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原发性痛经女性的肌筋膜疼痛综合征:一项病例对照研究。

Myofascial Pain Syndrome in Women with Primary Dysmenorrhea: A Case-Control Study.

作者信息

Serrano-Imedio Ana, Calvo-Lobo Cesar, Casañas-Martin Coraima, Garrido-Marin Alejandro, Pecos-Martin Daniel

机构信息

Grupo de Investigación en Fisioterapia y Dolor, Departamento de Fisioterapia, Facultad de Enfermería y Fisioterapia, Universidad de Alcalá, 28801 Alcalá de Henares, Spain.

CARMASALUD Clinical and Research Center, 28037 Madrid, Spain.

出版信息

Diagnostics (Basel). 2022 Nov 7;12(11):2723. doi: 10.3390/diagnostics12112723.

Abstract

There is limited information on myofascial trigger points (MTrPs) and specific symptoms of chronic pelvic pain and, more specifically, dysmenorrhea. The objective of this study was to determine whether patients suffering from primary dysmenorrhea present alterations in mechanosensitivity and pain patterns, and greater presence of MTrPs in the abdominal and pelvic floor muscles. A case-control study was carried out with a total sample of 84 participants distributed based on primary dysmenorrhea and contraceptive treatment. The sample was divided into four groups each comprising 21 women. Data on pain, quality of life, and productivity and work absenteeism were collected; three assessments were made in different phases of the menstrual cycle, to report data on pressure pain threshold, MTrP presence, and referred pain areas. One-way ANOVA tests showed statistically significant differences (p < 0.01) between the groups, for the Physical Health domain and the total score of the SF-12 questionnaire, and for all the domains of the McGill questionnaire; but no significant differences were found in the data from the WPAI-GH questionnaire. Statistically significant data (p < 0.01) were found for mechanosensitivity in the abdominal area and limbs, but not for the lumbar assessment, within the group, with very few significant intergroup differences. The frequency of active MTrPs is higher in the groups of women with primary dysmenorrhea and during the menstrual phase, with the prevalence of myofascial trigger points of the iliococcygeus muscle being especially high in all examination groups (>50%) and higher than 70% in women with primary dysmenorrhea, in the menstrual phase, and the internal obturator muscle (100%) in the menstrual phase. Referred pain areas of the pelvic floor muscles increase in women with primary dysmenorrhea.

摘要

关于肌筋膜触发点(MTrP)与慢性盆腔疼痛尤其是痛经的特定症状的信息有限。本研究的目的是确定原发性痛经患者是否存在机械敏感性和疼痛模式的改变,以及腹部和盆底肌肉中MTrP的存在情况是否更多。开展了一项病例对照研究,总样本为84名参与者,根据原发性痛经和避孕治疗进行分组。样本分为四组,每组21名女性。收集了疼痛、生活质量、生产力和工作缺勤的数据;在月经周期的不同阶段进行了三次评估,以报告压力疼痛阈值、MTrP存在情况和牵涉痛区域的数据。单因素方差分析显示,在SF - 12问卷的身体健康领域和总分以及麦吉尔问卷的所有领域中,各组之间存在统计学显著差异(p < 0.01);但在WPAI - GH问卷的数据中未发现显著差异。在组内,腹部区域和四肢的机械敏感性有统计学显著数据(p < 0.01),但腰部评估无显著数据,组间差异极少。原发性痛经女性组和月经期间活跃MTrP的频率较高,在所有检查组中,髂尾肌的肌筋膜触发点患病率特别高(>50%),在原发性痛经女性的月经期间高于70%,而闭孔内肌在月经期间为100%。原发性痛经女性盆底肌肉的牵涉痛区域增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc91/9689409/2962d05ba597/diagnostics-12-02723-g001.jpg

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