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比较经皮电解与干针疗法治疗颞下颌肌筋膜疼痛的随机双盲研究。

Randomized, double-blind study comparing percutaneous electrolysis and dry needling for the management of temporomandibular myofascial pain.

作者信息

Lopez-Martos R, Gonzalez-Perez L-M, Ruiz-Canela-Mendez P, Urresti-Lopez F-J, Gutierrez-Perez J-L, Infante-Cossio P

机构信息

Department of Oral and Maxillofacial Surgery, Virgen del Rocio University Hospital, Av. Manuel Siurot s/n, 41013 Seville, Spain,

出版信息

Med Oral Patol Oral Cir Bucal. 2018 Jul 1;23(4):e454-e462. doi: 10.4317/medoral.22488.

Abstract

BACKGROUND

To assess whether the techniques of percutaneous needle electrolysis (PNE) and deep dry needling (DDN) used on trigger points (TrP) of lateral pterygoid muscle (LPM) can significantly reduce pain and improve function in patients with myofascial pain syndrome (MPS) compared to a control group treated with a sham needling procedure (SNP).

MATERIAL AND METHODS

Sixty patients diagnosed with MPS in the LPM were selected and randomly assigned to one of three groups. The PNE group received electrolysis to the LPM via transcutaneous puncture. The DDN group received a deep puncture to the TrP without the introduction of any substance. In the SNP group, pressure was applied to the skin without penetration. Procedures were performed once per week for 3 consecutive weeks. Clinical evaluation was performed before treatment, and on days 28, 42 and 70 after treatment.

RESULTS

Statistically significant differences (p <0.01) were measured for the PNE and DDN groups with respect to pain reduction at rest, during chewing, and for maximum interincisal opening (MIO). Values for the PNE group showed significantly earlier improvement. Differences for PNE and DDN groups with respect to SNP group were significant (p <0.05) up to day 70. Evaluation of efficacy as reported by the patient and observer was better for PNE and DDN groups. No adverse events were observed for either of the techniques.

CONCLUSIONS

PNE and DDN of the LPM showed greater pain reduction efficacy and improved MIO compared to SNP. Improvement was noted earlier in the PNE group than in the DDN group.

摘要

背景

评估经皮针电解(PNE)和深部干针刺(DDN)技术应用于翼外肌(LPM)触发点(TrP)时,与假针刺程序(SNP)治疗的对照组相比,是否能显著减轻肌筋膜疼痛综合征(MPS)患者的疼痛并改善功能。

材料与方法

选取60例被诊断为LPM肌筋膜疼痛综合征的患者,随机分为三组。PNE组通过经皮穿刺对LPM进行电解。DDN组对TrP进行深部穿刺但不注入任何物质。SNP组对皮肤施加压力但不穿透。每周进行一次操作,连续进行3周。在治疗前以及治疗后第28、42和70天进行临床评估。

结果

PNE组和DDN组在静息时、咀嚼时以及最大切牙间开口度(MIO)方面的疼痛减轻情况有统计学显著差异(p<0.01)。PNE组的值显示改善明显更早。直到第70天,PNE组和DDN组与SNP组相比差异显著(p<0.05)。患者和观察者报告的PNE组和DDN组的疗效评估更好。两种技术均未观察到不良事件。

结论

与SNP相比,LPM的PNE和DDN显示出更大的疼痛减轻效果和MIO改善。PNE组比DDN组更早出现改善。

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