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[扳机点针刺治疗梨状肌综合征的临床研究]

[Clinical study of piriformis syndrome treated with trigger-point acupuncture].

作者信息

Liu Li-Xue, Shen Miao-Miao, Wang Qin-Ge, Shen Wen, Yuan Yan

机构信息

Department of Pain Treatment, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China.

出版信息

Zhen Ci Yan Jiu. 2024;49(9):957-963. doi: 10.13702/j.1000-0607.20230336.

Abstract

OBJECTIVES

To compare the difference in the clinical efficacy on piriformis syndrome between trigger-point (TrP) acupuncture and glucocorticoid injection.

METHODS

Sixty patients with piriformis syndrome were randomly allocated to an acupuncture group (30 cases, treated with TrP acupuncture) and a control group (30 cases, treated with glucocorticoid injection). In the two groups, the intervention was delivered once weekly and 2 treatments were required. Before treatment and 1 week, 1 month, 2 months and 3 months after treatment, the scores of the numerical rating scale (NRS) and Oswestry dysfunction index questionnaire (ODI), and the passive hip range of motion (PROM) were collected separately;the score of the 36-item short form of health survey (SF-36) was observed 3 months after treatment;and the administration of analgesic medication and the occurrence of adverse effects were recorded in the patients of 2 groups.

RESULTS

The scores of NRS and ODI were decreased, and PROM was increased at each time point compared with the baseline (before treatment) in both groups (<0.05). In comparison with the control group, the scores of NRS and ODI were decreased (<0.01, <0.05) and the range of hip internal rotation (HIR) was increased in the acupuncture group 2 and 3 months after treatment (<0.01). Three months after treatment, the scores for physiological function, body pain, and vitality of SF-36 in the acupuncture group were higher than those of the control group (<0.05). The number of patients with analgesic drugs was less (<0.05) in the acupuncture group than that in the control group in 2 and 3 months after treatment. During treatment and in follow-up stage, no serious adverse reactions occurred in the patients of 2 groups.

CONCLUSIONS

The clinical effect of TrP acupuncture is similar to that of glucocorticoid injection on piriformis syndrome in 1 month after treatment. In 2 months after treatment, TrP acupuncture is markedly effective for attenuating pain and the functional impairment of the lower limbs, improving the quality of life and reducing the use of analgesic drugs in comparison with glucocorticoid injection.

摘要

目的

比较触发点针刺与糖皮质激素注射治疗梨状肌综合征的临床疗效差异。

方法

将60例梨状肌综合征患者随机分为针刺组(30例,采用触发点针刺治疗)和对照组(30例,采用糖皮质激素注射治疗)。两组均每周干预1次,共需治疗2次。分别在治疗前及治疗后1周、1个月、2个月和3个月收集数字评分量表(NRS)评分、Oswestry功能障碍指数问卷(ODI)评分及被动髋关节活动度(PROM);治疗3个月后观察健康调查简表(SF-36)36项评分;记录两组患者止痛药物的使用情况及不良反应的发生情况。

结果

两组各时间点的NRS和ODI评分均较基线(治疗前)降低,PROM增加(<0.05)。与对照组相比,针刺组治疗后2个月和3个月时NRS和ODI评分降低(<0.01,<0.05),髋关节内旋(HIR)范围增加(<0.01)。治疗3个月后,针刺组SF-36的生理功能、身体疼痛和活力评分高于对照组(<0.05)。治疗后2个月和3个月,针刺组使用止痛药物的患者数量少于对照组(<0.05)。治疗期间及随访阶段,两组患者均未发生严重不良反应。

结论

治疗1个月后,触发点针刺治疗梨状肌综合征的临床效果与糖皮质激素注射相似。治疗2个月后,与糖皮质激素注射相比,触发点针刺在减轻疼痛和下肢功能障碍、改善生活质量及减少止痛药物使用方面疗效显著。

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