Морозова О Г, Ярошевский А А, Липинская Я В
Харьковская медицинская акдемия последипломного образования, Мorozova O.G., Yaroshevskiy A.A., Lipinskaya Y.V.Kharkov Medical Academy of Postgraduate Education. Kharkov, Ukraine.
Wiad Lek. 2015;68(3 pt 2):335-340.
The relevance of this study is due to the prevalence of autonomic disorders and musculoskeletal pain, especially among the young people of working age. In recent years, many authors in scientific works have been highlighted aspects of mutual development myofascial and autonomic dysfunction, which is caused by neurophysiological preconditions and anatomical and topographical relationships that need to be considered in the diagnostic and therapeutic approaches.
To study the characteristics of the formation and flow of autonomic dysfunction syndrome with paroxysmal and permanent types of flow in patients with myofascial pain syndromes cervicobrachial localization.
Using clinical neurological, vertebral neurological, neuropsychological methods of studying the severity of pain (visual analogue scale and Pain questionnaire of Mac Gill) examined 84 patients suffering from autonomic dysfunction on the background of myofascial pain syndromes cervicobrachial localization. To identify the features of vegetative regulation of patients were divided into two groups: group 1 (51 people) - with a permanent type of course; group 2 (33 patients) - a type of paroxysmal of course of autonomic dysfunction.
It was found more pronounced disturbances in patients with paroxysmal type of course of autonomic dysfunction. The frequency and severity of autonomic paroxysms associated with the severity of musculo-tonic syndrome and location of active trigger points in the muscles of the neck and shoulder girdle, due to anatomic and topographic features of these muscles, namely the proximity of their location to the sympathetic formations neck. The formation and development of emotional and affective disorders in both groups played a significant role of pain and musculo-tonic syndrome. The syndrome of autonomic dysfunction, in particular its paroxysmal type of flow, on the one hand is a response to the development of myofascial pain syndromes cervicobrachial localization, with another - a factor that facilitates the development of pain and muscular-tonic syndromes, burdening the disease.
In the diagnosis and treatment of myofascial and autonomic dysfunction should take into account comorbidity data of pathological conditions, which is important for developing individual therapeutic regimens.
本研究的相关性源于自主神经功能障碍和肌肉骨骼疼痛的普遍性,尤其是在工作年龄的年轻人中。近年来,许多作者在科学著作中强调了肌筋膜和自主神经功能障碍共同发展的方面,这是由神经生理学前提以及解剖学和地形学关系引起的,在诊断和治疗方法中需要考虑这些因素。
研究颈臂部肌筋膜疼痛综合征患者中发作性和持续性自主神经功能障碍综合征的形成和发展特征。
采用临床神经学、脊椎神经学、神经心理学方法研究疼痛严重程度(视觉模拟量表和麦吉尔疼痛问卷),对84例以颈臂部肌筋膜疼痛综合征为背景的自主神经功能障碍患者进行检查。为确定患者自主神经调节的特征,将其分为两组:第1组(51人)——病程为持续性;第2组(33例患者)——自主神经功能障碍病程为发作性。
发现自主神经功能障碍发作性病程的患者存在更明显的紊乱。自主神经发作的频率和严重程度与肌强直综合征的严重程度以及颈肩带肌肉中活跃触发点的位置有关,这是由于这些肌肉的解剖学和地形学特征,即它们的位置靠近颈部交感神经结构。两组中情绪和情感障碍的形成和发展在疼痛和肌强直综合征中起重要作用。自主神经功能障碍综合征,尤其是其发作性病程,一方面是对颈臂部肌筋膜疼痛综合征发展的一种反应,另一方面是促进疼痛和肌肉强直综合征发展的一个因素,加重了病情。
在肌筋膜和自主神经功能障碍的诊断和治疗中,应考虑病理状况的合并症数据,这对制定个体化治疗方案很重要。