节段性神经肌肉疗法阻滞治疗肌筋膜痛综合征的疗效分析

The effect of segmental neuromyotherapy by blocking on myofascial pain syndrome

目的:观察节段性神经肌肉疗法(SNMT)阻滞治疗用于肌筋膜痛综合征治疗的疗效及对患者运动功能恢复的影响。方法:选取32例肌筋膜痛综合征患者,其中12例患者的疼痛与膝关节活动相关且影响了关节活动度训练的进度。所有患者进行SNMT治疗。SNMT治疗是对患者进行椎旁阻滞,有的患者加局部浸润。SNMT治疗后进行运动功能康复训练。每例患者在SNMT治疗前、后及治疗后1周、4周、3个月及6个月进行0—10数字分级量表(NRS)评定;与疼痛相关膝关节活动受限的患者,在SNMT治疗前、后及治疗后6个月进行关节的被动关节活动度(PROM)评定。结果:SNMT治疗前NRS评分平均为(7.57±1.18)分,治疗后即刻降至(3.75±1.93)分,与治疗前比有显著性差异(P=0.000);治疗后1周、4周、3个月及6个月的平均NRS评分分别为3.68±1.86,3.48±2.03,3.20±1.64及2.55±1.70分,与治疗前比均有显著性差异(P=0.000);与疼痛相关膝关节活动受限的患者在SNMT治疗前PROM平均为97.50°±30.11°,治疗后即刻即增加为107.92°±29.11°,与治疗前相比有显著性差异(P=0.001);治疗后6个月时为135.83°±7.02°,与治疗前比有显著性差异(P=0.000)。结论:SNMT对肌筋膜痛综合征所致神经肌肉骨骼性疼痛具有迅速且较持久的疗效;对疼痛所致膝关节活动受限具有明显改善作用。

Objective： To investigate the effect of segmental neuromyotherapy（SNMT） by blocking on myofascial pain syndrome patients（MPS）, and its influence on the patients’ motor function recovery. Method： Thirty-two MPS patients were involved in this study, 12 patients＇ range of motion（ROM） training of knee joints were delayed by pain. All the patients received SNMT therapy by paravertebral block with or without local infiltration, and followed by motor function rehabilitative training. The 0—10 numeric rating scale（NRS） was assessed before and after SNMT therapy, and 1 week, 4 weeks, 3 months and 6 months after the treatment. To the patients whose ROM training were impacted by pain, passive ranges of motion（PROM） were measured before and after SNMT therapy, and also 6 months after treatment. Result： The original average NRS marks was 7.57±1.18, immediately decreased to 3.75±1.9 after SNMT, and were 3.68±1.86,3.48±2.03,3.20±1.64 and 2.55±1.70 at 1 week, 4 weeks, 3 months and 6 months after treatment. All of marks after SNMT changed significantly compared with the marks before treatment（P=0.000）. To the patients whose ROM training were impacted by pain, the average PROM was 97.50°±30.11° before SNMT therapy and 107.92°±29.11° immediately after treatment, 135.83°±7.026° 6 months after treatment. Both of the latter changed significantly （P=0.001 and 0.000 respectively）.Conclusion： SNMT by blocking has immediate and long-term effects on MPS. To the patients who have pain-related ROM limitation, SNMT by blocking is helpful to develop the PROM immediately.