热敏灸与辨证穴位灸治疗背肌筋膜炎临床随机对照观察

Heat-sensitive Moxibustion and Acupoint Moxibustion According to Syndrome Differentiation for the Treatment of Back Myofascitis: A Randomized Controlled Trial

目的:观察热敏灸与辨证穴位灸治疗背肌筋膜炎的疗效差异。方法:将50例符合纳入标准的背肌筋膜炎患者,随机分配到治疗组(电针加热敏灸治疗组)和对照组(电针加辨证穴位灸治疗组),两组各25例,每日治疗1次,10次为一疗程,采用国际公认的麦吉尔疼痛量表,以疼痛评定指数(PRI)、视觉模拟评分(VAS)和现时疼痛强度(PPI)为观察指标,观察两种方法治疗背肌筋膜炎的临床疗效。结果:背肌筋膜炎患者的热敏点出现率为92%,且热敏点与阿是穴具有高度重合性。两组组内治疗前后的PRI、VAS、PPI评分比较,差异均具有统计学意义(均P<0.01);组间治疗前后的PRI、VAS、PPI差值比较,差异均具有统计学意义(均P<0.01);两组疗效比较,差异有统计学意义(P<0.05)。结论:背肌筋膜炎患者容易出现热敏现象,热敏点与局部阿是穴高度重合,相比艾灸辨证取穴,艾灸热敏点治疗背肌筋膜炎的疗效更佳。

Objective： To observe the clinically therapeutic effect of moxibustion on heat-sensitive moxibustion and acupoint moxibustion according to syndrome differentiation on back myofascitis. Methods： A total of 50 eligible patients were randomly divided into a treatment group（ acupuncture at Ashi point plus moxibustion at heat-sensitive points,n = 25） and a control group（ acupuncture at Ashipoint plus acupoint moxibustion according to syndrome differentiation,n = 25）,one time a day,ten times as a course. The therapeutic effects were assessed according to changes of the score of the short-form of Mc Gill pain questionnaire composing of pain rating index（ PRI）,visual analogue scale（ VAS） and present pain intensity（ PPI） before and after treatment. Results： 92% of all back myofascitis patients had heat-sensitive acupoints. Coincidence rate of heat-sensitive acupoints and Ashi points was higher. Before treatment,no significant differences were found between the treatment group and the control group according to PRI,VAS and PPI. After treatment,PRI,VAS and PPI were all significantly lower in the treatment group than those in the control group（ P〈0. 01）. PRI,VAS and PPI were all lower in the treatment group than those in the control group before and after the treatment（ P〈0. 01）. The curative rate of the treatment group was significantly higher than that of the control group（ P〈0. 05）. Conclusion： Back myofascitis patients are easier to show up heat-sensitive phenomena. Heat-sensitive points have a high coincidence with Ashi points. Moxibustion at heat-sensitive acupoint is significantly superior to moxibustion according to syndrome differentiation for treating back myofascitis.