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干针疗法对慢性特发性颈痛患者疼痛敏感性和疼痛调节的即刻影响:一项单盲随机临床试验。

Immediate effects of dry needling on pain sensitivity and pain modulation in patients with chronic idiopathic neck pain: a single-blinded randomized clinical trial.

机构信息

Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, Gent 9000, Belgium.

Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, Gent 9000, Belgium; Pain in Motion International Research Group, www.paininmotion.be.

出版信息

Braz J Phys Ther. 2023 Jan-Feb;27(1):100481. doi: 10.1016/j.bjpt.2023.100481. Epub 2023 Jan 24.

DOI:10.1016/j.bjpt.2023.100481
PMID:36709694
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9894914/
Abstract

BACKGROUND

Dry needling is frequently used for the treatment of neck pain but knowledge about its neurophysiological central effects is scarce.

OBJECTIVES

To compare the immediate effects of a single session of dry needling (DN) and sham needling (SN) on local and distant pressure pain thresholds and conditioned pain modulation in patients with chronic idiopathic neck pain.

METHOD

Participants with chronic idiopathic neck pain were randomly allocated to a DN or SN group. The primary outcome measure was the pressure pain threshold (PPT) at one peripheral location: quadriceps muscle (Q). Secondary outcome measures were local PPTs at the treated (most painful) (tUT) and non-treated upper trapezius muscle (ntUT), absolute and relative conditioned pain modulation (CPM) effects and pain during hot water immersion. Patients were assessed at baseline and immediately post intervention. Linear mixed models were used to examine interaction effects as well as between- and within-group differences.

RESULTS

Fifty-four participants were included for statistical analysis. Linear mixed model analyses showed no significant "group X time" interaction effects for any of the outcome measures. The relative CPM effect at the Q was significantly higher post-intervention, compared to baseline within the DN group (mean difference= 13.52%; 95% CI: 0.46, 26.59).

CONCLUSION

The present study shows no superior effect of DN, compared to SN, in the immediate effect on local and distant PPTs and CPM in patients with chronic idiopathic neck pain.

摘要

背景

干针疗法常用于治疗颈痛,但对其神经生理中枢效应的了解甚少。

目的

比较单次干针(DN)和假干针(SN)治疗对慢性特发性颈痛患者局部和远处压痛阈值和条件性疼痛调制的即刻影响。

方法

将慢性特发性颈痛患者随机分配至 DN 或 SN 组。主要观察指标为一个外周部位(股四头肌[Q])的压痛阈值(PPT)。次要观察指标为治疗(最痛)(tUT)和非治疗上斜方肌(ntUT)局部 PPT、绝对和相对条件性疼痛调制(CPM)效应以及热水浸泡时的疼痛。患者在基线和干预后立即进行评估。线性混合模型用于检查交互效应以及组间和组内差异。

结果

54 名参与者被纳入进行统计分析。线性混合模型分析显示,任何结局指标均未显示“组 X 时间”交互效应。与基线相比,DN 组 Q 处的相对 CPM 效应在干预后显著升高(平均差异=13.52%;95%CI:0.46,26.59)。

结论

本研究显示,与 SN 相比,DN 对慢性特发性颈痛患者局部和远处 PPT 以及 CPM 的即刻效应无优势。