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超声引导下扳机点灭活治疗带状疱疹后神经痛合并肌筋膜疼痛综合征:一项前瞻性对照临床研究。

Ultrasound-Guided Dry Needling for Trigger Point Inactivation in the Treatment of Postherpetic Neuralgia Mixed with Myofascial Pain Syndrome: A Prospective and Controlled Clinical Study.

机构信息

Department of Anesthesiology, Guangdong Provincial People's Hospital Zhuhai Hospital (Zhuhai Golden Bay Center Hospital), Zhuhai, Guangdong 519040, China.

Department of Operation Anesthesiology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong 519000, China.

出版信息

Pain Res Manag. 2022 Aug 2;2022:2984942. doi: 10.1155/2022/2984942. eCollection 2022.

Abstract

OBJECTIVE

To evaluate the safety and effectiveness of ultrasound-guided dry needling for trigger point inactivation in the treatment of postherpetic neuralgia (PHN) mixed with myofascial pain syndrome (MPS).

METHODS

A prospective and controlled clinical study was conducted. From January 2020 to December 2020, among the 100 patients who received PHN treatment in the pain department, 54 patients complicated with MPS were randomly divided into the dry needling group D ( = 28) and pharmacotherapeutic group P ( = 26). Visual analogue score (VAS) and McGill Pain Questionnaire (MPQ) were taken as primary indicators. Ultrasound-guided inactivation of myofascial trigger points (MTrPs) with dry needling and intradermal needling combined with press needling were applied on group D and pharmacotherapeutic only treatment on group P respectively. The VAS score <3 and/or the MPQ score <2 represents effective treatment. The VAS score >3 and/or the MPQ score >2 represents recurrent in follow-up study three months after the treatment.

RESULTS

After four weeks treatment, the effective rate of one month later of the group D was 92.9% and the effective rate of group P was 38.5%, respectively. The recurrent rate of group D was 7.1% and 34.6% for group P, respectively, for follow-up three months later. The satisfactory rate of group D was higher than that of group P.

CONCLUSION

Ultrasound-guided dry needling and intradermal needling combined with press needling were more effective than only pharmacotherapeutic treatment for PHN mixed with MPS, with lower recurrent rate and higher patient's satisfactory rate.

摘要

目的

评估超声引导下肌筋膜触发点干针灭活治疗带状疱疹后神经痛(PHN)合并肌筋膜疼痛综合征(MPS)的安全性和有效性。

方法

前瞻性对照临床研究。2020 年 1 月至 12 月,疼痛科收治 PHN 患者 100 例,其中合并 MPS 者 54 例,采用随机数字表法分为干针组(D 组)和药物组(P 组),每组 28 例和 26 例。视觉模拟评分(VAS)和麦吉尔疼痛问卷(MPQ)为主要指标。D 组采用超声引导下肌筋膜触发点(MTrPs)干针灭活联合皮内针压针,P 组仅给予药物治疗。VAS 评分<3 分且/或 MPQ 评分<2 分表示治疗有效。VAS 评分>3 分且/或 MPQ 评分>2 分表示治疗后 3 个月随访时复发。

结果

治疗 4 周后,D 组 1 个月后有效率为 92.9%,P 组为 38.5%;D 组 3 个月后复发率为 7.1%,P 组为 34.6%,D 组的有效率和复发率均优于 P 组,差异有统计学意义(P<0.05)。

结论

超声引导下肌筋膜触发点干针灭活联合皮内针压针治疗 PHN 合并 MPS 比单纯药物治疗更有效,复发率更低,患者满意度更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a4f/9363202/57c875660b5b/PRM2022-2984942.001.jpg

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