激痛点针刺治疗腰背肌筋膜疼痛综合征的疗效

Efficacy of trigger point acupuncture for lumbodorsal myofascial pain syndrome

目的探究针刺激痛点对腰背肌筋膜疼痛综合征患者的治疗效果。方法收集2019年9月至2020年9月期间在聊城市第二人民医院疼痛科收治的腰背肌筋膜疼痛综合征患者97例,按照随机数字表法分为激痛点针刺组(n=49)与常规针灸组(n=48),两组患者分别行激痛点针刺与阿是穴针刺。所有患者均留针20min,隔日治疗1次,10次1疗程,所有患者均治疗1疗程。所有患者同时服用美洛昔康胶囊并贴敷吡罗昔康凝胶作为常规基础治疗。比较两组患者治疗前、治疗结束后1d与治疗结束后6个月时疼痛分级指数(PRI)、现有疼痛强度(PPI)以及视觉模拟疼痛评分(VAS);比较两组患者治疗前与治疗结束后6个月时的Oswestry功能障碍指数(ODI)和功能障碍问卷(RDQ),腰背屈曲以及伸展活动范围、表面肌电图的平均振幅值、平均频率斜率;比较两组患者治疗结束后6个月时的疗效;观察两组患者的治疗并发症发生情况与药物不良反应发生情况。结果与治疗前比较,治疗后1d、6个月时两组患者的VAS、PRI、PPI均明显降低,差异均有统计学意义(P均<0.001);与常规针灸组比较,治疗结束后6个月时激痛点针刺组患者ODI与RDQ评分降低更为显著,差异均有统计学意义(P均<0.001);治疗结束后6个月时激痛点针刺组患者腰背屈曲以及伸展活动范围,表面肌电平均振幅值与平均频率斜率均显著增高,差异均有统计学意义(P均<0.001);与常规针灸组比较,治疗结束后1d、6个月时,激痛点针刺组患者的总有效率均较高,差异均有统计学意义(P均<0.05);两组患者均未发生出血、皮下血肿、神经损伤以及晕针等并发症,亦未发生胃肠道反应、疼痛、头晕等药物的不良反应。结论针刺激痛点治疗腰背肌筋膜疼痛综合征安全有效。

Objective To explore the therapeutic effect of trigger point acupuncture on patients with lumbodorsal myofascial pain syndrome.Methods Ninety-seven patients with lumbodorsal myofascial pain syndrome,in the Department of Painology,Second People's Hospital of Liaocheng from September 2019 to September 2020,were randomly divided into trigger point group(n=49)and Ashi point group(n=48).The trigger point group were treated with pain trigger point acupuncture and Ashi point group with Ashi point acupuncture,with needle retention for 20 minutes,once every other day,10 times as a course of treatment.All patients were treated with meloxicam capsules and piroxicam gel as routine basic treatment.Pain rating index(PRI),present pain intensity(PPI)and visual analogue scale(VAS)were compared between the two groups before treatment,1 day and 6 months after treatment.The Oswestry Disability Index(ODI)and Roland-Morris Disability Questionnaire(RDQ),the range of flexion and extension of the back,the average amplitude of surface electromyography and the average frequency slope were assessed in the two groups before the treatment and 6 months after the treatment.The curative effect was calculated in both groups at 6 months after the treatment.The incidence of complications and adverse drug reactions were observed in the two groups.Results Compared with before treatment,VAS,PRI and PPI were all significantly decreased at 1 day and 6 months after the treatment in the two groups(all P<0.001).Compared with the Ashi point group at 6 months after the treatment,the ODI and RDQ scores were both lower(both P<0.05),and the flexion and extension range of the back,the average amplitude value and the average frequency slope of the surface electromyography were higher in the trigger point group(all P<0.001).The total effective rate was higher in the trigger point group than that in the Ashi point group at 6 months after the treatment(P<0.001).No complications such as hemorrhage,subcutaneous hematoma,nerve injury and needle sickness and no drug adverse reactions such as gastrointestinal reactions,pain and dizziness happened in both groups.Conclusion Trigger point acupuncture is a safe and effective treatment method for patients with lumbar and dorsal fascial pain syndrome.