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[一项关于触发点微灸治疗肩背部肌筋膜疼痛综合征的随机对照临床试验]

[A Randomized Controlled Clinical Trial for Treatment of Shoulder-back Myofascial Pain Syndrome with Mild Moxibustion at Trigger Points].

作者信息

Wang Lie, Ma Shuai, Zhao Yue, Cao Rui, Wang Ying, Ma Tie-Ming

机构信息

College of Acupuncture and Tuina, Liaoning University of Traditional Chinese Medicine, Shenyang 110847, China.

Department of Neurology, Shenyang Municipal Seventh People's Hospital, Shenyang 110003.

出版信息

Zhen Ci Yan Jiu. 2016 Aug 25;41(4):334-7.

Abstract

OBJECTIVE

To compare the efficacy difference between the mild moxibustion and acupuncture stimulation at trigger points in the treatment of shoulder and back myofascial pain syndrome (MPS), so as to provide a reference for clinical treatment of MPS.

METHODS

A total of 60 patients with shoulder and back MPS were equally and randomly divided into mild moxibustion group and acupuncture group. The myofascial trigger points in the shoulder and back regions were stimulated with mild moxibustion for 20-100 min every time or punctured with filiform needles by retaining the needles for 30 min after twirling for a while. The treatment was conducted once daily for 10 days. The short-form McGill pain questionnaire (SF-MPQ) including the pain rating index[PRI consisting of 15 descriptors (11 sensory, 4 affective) which are rated on an intensity scale as 0=none, 1=mild, 2=moderate and 3=severe], present pain intensity (PPI) index of the standard MPQ and a visual analogue scale (VAS) was used to assess the patient's pain severity before and after the treatment.

RESULTS

Following the treatment, of the two 30 cases of MPS patients in the acupuncture and mild moxibustion groups, 1 and 7 were cured, 11 and 17 experienced marked improvement, 14 and 5 were effective, 4 and 1 was invalid, with the effective rates being 86.7% (26/30) and 96.7%(29/30), respectively. The cured plus markedly effective rate of the mild moxibustion group was significantly better than that of the acupuncture group(<0.001). Self-comparison of the two groups showed that the scores of PRI, VAS and PPI after the treatment were apparently reduced in both groups compared with pre-treatment (<0.001), but without significant differences between the two groups in the PRI, VAS and PPI scores after the treatment (>0.05).

CONCLUSIONS

Mild moxibustion stimulation of myofascial trigger point is effective in relieving shoulder-back MPS, being comparable to that of acupuncture therapy.

摘要

目的

比较温和灸与针刺触发点治疗肩背部肌筋膜疼痛综合征(MPS)的疗效差异,为MPS的临床治疗提供参考。

方法

将60例肩背部MPS患者随机等分为温和灸组和针刺组。温和灸组每次对肩背部肌筋膜触发点进行20 - 100分钟的温和灸刺激,针刺组采用毫针针刺,捻转后留针30分钟。每日治疗1次,共治疗10天。采用包括疼痛评定指数[PRI,由15个描述词(11个感觉性、4个情感性)组成,强度分级为0 =无、1 =轻度、2 =中度、3 =重度]的简式McGill疼痛问卷(SF - MPQ)、标准MPQ的现时疼痛强度(PPI)指数和视觉模拟评分法(VAS)评估治疗前后患者的疼痛严重程度。

结果

治疗后,针刺组和温和灸组各30例MPS患者中,治愈例数分别为1例和7例,显效例数分别为11例和17例,有效例数分别为14例和5例,无效例数分别为4例和1例,有效率分别为86.7%(26/30)和96.7%(29/30)。温和灸组的治愈加显效率显著优于针刺组(<0.001)。两组自身比较显示,与治疗前相比,两组治疗后的PRI、VAS和PPI评分均明显降低(<0.001),但两组治疗后的PRI、VAS和PPI评分差异无统计学意义(>0.05)。

结论

温和灸刺激肌筋膜触发点对缓解肩背部MPS有效,与针刺疗法效果相当。

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