灭活肌筋膜疼痛触发点治疗膝骨性关节炎108例疗效观察

Clinical observation of effectiveness in the treatment of senile knee osteoarthritis with the inactivation of myofascial trigger points——108 cases reports

目的 :观察针刺和拉伸灭活膝关节周围肌的肌筋膜疼痛触发点治疗中老年膝骨性关节炎和缓解行走疼痛的疗效。方法:回顾性分析2010年至2014年在疼痛门诊治疗的108例中老年膝骨性关节炎的临床资料。男35例,女73例,利用针来回穿刺膝关节周围触发点,要求引出肌肉的局部抽搐反应。针刺治疗后对膝关节周围肌肉进行拉伸锻炼,拉伸的幅度以患者可耐受肌肉拉紧的酸痛为止,循序渐进逐渐增大。对治疗前后关节活动度测量和行走时疼痛的VAS评分进行统计分析。结果:所有患者获随访,1年后随访95例无疼痛。VAS评分,从治疗前重度7.6±0.5,中度4.9±0.7,下降至1年后随访的轻度1.9±0.6和无痛0.3±0.2。结论:对膝关节周围肌针刺和拉伸灭活其肌筋膜疼痛触发点可以缓解膝骨性关节炎造成的行走疼痛。

Objective：To study clinical treatment effects of inactivating myofascial trigger points with needling and muscle stretching for the treatment of knee osteoarthritis（OA）.Methods：Retrospective analyses were made to investigate the clinical data of pain-clinic outpatient in our hospital from 2010 to 2014,and 108 patients with knee OA,including 35 males and 73 females,were treated with acupuncturing of myofascial trigger points and stretching of muscles and structure around knee.The puncturing of trigger points,and the back and forth movement of needle were required to elicit local twitch response of muscle.After acupuncture treatment,muscle stretch around the knee joint was performed by a therapist.All patients must do homework of self-stretching exercise.The extent of stretching should be to gradually increased under a tolerable pain.The ROM and walking pain VAS scores were measured before and after whole therapy and were statistically analyzed during 1 year of follow-up.Results：All the patients were followed up,and 95 patients had no pain after 1 year.The VAS scores were improved from preoperative severe 7.6±0.5,moderate 4.9±0.7,to mild 1.9±0.6 and painless 0.3±0.2.Conclusion：The walking pain of knee OA might be alleviated by the acupuncture and stretch to inactivate the myofascial trigger point.