Martín-Herrero Clara, Rodrigues de Souza Daiana P, Alburquerque-Sendín Francisco, Ortega-Santiago Ricardo, Fernández-de-Las-Peñas César
Universidad Rey Juan Carlos. Facultad de Ciencias de la Salud, 28922 Alcorcon, Espana.
Rev Neurol. 2012 Aug 16;55(4):193-9.
INTRODUCTION. The referred pain induced by myofascial trigger points (MTP) and sleep disorders can be factors that contribute to chronic tension-type headache. AIM. To determine the relationship between MTP, intensity of pain, disability and quality of sleep in people with chronic tension-type headache. SUBJECTS AND METHODS. Participants in the study consisted of 16 patients with chronic tension-type headache and 15 healthy controls. A visual analogue scale was used to measure the intensity of the pain, and the neck disability questionnaire and the Pittsburgh (quality of sleep) questionnaire were also employed. MTP were explored in the temporal, masseter, upper trapezius, suboccipital, sternocleidomastoid, splenius capitis, semispinalis capitis and anterior digastric muscles by a blind evaluator. RESULTS. The subjects with chronic tension-type headache had greater cervical disability (p < 0.001) than the controls, whereas the quality of sleep showed a tendency (p = 0.092). A positive correlation was found between the worst pain last week with the Pittsburgh questionnaire (r = 0.631; p = 0.009) and disability (r = 0.521; p = 0.046), as well as a positive correlation between disability and quality of sleep (r = 0.815; p < 0.001). The patients with headache displayed a higher number of MTP than the healthy controls (p < 0.001), the presence of active MTP being found exclusively in the patients. No association was found between the number of MTP and intensity of pain, disability or quality of sleep. CONCLUSIONS. Quality of sleep and active MTP can be different factors contributing to chronic tension-type headache. Nevertheless, the presence of MTP could also be an epiphenomenon of the pain.
引言。肌筋膜触发点（MTP）引发的牵涉痛和睡眠障碍可能是导致慢性紧张型头痛的因素。目的。确定慢性紧张型头痛患者的MTP、疼痛强度、功能障碍和睡眠质量之间的关系。对象与方法。研究参与者包括16例慢性紧张型头痛患者和15名健康对照者。使用视觉模拟量表测量疼痛强度，同时采用颈部功能障碍问卷和匹兹堡睡眠质量问卷。由一名盲法评估者对颞肌、咬肌、上斜方肌、枕下肌、胸锁乳突肌、头夹肌、头半棘肌和二腹肌前腹进行MTP检查。结果。慢性紧张型头痛患者的颈部功能障碍程度高于对照组（p < 0.001），而睡眠质量有这种趋势（p = 0.092）。发现上周最严重疼痛程度与匹兹堡问卷得分（r = 0.631；p = 0.009）和功能障碍程度（r = 0.521；p = 0.046）呈正相关，功能障碍程度与睡眠质量也呈正相关（r = 0.815；p < 0.001）。头痛患者的MTP数量高于健康对照组（p < 0.001），且仅在患者中发现有活性的MTP。未发现MTP数量与疼痛强度、功能障碍或睡眠质量之间存在关联。结论。睡眠质量和有活性的MTP可能是导致慢性紧张型头痛的不同因素。然而，MTP的存在也可能是疼痛的一种附带现象。
