Charles Derek, Hudgins Trey, MacNaughton Josh, Newman Eric, Tan Joanne, Wigger Michael
Department of Physical Therapy, Tennessee State University, Nashville, TN, USA.
Department of Physical Therapy, Tennessee State University, Nashville, TN, USA.
J Bodyw Mov Ther. 2019 Jul;23(3):539-546. doi: 10.1016/j.jbmt.2019.04.001. Epub 2019 Apr 4.
Myofascial pain with myofascial triggers are common musculoskeletal complaints. Popular treatments include manual therapy, dry needling, and dry cupping. The purpose of this systematic review was to compare the efficacy of each treatment in the short-term relief of myofascial pain and myofascial trigger points.
Search engines included Google Scholar, EBSCO Host, and PubMed. Searches were performed for each modality using the keywords myofascial pain syndrome and myofascial trigger points. The inclusion criteria included English-language, peer-reviewed journals; a diagnosis of myofascial pain syndrome or trigger points; manual therapy, dry needling, or dry cupping treatments; retrospective studies or prospective methodology; and inclusion of outcome measures.
Eight studies on manual therapy, twenty-three studies on dry needling, and two studies on dry cupping met the inclusion criteria. The Physiotherapy Evidence Database (PEDro) was utilized to assess the quality of all articles.
While there was a moderate number of randomized controlled trials supporting the use of manual therapy, the evidence for dry needling ranged from very low to moderate compared to control groups, sham interventions, or other treatments and there was a paucity of data on dry cupping. Limitations included unclear methodologies, high risk for bias, inadequate blinding, no control group, and small sample sizes.
While there is moderate evidence for manual therapy in myofascial pain treatment, the evidence for dry needling and cupping is not greater than placebo. Future studies should address the limitations of small sample sizes, unclear methodologies, poor blinding, and lack of control groups.
伴有肌筋膜触发点的肌筋膜疼痛是常见的肌肉骨骼疾病。常用的治疗方法包括手法治疗、干针疗法和闪罐疗法。本系统评价的目的是比较每种治疗方法在短期缓解肌筋膜疼痛和肌筋膜触发点方面的疗效。
搜索引擎包括谷歌学术、EBSCO主机和PubMed。使用关键词“肌筋膜疼痛综合征”和“肌筋膜触发点”对每种治疗方式进行检索。纳入标准包括英文、经同行评审的期刊；肌筋膜疼痛综合征或触发点的诊断；手法治疗、干针疗法或闪罐疗法；回顾性研究或前瞻性方法；以及纳入结局指标。
八项关于手法治疗的研究、二十三项关于干针疗法的研究和两项关于闪罐疗法的研究符合纳入标准。使用物理治疗证据数据库（PEDro）评估所有文章的质量。
虽然有适量的随机对照试验支持手法治疗的应用，但与对照组、假干预或其他治疗相比，干针疗法的证据强度从极低到中等不等，且闪罐疗法的数据匮乏。局限性包括方法不明确、偏倚风险高、盲法不足、无对照组和样本量小。
虽然有中等证据支持手法治疗肌筋膜疼痛，但干针疗法和拔罐疗法的证据并不优于安慰剂。未来的研究应解决样本量小、方法不明确、盲法差和缺乏对照组等局限性问题。
