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肌内和神经根刺激与利多卡因注射治疗肌筋膜疼痛综合征触发点的比较

Intramuscular and nerve root stimulation vs lidocaine injection to trigger points in myofascial pain syndrome.

作者信息

Ga Hyuk, Koh Hee-Jeong, Choi Ji-Ho, Kim Chang-Hwan

机构信息

Department of Family Medicine, Inha University College of Medicine, Incheon, Korea.

出版信息

J Rehabil Med. 2007 May;39(5):374-8. doi: 10.2340/16501977-0058.

Abstract

OBJECTIVES

To compare the efficacies of an intramuscular stimulation technique and 0.5% lidocaine injection to trigger points in myofascial pain syndrome.

PARTICIPANTS

Forty-three people with myofascial pain syndrome of the upper trapezius muscle.

INTERVENTIONS

Twenty-two subjects were treated with intramuscular stimulation and another 21 with 0.5% lidocaine injection at all the trigger points on days 0, 7 and 14.

RESULTS

Intramuscular stimulation resulted in a significant reduction in Wong-Baker FACES pain scale scores at all visits and was more effective than trigger point injection. Intramuscular stimulation also resulted in significant improvement on the Geriatric Depression Scale - Short Form. Local twitch responses occurred in 97.7% (42/43) of patients. All the passive cervical ranges of motion were significantly increased. Post-treatment soreness was noted in 54.6% of patients in the intramuscular stimulation group and 38.1% in the trigger point injection group, respectively, and gross subcutaneous haemorrhage (> 4 cm2) was seen in only one patient in the trigger point injection group.

CONCLUSION

In managing myofascial pain syndrome, after one month intramuscular stimulation resulted in more significant improvements in pain intensity, cervical range of motion and depression scales than did 0.5% lidocaine injection of trigger points. Intramuscular stimulation is therefore recommended for myofascial pain syndrome.

摘要

目的

比较肌内刺激技术与0.5%利多卡因注射到肌筋膜疼痛综合征触发点的疗效。

参与者

43例上斜方肌肌筋膜疼痛综合征患者。

干预措施

22名受试者接受肌内刺激治疗,另外21名在第0、7和14天对所有触发点进行0.5%利多卡因注射治疗。

结果

肌内刺激在所有随访中均使面部表情疼痛量表评分显著降低,且比触发点注射更有效。肌内刺激还使老年抑郁量表简表有显著改善。97.7%(42/43)的患者出现局部抽搐反应。所有被动颈部活动范围均显著增加。肌内刺激组和触发点注射组分别有54.6%和38.1%的患者在治疗后出现酸痛,触发点注射组仅1例患者出现大面积皮下出血(>4 cm²)。

结论

在治疗肌筋膜疼痛综合征时,一个月后肌内刺激在疼痛强度、颈部活动范围和抑郁量表方面比0.5%利多卡因注射触发点有更显著的改善。因此,推荐肌内刺激用于治疗肌筋膜疼痛综合征。

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