A型肉毒毒素盆底痛点定位注射在女性盆底肌筋膜疼痛治疗中的意义

Botulinum toxin A myofascial trigger points injection in the treatment of myofascial pelvic pain in women

目的:探讨A型肉毒毒素(BTXA)盆底痛点定位注射治疗女性盆底肌筋膜疼痛(MFPP)的临床疗效。方法:回顾性分析2013年1月～2017年6月收治的女性MFPP患者107例,进行盆底痛点评估后行BTXA痛点定位注射治疗。按有无合并下尿路症状(LUTS)分为单纯MFPP组和MFPP并LUTS组,比较两组患者临床症状特点,盆底痛点定位注射治疗前及治疗3个月后患者盆底疼痛、生活质量及排尿症状的改善情况。结果:MFPP并LUTS组的患者年龄更大,盆底疼痛程度更严重,生活质量更差(P<0.05)。两组患者经BTXA盆底痛点注射后盆底疼痛NRS评分下降,生活质量评分(QOL)下降,MFPP并LUTS组的患者排尿次数减少,排尿量增多(P<0.05),两组患者在治疗后未见明显并发症。结论:女性MFPP易合并LUTS,BTXA盆底痛点定位注射不仅能缓解女性MFPP,同时能缓解LUTS,是一种安全、经济、有效的治疗方法。

Objective:To explore the effect of botulinum toxin A myofascial trigger points injection in the treatment of female patients with myofascial pelvic pain.Method:Clinical data of 107 cases of myofascial pelvic pain were collected during January 2013 to June 2017.According to the presence of lower urinary tract symptoms,the patients were divided into 2 groups.We compared the improvement about the clinical symptoms,the pelvic pain,the quality of life and urination between the two groups for pelvic trigger point injections after 3 month.Result:The patients with myofascial pelvic pain accompanied by lower urinary tract symptoms showed the older age,more severe pelvic pain and poorer quality of life(P<0.05).The myofascial pelvic pain symptoms were relieved effectively and the quality of life improved obviously both in the two groups of patients after treatment(P<0.05).There was no obvious complication in both two groups of patients after treatment.Conclusion:Female patients with myofascial pelvic pain are more likely to merge with the urinary symptoms.Application of botulinum toxin A myofascial trigger points injections can not only alleviate the symptoms of female pelvic pain,but also the lower urinary tract symptoms,which is a safe and effective method.