摘要
目的:观察针刺激痛点结合脏腑推拿对慢性腰背肌筋膜疼痛综合征患者的临床疗效及对情绪的影响。方法:将70例慢性腰背肌筋膜疼痛综合征伴焦虑的患者随机分为观察组(35例)与对照组(35例),两组均治疗两个月,隔天治疗1次。疗程结束后比较两组患者McGill疼痛评分(包括VAS、PRI及PPI 3项)、Oswestry功能障碍指数评分(ODI)、汉密尔顿焦虑量表评分(HAMA)及血清5-羟色胺(5-HT)、多巴胺(DA)水平,并于3个月随访时再次比较两组患者McGill疼痛评分、Oswestry功能障碍指数评分和汉密尔顿焦虑量表评分(HAMA)。结果:两组患者治疗后VAS、PRI、PPI、ODI及HAMA评分较治疗前显著降低,血清5-HT、DA水平显著升高,且观察组改善程度明显优于对照组,差异具有统计学意义(P<0.05);疗程结束3个月随访时观察组患者VAS、PRI、PPI、ODI及HAMA评分明显低于对照组,差异具有统计学意义(P<0.05);观察组总有效率84.38%(27/32),对照组总有效率73.33%(22/30),观察组疗效优于对照组,差异具有统计学意义(P<0.05)。结论:针刺激痛点结合脏腑推拿治疗于慢性腰背肌筋膜疼痛综合征伴焦虑患者疗效优于单独针刺,其机制可能与脏腑推拿对神经递质的调控有关。
Objective:To observe the effect of needling trigger points combined with viscera massage in treatment of chronic lumbar myofascial pain syndrome(MPS)and its influence to mood.Methods:A total of 70 patients with chronic lumbar MPS accompanied by anxiety were randomly divided into the observation group(n=35)and the control group(n=35).The control group was treated with needling trigger points;on which basis,the observation group was also treated with visceral massage.Both groups were treated once every other day for 2 months.The scores of McGill(VAS,PRI,PPI),ODI and HAMA,as well as the serum levels of 5-HT and DA were observed and compared between the two groups after the treatment.The scores of McGill,ODI and HAMA were compared again between the two groups during the 3-month follow-up.Results:The scores of VAS,PRI,PPI,ODI and HAMA were decreased,and the serum levels of 5-HT and DA were increased in both groups after the treatment(P<0.05);of which the improvements in the observation group were more significant than those in the control group(P<0.05).The scores of VAS,PRI,PPI,ODI and HAMA were lower in the observation group than those in the control group during the follow-up(P<0.05).The total effective rate of the observation group was 84.38%(27/32),which was significantly higher than 73.33%(22/30)of the control group(P<0.05).Conclusion:Needling trigger points combined with viscera massage is better than single needling trigger points,which mechanism may be related to the regulation of neurotransmitters by viscera massage.
作者
龙抗胜
叶勇
孙梦龙
范升
刘巨尧
李洪亮
LONG Kangsheng;YE Yong;SUN Menglong;FAN Sheng;LIU Juyao;LI Hongliang(The First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410007,China;Hunan University of Chinese Medicine,Changsha 410208,China)
出处
《针灸临床杂志》
2022年第9期16-20,共5页
Journal of Clinical Acupuncture and Moxibustion
基金
石学敏院士工作站开放基金,编号:2019YSZJJ12
湖南省发改委创新研发项目(2019年)
湖南中医药大学教改项目,编号:2018-JG059。
关键词
脏腑推拿
激痛点
针刺
慢性肌筋膜疼痛综合征
焦虑
Visceral massage
Trigger points
Acupuncture
Chronic myofascial pain syndrome
Anxiety
