肌筋膜疼痛触发点

Myofascial trigger points:the common cause of clinical tissue pain

背景:肌筋膜疼痛触发点技术在欧美国家临床康复和组织疼痛领域已得到广泛性应用,国内相关专家对其病理机制认识,以及如何诊断和治疗该疾病还存在误区和局限。目的:从病因学、病理机制、诊断和定位、治疗手段等方面,系统阐述该疾病的理论基础及治疗经验。方法:以"myofascial trigger points"及"肌筋膜疼痛触发点,激痛点,扳机点"为关键词搜索PubM ed、Scice Direct和中国知网数据库相关文献,搜索时限为数据库建库至2014年8月,并通过摘要进行文献筛选。结果与结论:人类从4岁开始才在某些骨骼肌上出现疼痛触发点,组织创伤、姿势不正、骨与关节退行性改变、营养因子缺乏、精神压力、慢性感染等为导致肌筋膜疼痛触发点形成的主要病因。肌筋膜疼痛触发点的发病机制至今还不清楚,但Simons等提出的"整体学说"最为公认,如何准确找到并定位肌筋膜疼痛触发点是成功治疗该疾病的关键。应用肌筋膜疼痛触发点理论技术,不仅有助于提高临床组织疼痛的康复效率,而且有利于预防骨与关节损伤、肌筋膜炎、肌痛、肌疲劳等疾病的发生与发展。

BACKGROUND：Myofascial trigger points have been widely applied in clinical rehabilitation and tissue pain field in the United States and Europe countries, and they have been recognized as the common cause of clinical musculoskeletal pain, joint function limitation, tissue injuries and muscle fatigue by many physiotherapists abroad. However, in China, many experts stil have some mistaken ideas and limitations to understand the pathological mechanism and to diagnosis and treat myofascial trigger points. OBJECTIVE：From the aspects of the etiology, pathological mechanism, diagnosis and positioning, treatments, to elaborate the method issues and the clinical experience of treatments of myofascial trigger points. METHODS：PubMed, ScienceDirect, EBSCO and CNKI databases were searched by the keywords of “myofascial trigger points, myofascial pain syndrome” in Chinese and English, respectively, in the titles and abstract to retrieve relevant articles published from the time of database construction to August 2014. RESULTS AND CONCLUSION：It is concluded that a child has myofascial trigger points in some skeletal muscles after age of 4 years. The main causes of myofascial trigger points include issue trauma, the wrong posture, bone and joint degeneration, nutrition deficiency, mental stress, chronic infection and so on. The pathological mechanism of myofascial trigger points remains unknown, but what has been widely accepted is the integrated trigger point hypothesis introduced by Simons. And how to find and position myofascial trigger points is the key point to treat this disease successfuly. The application of myofascial trigger points techniques is important for the rehabilitation of clinical tissue pain and the occurrence and spread of bone and joint injuries, myofascitis, muscle pain, muscle fatigue and so on.