肌筋膜触发点针刺和牵伸运动对原发性痛经的即刻镇痛效果比较

Comparison of the immediate effects of myofascial trigger point acupuncture treatment and stretching exercise on primary dysmenorrhea

目的:探究一次腹部肌筋膜触发点针刺治疗和一次牵伸运动练习对原发性痛经女性在经期时的即刻镇痛效果。方法:共54例原发性痛经女性参与试验,将所有受试者随机分为肌筋膜触发点组(20例)、运动组(18例)和空白对照组(16例),肌筋膜触发点组在经期第一天痛感最强时接受一次腹部触发点针刺治疗,运动组在经期第一天痛感最强时接受一次时长为30-45min的牵伸运动练习,对照组不接受任何干预。在干预前后采集压痛阈值、Mc Gill疼痛评分和痛经症状评分。结果:即刻治疗后,组内比较时,肌筋膜触发点组在各个部位的压痛阈值显著升高(P<0.05)、Mc Gill疼痛评分和痛经症状积分均显著降低(P<0.05),运动组在腹部远端区域见压痛阈值显著提高(P<0.05),在部分腹部近端区域(腰椎左侧、上腹直肌处)见压痛阈值显著降低(P<0.05)、Mc Gill疼痛评分显著降低(P<0.05),但痛经症状积分仅有下降趋势(P>0.05);组间比较时,肌筋膜触发点组与对照组之间仅在腕背部右侧、斜方肌右侧、下腹直肌左侧不存在显著性差异(P>0.05)。结论:经期时,肌筋膜触发点针刺治疗可以立即降低机体的疼痛敏感性和疼痛强度,以及缓解痛经相关症状,而即刻的牵伸运动可能提高机体的疼痛敏感性。

Objective:To explore the immediate analgesic effect of abdominal myofascial trigger point acupuncture treatment and stretching exercise on women with primary dysmenorrhea during menstruation.Method:A total of 45 women with primary dysmenorrhea participated in this trial. All subjects were randomly divided into myofascial trigger point group(n=20), exercise group(n=18) and control group(n=16). The membrane trigger point group received an abdominal trigger point acupuncture treatment on the first day of menstruation when the pain was the strongest. The exercise group received a 30—45 minutes stretching exercise on the first day of menstruation when the pain was the strongest. The control group did not receive any intervention. The pressure pain threshold, Mc Gill pain score and dysmenorrhea symptom score were collected before and after the intervention.Result:After immediate treatment,when comparing within the group,in the myofascial trigger point group,the tenderness threshold of each part was significantly increased(P<0.05),and the Mc Gill pain score and dysmenorrhea score were significantly reduced(P<0.05). In the exercise group,the pressure pain threshold of the distal region of abdomen was significantly increased(P<0.05). However, the pressure pain threshold of several parts in the proximal region of abdomen(the left side of the lumbar spine,the upper rectus abdominis) was significantly reduced(P<0.05). The Mc Gill pain score was significantly reduced(P<0.05) and the dysmenorrhea symptom score presented a downward trend(P>0.05). When comparing between three groups, there was no significant difference between the trigger point group and the control group only on the right side of the wrist and the trapezius muscle,and the right side of the lower abdomen. the left side of the rectus muscle(P>0.05).Conclusion:The acupuncture treatment of abdominal myofascial trigger point can immediately reduce the body pain sensitivity and pain intensity during menstruation, and relieve dysmenorrhea-related symptoms, while stretching exercise may increase body pain sensitivity.