小针刀治疗颈肩部肌筋膜炎临床疗效评价

Clinical therapeutic evaluation of Small Needle-knife on neck-shoulder myofascitis

目的观察小针刀治疗颈肩部肌筋膜炎临床疗效。方法将134例颈肩部肌筋膜炎患者随机分为2组,对照组67例予激痛点阻滞。治疗组67例在对照组治疗基础上加用小针刀治疗。2组均治疗5周后统计临床疗效,并观察2组治疗前后疼痛视觉模拟评分(VAS)、颈椎功能障碍指数(NDI)评分、5-羟色胺(5-HT)及β-内啡肽(β-EP)情况。结果治疗组总有效率94.03%,对照组总有效率76.12%,2组比较差异有统计学意义(P<0.05),治疗组疗效优于对照组。2组治疗后VAS评分、NDI评分及5-HT均明显下降,β-EP明显增加,与本组治疗前比较差异均有统计学意义(P<0.05),且2组治疗后组间比较差异均有统计学意义(P<0.05)。治疗组不同疗效的5-HT、β-EP比较差异均有统计学意义(P<0.05)。Pearson相关分析显示疗效与5-HT呈负相关,与β-EP呈正相关(P<0.05)。结论小针刀治疗颈肩部肌筋膜炎能明显缓解疼痛和颈部功能,提高临床疗效,其机制可能与降低5-HT和升高β-EP有关。

Objective To observe the clinical effects of Small Needle-knife on the treatment of neck-shoulder myofascitis. Methods 134 neck-shoulder myofascitis patients were randomly divided into two groups.The control group（n = 67） were treated by trigger point block,the treatment group（n = 67） were treated by Small Needle-knife on the basis of the control group treatment. The curative effects were evaluated after 5 weeks treatment,and the scores of visual analogue scale（VAS） and the Neck Disability Index（NDI）, the 5-hydroxytryptamine（5-HT） and beta-endorphin（β-EP） before and after treatment were observed in two groups.Results The total effective rate in treatment group（94. 03%） was superior to that in control group（76. 12%,P〈0. 05）. The VAS,NDI and 5-HT after treatment were significantly decreased in two groups,and the β-EP was significantly increased,with statistical differences（P〈0. 05）,and there were statistical differences after treatment between two groups（P〈0. 05）. There were statistical differences on 5-HT and β-EP among difference effects in treatment group（P〈0. 05）. Pearson correlation analysis showed that the efficacy was negatively correlated with 5-HT and positively correlated with β-EP（P〈0. 05）. Conclusion Small Needle-knife can obviously relieve pain and neck function on neck-shoulder myofascitis,enhance clinical efficacy,its mechanism may be related with the reduction of 5-HT and the increase of β-EP.