扳机点温和灸治疗颈肩肌筋膜痛综合征的疗效及对患者血清炎症因子的影响

Clinical efficacy of mild moxibustion on myofascial trigger point in patients with myofascial pain syndrome and its effect on inflammatory factors

目的观察局部扳机点(MTrPs)温和灸治疗颈肩肌筋膜痛综合征(MPS)患者的疗效,并检测其对患者血清环氧化酶2 (COX-2)、前列腺素E2(PGE2)、白介素6 (IL-6)、肿瘤坏死因子α(TNF-α)等炎症因子的影响。方法于2016年1月至2018年1月在海南省中医院骨伤科门诊,采用电脑随机数字生成器法纳入50例符合条件的颈肩MPS患者,均分为A组和B组,每组25例,A组进行10 d的MTrPs温和灸治疗,B组口服艾瑞昔布片10 d,比较两组患者治疗前和治疗结束后的简化McGill疼痛量表积分以及血清COX-2、PGE2、IL-6、TNF-α等炎症因子水平。结果治疗结束后,两组患者的疼痛评级指数(PRI)、视觉模拟评分(VAS)和现在疼痛强度(PPI)均较治疗前明显减轻,差异均有统计学意义(P<0.05);但两组患者治疗前和治疗结束后的PRI、VAS、PPI比较差异均无统计学意义(P>0.05)。治疗前,两组患者的COX-2、PGE2、IL-6、TNF-α表达水平比较差异无统计学意义(P>0.05);治疗后,两组患者的COX-2、PGE2、IL-6、TNF-α较治疗前均降低,差异均有显著统计学意义(P<0.01);但治疗后两组患者的COX-2、PGE2、IL-6、TNF-α比较差异均无统计学意义(P>0.05)。结论 MTrPs温和灸治疗可明显改善MPS患者疼痛和不适感,明显减轻症状,降低血清中COX-2,PGE2、IL-6、TNF-α等炎症因子。

Objective To investigate the clinical efficacy of mild moxibustion on myofascial trigger points(MTrPs) in patients suffering from myofascial pain syndrome(MPS), and its effect on inflammatory factors such as serum cyclooxygenase 2(COX-2), prostaglandin E2(PGE2), and interleukin 6(IL-6), and tumor necrosis factor-α(TNF-α). Methods A total of 50 eligible patients suffering from neck or shoudler MPS were divided into two groups equally and randomly by computer random number generator from January 2016 to January 2018 at the Out-patient Department of Orthopedics, Hainan Provincial Hospital of Traditional Chinese Medicine. And patients in group A were treated by mild moxibustion on MTrPs for ten days, while patients in group B took medicine of imrecoxib tablets for ten days. Short form McGill pain questionnaire were compared, and serum inflammatory factors such as COX-2, PGE2,IL-6, and TNF-α one day before and after treatment were compared between the two groups. Results The pain rating index(PRI), Visual Analogue Score(VAS), and present pain intensity(PPI) after treatment all reduced significantly in group A and group B(P<0.05), while the differences were insignificant between group A and group B before and after treatment(P>0.05). Before treatment, there was no significant difference in the expression of COX-2, PGE2, IL-6, and TNF-α between the two groups(P>0.05);after treatment, the expression of COX-2, PGE2, IL-6, and TNF-α in the two groups all decreased significantly(P<0.01);but after treatment, there was no significant difference in the expression of COX-2, PGE2, IL-6, and TNF-α between the two groups(P>0.05). Conclusion Mild moxibustion on MTrPs could significantly reduce pain and discomfort in patients with MPS, and reduce the expression of serum inflammatory factors such as COX-2, PGE2, IL-6, TNF-α.