针刀浅刺法治疗项背筋膜炎的临床研究

Observation on the clinical curative effect of shallow acupuncture with small knife needle in the treatment of fasciitis of nape muscle

目的:观察针刀浅刺法治疗项背筋膜炎的临床疗效。方法:将60例符合要求的项背筋膜炎患者随机分为2组,每组30例。治疗组采用针刀浅刺松解筋膜法治疗,对照组采用常规针刺夹脊穴联合TDP灯照射治疗。治疗隔天1次,共治疗5次。分别于治疗前和治疗结束后采用视觉模拟评分法评定患者的疼痛情况,并于治疗结束后采用根据《中医病证诊断疗效标准》中背肌筋膜炎的疗效标准自拟的疗效标准评定2组患者的总体疗效。结果:①疼痛情况。治疗前2组患者疼痛VAS评分比较,差异无统计学意义(t=0.116,P=0.908);治疗后2组患者疼痛VAS评分均降低[(7.58±0.56),(1.39±0.63),t=24.677,P=0.000;(7.62±0.31),(3.07±1.06),t=17.041,P=0.000],治疗组降低更明显[(6.18±0.35),(4.55±0.62),t=4.889,P=0.000]。②总体疗效。治疗组优19例、良5例、中4例、差2例,对照组优11例、良3例、中6例、差10例,治疗组疗效优于对照组[R治疗组=0.409,95%CI(0.325,0.492);R对照组=0.591,95%CI(0.485,0.697)]。结论:针刀浅刺法可有效缓解项背筋膜炎患者的疼痛症状,改善临床体征,其疗效优于常规针刺夹脊穴联合TDP灯照射治疗。

Objective：To observe the clinical effect of shallow acupuncture with small knife needle in the treatment of fasciitis of nape muscle.Methods：Sixty patients with fasciitis of nape muscle that met the requirements were randomly divided into 2 groups,30 cases in each group.Patients in the treatment group were treated with shallow acupuncture with small knife needle,while the others in the control group were treated with acupuncture at Jiaji point combined with TDP irradiation.The treatment was carried out every other day,and totally 5 times.The visual analogue scores（VAS） of nape muscle were compared between the 2 groups before the treatment and after the end of the treatment,and the total curative effects were determined after the end of the treatment according to the self-designed therapeutic effect evaluation standard of dorsal muscles fasciitis which was extracted from Standard for diagnosis and therapeutic effectiveness evaluation of traditional Chinese medicine syndromes.Results： There was no statistical difference in VAS between the 2 groups before the treatment （t =0.116,P =0.908）,while the VAS decreased in both of the 2 groups after the treatment （7.58 ＋/-0.56 vs 1.39 ＋/-0.63 points,t =24.677,P =0.000 ;7.62 ＋/-0.31 vs 3.07 ＋/-1.06 points,t =17.041,P =0.000）,and the VAS decreased more significantly in the treatment group（6.18 ＋/-0.35 vs 4.55 ＋/-0.62 points,t =4.889,P =0.000）.Nineteen patients obtained an excellent result,5 good,4 fair and 2 poor in the treatment group,while 11 patients obtained an excellent result,3 good,6 fair and 10 poor in the control group.The treatment group surpassed the control group in the total curative effect （（treatment group： （R-） =0.409,95% CI （0.325,0.492） ; control group：（R-） =0.591,95% CI（0.485,0.697））.Conclusion：The therapy of shallow acupuncture with small knife needle can effectively relieve the pain of nape muscle and improve the clinical signs,and it has better curative effects compared with the method of acupuncture at Jiaji point combined with TDP irradiation.