温针灸联合康复训练治疗肩部肌筋膜疼痛综合征疗效观察

Clinical Observation on Warm Needling Moxibustion and Rehabilitation Training in Treating Myofascial Pain Syndrome in Shoulder

目的:观察温针灸联合康复训练治疗肩部肌筋膜疼痛综合征的疗效及其对血清五羟色胺(5-hydroxytryptamine,5-HT)、去甲肾上腺素(noradrenaline,NE)水平的影响。方法:将60例肩部肌筋膜疼痛综合征患者采用随机数字表法分为对照组、观察组各30例。对照组予康复训练治疗,观察组予温针灸联合康复训练治疗。观察两组患者临床疗效、功能独立性评定(functional independence measure,FIM)量表评分、上肢运动功能评测(Fugl-Meyer,FMA)评分、疼痛视觉模拟评分(visual analogue scale,VAS)、肩关节外展角度(range of motion,ROM)与5-HT、NE水平及不良反应情况。结果:临床疗效观察组优于对照组,差异具有统计学意义(P<0.05);两组患者治疗后ROM、FMA、FIM评分均较治疗前升高,VAS评分较治疗前降低(P<0.05);观察组治疗后ROM、FMA、FIM、VAS评分均较对照组改善明显(P<0.05);与治疗前比较,两组患者5-HT、NE水平均下降(P<0.05),观察组下降更显著(P<0.05);两组患者治疗期间均未出现明显不良反应。结论:温针灸联合康复训练可有效改善肩部肌筋膜疼痛综合征患者日常生活独立能力及上肢运动功能,缓解肩部疼痛,增加肩关节活动度,效果优于单纯康复训练,且安全性高。

Objective:To observe clinical effects of warm needling moxibustion and rehabilitation training in the treatment of myofascial pain syndrome in the shoulder and its influence on the levels of 5-HT and NE.Methods:Sixty patients were allocated to the control group and the observation group by using random number table method.The control group was treated by rehabilitation training,and the observation group was given warm needling moxibustion and rehabilitation training.To observe clinical effects,FIM scores,FMA scores,VAS,ROM,the levels of 5-HT and NE as well as adverse reaction between both groups.Results:The observation group was better than the control group in clinical effects,and the difference had statistical meaning(P<0.05);after the treatment,the scores of ROM,FMA,FIM of both groups lifted than these before the treatment,VAS scores decreased than these before the treatment(P<0.05);the improvements of ROM,FMA,FIM and VAS scores of the observation group were more noticeable than these of the control group(P<0.05);compared with before the treatment,the levels of 5-HT and NE reduced in both groups(P<0.05),the decrease of the observation group was more remarkable(P<0.05);No obvious adverse reaction happened during therapeutic period between both groups.Conclusion:Warm needling moxibustion and rehabilitation training could effectively improve independent ability of daily life and motor function of upper limbs,relieve shoulder pain,increase shoulder motion,and its effects superior to single rehabilitation training with high safety.