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运用体内微透析技术揭示肌筋膜触发点的生化环境:肌肉疼痛概念在肌筋膜疼痛综合征中的应用

Uncovering the biochemical milieu of myofascial trigger points using in vivo microdialysis: an application of muscle pain concepts to myofascial pain syndrome.

作者信息

Shah Jay P, Gilliams Elizabeth A

机构信息

Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, 10 Center Drive, Room 1-1469, MSC 1604, Bethesda, MD 20892-1604 USA.

Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, 10 Center Drive, Room 1-1469, MSC 1604, Bethesda, MD 20892-1604 USA.

出版信息

J Bodyw Mov Ther. 2008 Oct;12(4):371-384. doi: 10.1016/j.jbmt.2008.06.006. Epub 2008 Aug 13.

DOI:10.1016/j.jbmt.2008.06.006
PMID:19083696
Abstract

This article discusses muscle pain concepts in the context of myofascial pain syndrome (MPS) and summarizes microdialysis studies that have surveyed the biochemical basis of this musculoskeletal pain condition. Though MPS is a common type of non-articular pain, its pathophysiology is only beginning to be understood due to its enormous complexity. MPS is characterized by the presence of myofascial trigger points (MTrPs), which are defined as hyperirritable nodules located within a taut band of skeletal muscle. MTrPs may be active (spontaneously painful and symptomatic) or latent (non-spontaneously painful). Painful MTrPs activate muscle nociceptors that, upon sustained noxious stimulation, initiate motor and sensory changes in the peripheral and central nervous systems. This process is called sensitization. In order to investigate the peripheral factors that influence the sensitization process, a microdialysis technique was developed to quantitatively measure the biochemical milieu of skeletal muscle. Biochemical differences were found between active and latent MTrPs, as well as in comparison with healthy muscle tissue. In this paper we relate the findings of elevated levels of sensitizing substances within painful muscle to the current theoretical framework of muscle pain and MTrP development.

摘要

本文在肌筋膜疼痛综合征(MPS)的背景下讨论了肌肉疼痛的概念,并总结了一些微透析研究,这些研究调查了这种肌肉骨骼疼痛状况的生化基础。尽管MPS是一种常见的非关节性疼痛,但其病理生理学因其极其复杂才刚刚开始被理解。MPS的特征是存在肌筋膜触发点(MTrP),其被定义为位于骨骼肌紧张带内的高敏结节。MTrP可能是活跃的(自发疼痛且有症状)或潜伏的(非自发疼痛)。疼痛的MTrP激活肌肉伤害感受器,在持续的有害刺激下,会引发外周和中枢神经系统的运动和感觉变化。这个过程称为敏化。为了研究影响敏化过程的外周因素,开发了一种微透析技术来定量测量骨骼肌的生化环境。在活跃和潜伏的MTrP之间以及与健康肌肉组织相比,发现了生化差异。在本文中,我们将疼痛肌肉中敏化物质水平升高的发现与当前肌肉疼痛和MTrP发展的理论框架联系起来。

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