恢刺联合温针灸治疗颈肩肌筋膜疼痛综合征疗效观察

目的比较恢刺联合温针灸与温针灸治疗颈肩肌筋膜疼痛综合征(MPS)的疗效。方法将66例颈肩MPS患者随机分为观察组(31例,脱落2例)与对照组(32例,脱落1例)。治疗部位均为激痛点(TrP)。观察组采用恢刺针法后,针尾接艾柱,灸2壮。对照组采用直刺进针,针尾接艾柱,灸2壮。两组均留针40 min,隔日治疗1次,3次/周,共2周。分别在治疗前、治疗后即刻、治疗1周及2周后评估疼痛视觉模拟量表(VAS)评分与颈椎功能障碍指数(NDI)。在治疗前及治疗2周后采用超声检测杨氏模量(E_(mean))及剪切波速度(V_(mean))。结果两组VAS评分及NDI在治疗后即刻、治疗1周及治疗2周后均低于治疗前(P<0.01)。两组间VAS评分及NDI在治疗后即刻及治疗1周后比较差异无统计学意义(P>0.05)。观察组VAS评分及NDI在治疗2周后均低于对照组(P<0.05)。两组E_(mean)及V_(mean)在治疗2周后均低于治疗前(P<0.01)。观察组E_(mean)及V_(mean)在治疗2周后均低于对照组(P<0.05)。结论恢刺联合温针灸与温针灸疗法,均可改善颈肩MPS患者的疼痛及颈椎的活动度,其疗效可能与降低TrP的组织硬度、恢复肌肉弹性有关。随着治疗次数的增加,恢刺联合温针灸在改善颈肩MPS患者的疼痛、颈椎活动度,降低TrP的组织硬度、改善肌肉弹性方面优于温针灸治疗。

Objective To compare the therapeutic effects of relaxing needling combined with warming acupuncture in treatment of myofascial pain syndrome(MPS)in the neck and shoulder.Methods 66 cases of neck and shoulder MPS were randomly divided into two groups.The observation group had 31 cases with 2 cases dropped off.The control group had 32 cases with 1 case dropped off.The trigger point(TrP)was the therapeutic target.The observation group was intervened by relaxing needling and warming acupuncture.And the moxibustion was burned two times.The control group was intervened by warming acupuncture.The moxibustion was burned two times.Two groups were intervened once every other day,three times a week for two weeks.Visual analogue Scale(VAS)and cervical dysfunction index(NDI)were evaluated before,immediately,after one week and two weeks after the treatment.Young's modulus and shear wave velocity were evaluated by ultrasound before and after two weeks.Results VAS score and NDI in both groups were lower than before(P<0.01)after treatment Immediately,one week and two weeks.There was no difference between the two groups in VAS score and NDI immediately after treatment and one week after treatment(P>0.05).After 2 weeks of the treatment,the observation group's VAS score and NDI were lower than those in the control group(P<0.05).After 2 weeks of the treatment,the average Young's modulus and average shear wave velocity of the two groups were lower than those before(P<0.01).After 2 weeks of the treatment,the average Young's modulus and average shear wave velocity in the observation group were lower than those in the control group(P<0.05).Conclusion Relaxing needling combined with warming acupuncture and warming acupuncture can relieve pain and improve activity degree of cervical vertebra of patients with neck and shoulder MPS.The effect may be related to the reduce of the TrP's hardness and restore muscle elasticity.With the increase of the treatment times number,the relaxing needling combined with warming acupuncture in the improvement of the pain of patients with neck and shoulder MPS and cervical activity,reducing the organization of the TrP hardness and improving the elasticity of the muscle are better than the warm acupuncture treatment.