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干针疗法对自主神经系统和机械性痛觉过敏的即刻影响:一项随机对照试验。

Immediate Effects of Dry Needling on the Autonomic Nervous System and Mechanical Hyperalgesia: A Randomized Controlled Trial.

机构信息

Department of Physical Therapy, University Hospital Ramón y Cajal, 28034 Madrid, Spain.

University of Alcalá, Instituto de Fisioterapia y Dolor, 28805 Madrid, Spain.

出版信息

Int J Environ Res Public Health. 2021 Jun 3;18(11):6018. doi: 10.3390/ijerph18116018.

Abstract

BACKGROUND

Dry needling (DN) is often used for the treatment of muscle pain among physiotherapists. However, little is known about the mechanisms of action by which its effects are generated. The aim of this randomized controlled trial was to determine if the use of DN in healthy subjects activates the sympathetic nervous system, thus resulting in a decrease in pain caused by stress.

METHODS

Sixty-five healthy volunteer subjects were recruited from the University of Alcala, Madrid, Spain, with an age of 27.78 (SD = 8.41) years. The participants were randomly assigned to participate in a group with deep DN in the adductor pollicis muscle or a placebo needling group. The autonomic nervous system was evaluated, in addition to local and remote mechanical hyperalgesia.

RESULTS

In a comparison of the moment at which the needling intervention was carried out with the baseline, the heart rate of the dry needling group significantly increased by 20.60% (SE = 2.88), whereas that of the placebo group increased by 5.33% (SE = 2.32) ( = 0.001, d = 1.02). The pressure pain threshold showed significant differences between both groups, being significantly higher in the needling group (adductor muscle = 0.001; d = 0.85; anterior tibialis muscle = 0.022, d = 0.58).

CONCLUSIONS

This work appears to indicate that dry needling produces an immediate activation in the sympathetic nervous system, improving local and distant mechanical hyperalgesia.

摘要

背景

干针疗法(DN)常被理疗师用于治疗肌肉疼痛。然而,其作用机制知之甚少。本随机对照试验的目的是确定 DN 在健康受试者中是否激活交感神经系统,从而减轻应激引起的疼痛。

方法

从西班牙马德里阿尔卡拉大学招募了 65 名年龄为 27.78(SD=8.41)岁的健康志愿者。参与者被随机分配到拇内收肌深部 DN 组或安慰剂针刺组。除了局部和远程机械性痛觉过敏外,还评估了自主神经系统。

结果

与基线相比,在干针针刺干预进行的时刻,干针组的心率显著增加 20.60%(SE=2.88),而安慰剂组仅增加 5.33%(SE=2.32)(=0.001,d=1.02)。两组间的压力疼痛阈值存在显著差异,针刺组明显较高(拇内收肌=0.001;d=0.85;胫骨前肌=0.022,d=0.58)。

结论

本研究似乎表明,干针疗法可立即激活交感神经系统,改善局部和远处的机械性痛觉过敏。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c99/8199958/93065d7b722b/ijerph-18-06018-g001.jpg

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