经筋理论指导下针刀治疗胸背肌筋膜炎的近期及远期疗效

Short and long term efficacy of acupotomy in the treatment of thoracic and dorsal myofascitis syndrome guided by the Jingjin Theory

目的:观察经筋理论指导下针刀对比塞来昔布治疗胸背肌筋膜炎(TDMS)的近期及远期疗效。方法:纳入66例TDMS患者,按随机数字表法分为针刀组和西药组,每组33例。针刀组予以经筋理论指导下针刀疗法,1次/周;西药组采用塞来昔布胶囊口服,0.2g/次,1次/d。均连续治疗2周。观察两组患者治疗前、治疗后2周和3个月时的治疗总有效率、视觉模拟疼痛评分(VAS)、Oswestry功能障碍指数问卷(ODI)评分、疼痛焦虑状态(PASS)评分并记录不良反应。结果:与治疗前相比,针刀组治疗后2周和3个月时的总有效率均优于西药组,差异有统计学意义(P<0.05);两组患者VAS评分、ODI评分、PASS评分均降低,且针刀组评分降低更明显,差异有统计学意义(P<0.05)。治疗后3个月与治疗后2周比,针刀组VAS评分、PASS评分比较,差异无统计学意义(P>0.05),ODI评分下降,差异有统计学意义(P<0.001);与治疗2周后比较,治疗3个月后西药组VAS评分、ODI评分均上升,差异有统计学意义(P<0.05),PASS评分改善不明显,差异无统计学意义(P>0.05)。结论:经筋理论指导下针刀能有效地改善TDMS患者疼痛、功能障碍和疼痛焦虑程度,具有良好的近期及远期疗效。

Objective:To observe the short and long term efficacy of acupotomy in the treatment of thoracic and dorsal myofascitis syndrome(TDMS)under the guidance of Jingjin Theory compared with celecoxib.Methods:66 patients with TDMS were divided into acupotomy group and western medicine group according to the random number table method,with 33 cases in each group.The patients in the acupotomy group were treated with acupotomy therapy under the guidance of Jingjin Theory,once a week.In the western medicine group,the patients took celecoxib capsules orally,0.2 g each time,once a day.All patients were treated for 2 weeks.The total effective rate,visual analogue scale(VAS)score,Oswestry disfunction index questionnaire(ODI)score,pain anxiety state score(PASS)and adverse reactions were observed before treatment and at 2nd week and 3rd month after treatment.Results:Compared with that before treatment,the total effective rate of acupotomy group was better than that of western medicine group at 2nd week and 3rd month after treatment,and the differences were statistically significant(P<0.05).VAS score,ODI score and PASS score were all decreased in two groups,and the decrease was more obvious in acupotomy group.The difference was statistically significant(P<0.05).There were no statistical significances in VAS scores and PASS scores in the acupotomy group between 3rd month and 2nd week after treatment(P>0.05).ODI score decreased,and the difference was statistically significant(P<0.001).Compared with those at 2nd week after treatment,VAS score and ODI score of the western medicine group increased after at 3rd month of treatment,and the differences were statistically significant(P<0.05);improvement of PASS score was not obvious,and the difference was not statistically significant(P>0.05).Conclusion:Acupotomy under the guidance of Jingjin Theory can effectively improve the pain,dysfunction and pain anxiety in patients with TDMS,with good short-term and long-term efficacy.