摘要
目的探讨超声引导下针刺治疗背部慢性肌筋膜炎的疗效、安全性及影响该疼痛的重要因素。方法收集2021年3月至11月广州医科大学附属第二医院疼痛科收治的背部慢性肌筋膜炎患者60例, 按随机数字表法随机分为针刺组和超声引导针刺组, 每组30例。所有患者均口服抗炎镇痛及护胃药, 针刺组针刺背部阿是穴3~6穴, 超声引导针刺组在超声引导下针刺痛区阿是穴3~6穴。痛痹加肾俞, 关元, 着痹加阴陵泉、足三里。连接电针仪, 给予疏密波, 刺激20~30 min。两组疗程均为两周, 共治疗6次。治疗前、治疗6次后和治疗结束1个月时记录患者视觉模拟评分(VAS)、疼痛评级指数(PRI)和健康调查简表(SF-36)分数, 治疗结束后评价不良反应。治疗结束1个月时作相关分析及多元回归分析, 探讨影响背部慢性肌筋膜疼痛的重要因素。结果治疗6次、治疗结束1个月时, 两组VAS与PRI评分均比治疗前显著降低, SF-36各项评分均显著提高(P均<0.05), 超声引导针刺组的生理功能(PF)、精力(VT)、社会功能(SF)、情感职能(RE)、精神健康(MH)评分比针刺组显著升高(P均<0.05)。治疗结束1个月时, 超声引导针刺组的VAS、PRI评分比针刺组显著降低, 躯体疼痛(BP)评分比针刺组显著升高(P均<0.05), 相关分析显示VAS与PRI呈正相关(P<0.05), 与总体健康(GH)、精力(VT)、社会功能(SF)呈负相关(P<0.05), 多元回归分析显示社会功能(SF)、总体健康(GH)、疼痛评级指数(PRI)是VAS评分的重要影响因素(P<0.05)。两组不良反应总发生率差异无统计学意义(P>0.05)。结论超声引导下针刺治疗背部慢性肌筋膜炎是一种安全、高效可行的方法。治疗结束1个月时多元回归分析显示社会功能评分、总体健康评分及疼痛评级指数是影响背部慢性肌筋膜炎疼痛的重要影响因素。
Objective To explore the efficacy and safety of ultrasound-guided acupuncture in back chronic myofascitis and analyze important pain influencing factors of the disease.Methods Sixty patients with back chronic myofascitis admitted to Department of Painology,Second Affiliated Hospital of Guangzhou Medical University from March to November 2021,were divided into acupuncture group and ultrasound-guided acupuncture group,with 30 patients in each group,according to random number table method.All patients were given oral anti-inflammatory analgesics and stomach-protecting drugs.In acupuncture group,3-6 Ashi points in the back were needled,while in ultrasound-guided acupuncture group,3-6 Ashi points in the painful area were needled under ultrasound guidance.Shenshu point and Guanyuan point in agonizing numbness syndrome were added,while Yinlingquan point and Zusanli point in dampness numbness syndrome were added.Electric acupuncture machines were used with rarefaction-dense wave for 20-30 min,6 times for 2 weeks.VAS,PRI and SF-36 scores were recorded before the treatment,after 6 treatments and 1 month after the treatment.Adverse effects were assessed after the treatment.Correlation analysis and multiple regression analysis were performed at 1 month after the treatment to explore the important factors influencing back chronic myofascitis pain.Results VAS and PRI scores were significantly decreased and SF-36 scores were significantly increased in both groups after 6 treatments and 1 month after treatment comparing with before the treatment(P<0.05).The scores of physical functioning(PF),vitality(VT),social functioning(SF),role-emotional(RE)and mental health(MH)were significantly higher in the ultrasound-guided acupuncture group than those in the acupuncture group after 6 treatments and 1 month after the treatment(P<0.05).VAS and PRI scores were significantly lower in the ultrasound-guided acupuncture group and bodily pain(BP)scores were significantly higher than those in the acupuncture group at 1 month after treatment(P<0.
作者
罗秀英
万丽
Luo Xiuying;Wan Li(Department of Painology,Second Affiliated Hospital of Guangzhou Medical University,Guangzhou City,Guangzhou City,Guangdong Province 510260,China)
出处
《中华疼痛学杂志》
2023年第5期745-751,共7页
Chinese Journal Of Painology
关键词
针刺
背部慢性肌筋膜炎
超声引导
影响因素
Acupuncture
Back chronic myofascitis
Ultrasonic guidance
Affecting factors
