Hasuo Hideaki, Kanbara Kenji, Abe Tetsuya, Sakuma Hiroko, Fukunaga Mikihiko
Department of Psychosomatic Medicine, Kansai Medical University , Hirakata, Japan .
J Palliat Med. 2017 Oct;20(10):1085-1090. doi: 10.1089/jpm.2016.0541. Epub 2017 Apr 20.
Few studies have reported the efficacy of trigger point injection (TPI) to myofascial trigger points (MTrPs) in advanced cancer patients. Factors that are associated with TPI efficacy have not yet been elucidated.
The study was aimed at evaluating factors that are associated with TPI efficacy to MTrPs in advanced cancer patients.
Factors that are associated with TPI efficacy were retrospectively identified based on a comparison between clinically relevant responders and nonresponders by using multivariate regression analysis.
SETTING/SUBJECTS: One hundred five advanced cancer patients who visited the Palliative Care Department with a chief complaint of pain and who received TPI treatment to the MTrP at the pain site.
The TPI efficacy rate on the day after TPI treatment was 0.59 (95% confidence interval [CI]: 0.50-0.68). Significant factors associated with TPI efficacy were coexistence of cancer pain with MTrP at the pain site (odds ratio [OR]: 3.87, 95% CI: 1.21-12.4), MTrP at areas other than lower back or hip (OR: 6.45, 95% CI: 1.98-21.0), and fewer MTrPs (OR: 0.64, 95% CI: 0.42-0.99). Coexistence of cancer pain at the pain site of the chief complaint was observed in 64% of study subjects (95% CI: 0.55-0.73).
The TPI efficacy is likely high when advanced cancer patients have fewer MTrPs together with cancer pain at areas other than the lower back or hip. MTrPs in advanced cancer patients are more commonly observed together with cancer pain rather than independently. Healthcare providers should recognize the relationship between MTrP and cancer pain and proactively perform physical examinations to detect MTrPs for potential TPI.
很少有研究报道触发点注射（TPI）对晚期癌症患者肌筋膜触发点（MTrP）的疗效。与TPI疗效相关的因素尚未阐明。
本研究旨在评估与晚期癌症患者MTrP的TPI疗效相关的因素。
通过多变量回归分析，比较临床相关的反应者和无反应者，回顾性确定与TPI疗效相关的因素。
地点/受试者：105例以疼痛为主诉就诊于姑息治疗科并在疼痛部位接受MTrP的TPI治疗的晚期癌症患者。
TPI治疗后一天的TPI有效率为0.59（95%置信区间[CI]：0.50 - 0.68）。与TPI疗效相关的显著因素包括疼痛部位癌症疼痛与MTrP共存（比值比[OR]：3.87，95% CI：1.21 - 12.4）、下背部或臀部以外区域的MTrP（OR：6.45，95% CI：1.98 - 21.0）以及较少的MTrP（OR：0.64，95% CI：0.42 - 0.99）。64%的研究对象（95% CI：0.55 - 0.73）主诉疼痛部位存在癌症疼痛。
当晚期癌症患者的MTrP较少且下背部或臀部以外区域存在癌症疼痛时，TPI疗效可能较高。晚期癌症患者的MTrP更常与癌症疼痛同时出现而非单独出现。医疗服务提供者应认识到MTrP与癌症疼痛之间的关系，并积极进行体格检查以检测MTrP以便进行潜在的TPI治疗。
