铍针治疗肩胛肌筋膜炎的病例对照研究

Case control study on the treatment of patients with scapular muscle fasciitis by Pizhen

目的：观察铍针治疗肩胛肌筋膜炎的临床疗效,并分析作用机制.方法：自2012年1月至2013年3月治疗116例肩胛肌筋膜炎患者,其中治疗组58例,对照组58例,治疗组脱落2例,对照组剔除1例、脱落4例.剔除脱落病例后共109例,治疗组56例,男15例,女41例,平均年龄（28.02±4.85）岁,病程0.25～3年;对照组53例,男19例,女34例,平均年龄（27.23±4.54）岁,病程0.25～1年.治疗组采用铍针治疗,一次性治疗,松解1～3个痛点,1周后复查,根据痛点分布可再治疗1次,松解1～3个痛点,第2周后采集数据.对照组采用针灸按摩仪治疗,每次治疗20 min,隔日1次,治疗6次为1个疗程,第2周后采集数据.两组治疗前后通过软组织张力测试仪测量局部软组织位移值、香蕉面积,用压痛测量仪测量压痛值,用疼痛视觉模拟量表记录VAS评分,最后对上述结果进行统计分析.结果：治疗后治疗组软组织位移值、压痛值高于对照组,香蕉面积和VAS低于对照组.治疗组临床痊愈30例,显效13例,好转12例,无效1例;对照组临床痊愈16例,显效19例,好转11例,无效7例.治疗组疗效优于对照组.结论：铍针通过减轻肩胛部局部痛点的软组织张力,解除神经压迫和刺激,从而有效缓解肩胛肌筋膜炎患者的疼痛症状,具有很好的临床疗效.

To evaluate and analyze the mechanism of Pizhen for the treatment of patients with scapular muscle fasciitis. Methods： One hundred and sixteen patients were divided into two groups according to random number table method, 58 cases in the treatment group and 58 cases in the control group. After treatment, 109 patients were followed up,and 7 pa- tients lost follow-up （2 cases in the treatment group and 5 patients in the control group）. In the treatment group, there were 15 males and 41 females, with a mean age of （28.02±4.85） years; the course of disease ranged from 0.25 to 3 years;and the patients were treated by Pizhen once a week, and 2 weeks were one treatment course. In the control group,there were 19 males and 34 females,with a mean age of （27.23±4.54） years old;the course of disease ranged from 0.25 to 1 year;and the patients were treated by acupuncture massage instrument, 20 minutes at a time,once a day for 2 weeks. Soft tissue displacement and banana area were tested by a soft tissue tension tester, pressure value was measured by pressure measuring instrument, and VAS was recorded by pain visual analog scale record. Results： There were significant differences in tissue displacement, banana area, pressure value and VAS between two groups before and after treatment. The tissue displacement and pressure value in the treatment group were higher than those in the control group,while banana area and VAS were lower than those in the control group. In the treatment group, 30 patients healed, 13 patients got marked improvement, 12 good and 1 poor;while 16 patients healed, 19 patients got marked improvement, 11 good and 7 poor in the control group. The therapeutic effects in the treatment group was better than that in the control group. Conclusion：Pizhen is an effective method to treat pain in patients with scapular muscle fasciitis by relaxing tendon of soft tissue around pain point of scapular and relaxing compress and stimulation of nerves.