激痛点针刺治疗慢性腰肌筋膜疼痛综合征的临床治疗效应研究

THE THERAPEUTIC EFFECTS OF TRIGGER POINT ACUPUNCTURE ON CHRONIC LOW BACK MYOFA-SCIAL PAIN SYNDROME

目的:评价激痛点针刺对慢性腰肌筋膜疼痛综合征病人主客观功能障碍指标的临床治疗效应及不良反应。方法:60名慢性腰肌筋膜疼痛综合征病人被随机分配到针刺组和对照组。针刺组30名病人在腰臀部肌筋膜激痛点上接受针刺治疗,而对照组30名病人在腰臀部疼痛部位上接受低强度感觉阈经皮电刺激安慰性对照治疗。两组各接受每周一次,共4周的治疗。两组病人分别在治疗前后进行临床评估,内容包括测量视觉模拟评分(visual analogue scale,VAS)和功能障碍(Roland-Morris dysfunction questionnaire,RDQ)水平以及客观的压力疼痛阈值(pressure pain threshold,PPT)和腰部活动范围(range of motion,ROM)。结果:各项主观(VAS、RDQ)和客观(PPT、ROM)指标在针刺后均显示有显著改善,而对照组在治疗后仅有主观症状的显著改善,并且两组间比较仍显示针刺组主观症状改善显著优于对照组。除了针刺后酸痛反应,没有观察到其他显著不良反应。结论:激痛点针刺对于改善慢性腰肌筋膜疼痛病人的疼痛症状和功能性表现均具有积极的治疗效应,是治疗慢性腰肌筋膜疼痛综合征的一种有效方法。

Objectives:To evaluate the therapeutic and side effects of trigger point acupuncture in patients with chronic low back myofascial pain mainly on subjective and objective parameters of pain and dysfunction.Methods:Sixty patients with chronic low back myofascial pain were randomly assigned into two treatment groups.The trigger point acupuncture group received acupuncture on myofascial trigger points at low back region,while the control group received transcutaneous electrical stimulation with lowintensity sensory threshold as placebo treatment.All patients received the assigned treatment once per week for4weeks.Patients were evaluated before and after treatment by the subjective pain(visual analogue scale,VAS)and dysfunction(Roland-Morris dysfunction questionnaire,RDQ)level,as well as objectivepressure pain threshold(pressure pain threshold,PPT)and lumbar range of motion(range of motion,ROM).Results:The trigger point acupuncture group showed significant improvements in every subjective(VAS,RDQ)and objective(PPT,ROM)measurements,while the control group only showed significant improvements in subjective measurements after4weeks of treatment and the comparison between groups showed the subjective improvements in the trigger point acupuncture group were significantly better than the control group.Except the post-needling soreness was noted in the trigger point acupuncture group,no other significant side effects were noted in both groups.Conclusions:Trigger point acupuncture may have positive therapeutic effects in improving pain symptoms and functional performance in patients with chronic low back myofascial pain,and is suggested to be an effective method for chronic low back myofascial pain syndrome.