Department of Nursing, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, People's Republic of China.
Department of Hepatobiliary Surgery, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, People's Republic of China.
Chiropr Man Therap. 2022 Sep 1;30(1):34. doi: 10.1186/s12998-022-00441-5.
Myofascial pain syndrome (MPS) is a condition with local and referred pain characterized by trigger points (taut bands within the muscle). Ischemic compression is a noninvasive manual therapy technique that has been employed for the treatment of MPS in past decades. However, little attention has been devoted to this topic.
The present review was designed to explore the efficacy of ischemic compression for myofascial pain syndrome by performing a descriptive systematic review and a meta-analysis to estimate the effect of ischemic compression on MPS.
A systematic review and meta-analysis concerning randomized controlled trials (RCTs) with myofascial pain subjects who received ischemic compression versus placebo, sham, or usual interventions. Five databases (PubMed, The Cochrane Library, Embase, Web of Science, Ovid) were searched from the earliest data available to 2022.1.2. The standardized mean difference (SMD) and the 95% confidence interval (CI) were used for statistics. Version 2 of the Cochrane risk of tool 2 (RoB 2) was used to assess the quality of the included RCTs.
Seventeen studies were included in the systematic review, and 15 studies were included in the meta-analysis. For the pressure pain threshold (PPT) index, 11 studies and 427 subjects demonstrated statistically significant differences compared with the control at posttreatment (SMD = 0.67, 95% CI [0.35, 0.98], P < 0.0001, I = 59%). For visual analog scale (VAS) or numeric rating scale (NRS) indices, 7 studies and 251 subjects demonstrated that there was no significant difference between ischemic compression and controls posttreatment (SMD = - 0.22, 95% CI [- 0.53, 0.09], P = 0.16, I = 33%).
Ischemic compression, as a conservative and noninvasive therapy, only enhanced tolerance to pain in MPS subjects compared with inactive control. Furthermore, there was no evidence of benefit for self-reported pain. The number of currently included subjects was relatively small, so the conclusion may be changed by future studies. Big scale RCTs with more subjects will be critical in future.
肌筋膜疼痛综合征（MPS）是一种以局部和牵涉痛为特征的疾病，其特点是触发点（肌肉内的紧张带）。缺血性压迫是一种非侵入性的手动治疗技术，过去几十年来一直用于治疗 MPS。然而，人们对这个问题的关注甚少。
本综述旨在通过描述性系统评价和荟萃分析来探讨缺血性压迫治疗肌筋膜疼痛综合征的疗效，以评估缺血性压迫对 MPS 的影响。
对接受缺血性压迫与安慰剂、假治疗或常规干预的肌筋膜疼痛受试者的随机对照试验（RCT）进行系统评价和荟萃分析。从最早的数据到 2022 年 1 月 2 日，在 5 个数据库（PubMed、Cochrane 图书馆、Embase、Web of Science、Ovid）中进行了检索。使用标准化均数差（SMD）和 95%置信区间（CI）进行统计学分析。使用 Cochrane 偏倚风险工具 2 版本（RoB 2）评估纳入 RCT 的质量。
本系统评价纳入了 17 项研究，荟萃分析纳入了 15 项研究。对于压力疼痛阈值（PPT）指数，11 项研究和 427 名受试者在治疗后与对照组相比具有统计学显著差异（SMD=0.67，95%CI[0.35，0.98]，P<0.0001，I=59%）。对于视觉模拟评分（VAS）或数字评分量表（NRS）指数，7 项研究和 251 名受试者在治疗后发现缺血性压迫与对照组之间无显著差异（SMD=-0.22，95%CI[-0.53，0.09]，P=0.16，I=33%）。
作为一种保守和非侵入性的治疗方法，缺血性压迫仅能提高 MPS 受试者对疼痛的耐受力，与非活动对照组相比。此外，没有证据表明自我报告的疼痛有获益。目前纳入的受试者数量相对较少，因此未来的研究可能会改变这一结论。未来需要进行更多受试者的大样本 RCT 来验证这一结论。
