),the pain scale of treat-after was significantly lower than before.Conclusion:Trigger points of lumbar and breech muscles with referred pains of buttock and leg are very effective and easy to be applied.