手针联合运动治疗腰部肌筋膜疼痛综合征的临床疗效观察

Clinical effectiveness of hand acupuncture combined with exercise therapy in treatment of lumbar myofascial pain syndrome

  • 摘要: 目的 观察手针联合运动治疗腰部肌筋膜疼痛综合征(myofascial pain syndrome,MPS)的即刻临床疗效。方法 2018年1-12月在解放军总医院第一医学中心针灸科招募符合标准的40例腰部MPS患者,其中男性21例,女性19例,年龄18 ~60(39.65±13.09)岁,平均病程31 d。针刺患者腰痛部位同侧手第二掌骨微针系统的腰穴,产生针感后留针10 min,期间嘱患者缓慢均匀地进行腰部前屈、后伸运动,活动范围逐渐加大,观察并记录患者治疗前后的红外热像图、VAS评分和腰椎关节活动度变化。结果 40例中治疗前的红外热像图显示28例(70.0%)在腰部存在异常高温区,3例(7.50%)存在异常低温区,13例(32.5%)脊柱热力线连续,27例(67.5%)脊柱热力线不连续。治疗后21例(62.5%)腰部温度上升,22例(55.0%)脊柱热力线连续,18例(45.0%)脊柱热力线仍不连续。VAS评分治疗前为(5.15±1.34)分,治疗后降至(2.51±1.21)分(P<0.001)。腰椎前屈角度治疗前为(51.41±15.00)°,治疗后为(61.47±18.06)°;后伸角度治疗前为(22.08±10.31)°,治疗后为(27.27±11.77)°;左侧屈角度治疗前为(32.12±8.38)°,治疗后为(36.07±7.28)°;右侧屈角度治疗前为(33.49±7.62)°,治疗后为(37.49±6.13)° (P均<0.001)。结论 腰背部红外热像图显示,手针联合运动使得腰部温度升高,能够即刻减轻腰部MPS患者疼痛,并增加腰椎关节活动范围。

     

    Abstract: Objective To observe the immediate clinical effect of hand acupuncture combined with exercise therapy in the treatment of lumbar myofascial pain syndrome (MPS). Methods From January to December in 2018,40 patients suffering lumbar MPS who met the criteria were enrolled in the acupuncture department of the first medical center of Chinese PLA General Hospital.Among them,21 were male and 19 were female,aged 39.65±13.09 (18 to 60) years old.The mean disease course was 31 days.The needle was inserted at the lumbar acupoint of the second metacarpal microneedle system of the affected side,and left for 10 minutes after the needling sensation was felt.During the period,the patients were slowly and evenly flexed and extended with the range of motion gradually increasing.The infrared thermal image,VAS scores and changes in lumbar joint mobility before and after treatment were observed and recorded. Results Of the 40 patients with lumbar MPS,the infrared thermal image before treatment showed that 28 cases (70.0%) had multiple focal regions with higher temperature contrast in the waist,3 cases (7.5%) had lower temperature contrast regions;13 cases (32.5%) had a continuous spinal thermal line,27 cases (67.5%) had discontinuous one.After treatment,21 patients (62.5%) had elevated waist temperature;22 patients (55.0%) had a continuous spinal thermal line,and 18 (45.0%) cases still had a discontinuous spinal thermal line.The VAS score was (5.15±1.34) before treatment and decreased to (2.51±1.21) after treatment (P<0.001).The ROM of back flexion (51.41±15.00)° vs (61.47±18.06)°,extension (22.08±10.31)° vs (27.27±11.77)°,left side flexion (32.12±8.38)° vs (36.07±7.28)°,right side flexion (33.49±7.62)° vs (37.49±6.13)° all increased significantly after treatment (all P<0.001). Conclusion The infrared thermal image of the lower back shows that hand acupuncture combined with exercise therapy increases the temperature of the waist area in MPS patients,which can instantly relieve the pain and increase the range of lumbar mobility.

     

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