针刺联合肌肉能量技术治疗慢性非特异性颈痛疗效研究
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摘要
目的:探讨针刺颈部肌筋膜触发点联合肌肉能量技术治疗慢性非特异性颈痛(NCNP)的临床疗效。方法:将符合纳入标准的60例NCNP患者按照随机分组原则分为观察组和对照组,各30例。观察组给予针刺颈部肌筋膜触发点联合肌肉能量技术治疗,对照组给予针刺颈部肌筋膜触发点治疗,共治疗4周。分别在治疗前、治疗后即刻、治疗2周、治疗4周采用颈椎功能障碍指数(NDI)、颈椎主动活动度(AROM)、McGill疼痛问卷简表(SF-MPQ)进行评定。结果:两组在治疗后即刻NDI、AROM、McGill评分均较治疗前明显降低(P <0. 05),观察组治疗后即刻和4周NDI评分低于对照组(P <0. 05),观察组AROM在治疗后即刻和4周高于对照组(P <0. 05),观察组McGill评分在治疗后即刻和4周低于对照组(P <0. 05)。结论:针刺颈部肌筋膜触发点联合肌肉能量技术有利于改善颈椎关节活动度、减轻颈部疼痛,效果优于单一的针刺治疗。
Objective: To explore the clinical efficacy of needling neck myofascial trigger points combined with muscle energy techniques( MET) in the treatment of nonspecific chronic neck pain( NCNP). Methods: 60 NCNP patients who met the inclusion criteria were randomly divided into the observation group( n = 30) and the control group( n = 30). The control group was treated with needling neck myofascial trigger points; on which basis,the observation group was also treated with MET. The total treatment was four weeks. Neck Disability Index( NDI),Neck Active Range of Motion( AROM),and Short-form of McGill pain questionnaire( SF-MPQ) were assessed before and immediately after the treatment,as well as after two weeks and four weeks of the treatment. Results: The scores of NDI,AROM and McGill were significantly lower immediately after the treatment than those before the treatment in the two groups( P < 0. 05). The scores of NDI and McGill were significantly lower,and AROM score was obviously higher in the observation group than those of the control group immediately after the treatment and after four weeks of the treatment( P < 0. 05). Conclusion: Needling neck myofascial trigger points combined with MET can improve neck AROM and relieve neck pain,and its effect is better than that of single acupuncture.
Objective: To explore the clinical efficacy of needling neck myofascial trigger points combined with muscle energy techniques( MET) in the treatment of nonspecific chronic neck pain( NCNP). Methods: 60 NCNP patients who met the inclusion criteria were randomly divided into the observation group( n = 30) and the control group( n = 30). The control group was treated with needling neck myofascial trigger points; on which basis,the observation group was also treated with MET. The total treatment was four weeks. Neck Disability Index( NDI),Neck Active Range of Motion( AROM),and Short-form of McGill pain questionnaire( SF-MPQ) were assessed before and immediately after the treatment,as well as after two weeks and four weeks of the treatment. Results: The scores of NDI,AROM and McGill were significantly lower immediately after the treatment than those before the treatment in the two groups( P < 0. 05). The scores of NDI and McGill were significantly lower,and AROM score was obviously higher in the observation group than those of the control group immediately after the treatment and after four weeks of the treatment( P < 0. 05). Conclusion: Needling neck myofascial trigger points combined with MET can improve neck AROM and relieve neck pain,and its effect is better than that of single acupuncture.
引文
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[13] Leon Chaitow. Muscle Energy Techniques[M]. Holland:Elsevier Limited,2006:3-10.
[14] Lee JH,Park SJ,Na SS. The effect of proprioceptive neuromuscular facilitation therapy on pain and function[J]. J Phys Ther Sci,2013,26(6):713-716.
[15] Jull G,Trott P,Potter H,et al. A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache[J]. Spine,2002,27(17):1835-1843.
[16]黄强民,张雄文,王俊,等.腰臀肌筋膜触发点疼痛和其下肢牵涉痛的诊断与治疗[J].中国康复医学杂志,2005,20(3):193-195.
[2]张佳玮,王刚,李飞,等.中医推拿联合功法训练治疗慢性非特异性颈痛的效果[J].中国康复理论与实践,2016,22(4):459-463.
[3]王立公,常双超.广州市中青年不同人群颈椎病发病率的调查研究[J].中国疗养医学,2010,19(5):473-474.
[4]刘琳,黄强民,刘庆广,等.肌筋膜触发点理论及其在运动康复临床实践中应用的研究进展[J].中国康复理论与实践,2016,22(10):1167-1170.
[5] Wu S,Ma C,Mai M,et al. Translation and validation study of Chinese versions of the neck disability index and the neck pain and disability scale[J]. Spine,2010,35(16):1575-1579.
[6]卓大宏.中国康复医学[M]. 2版.北京:华夏出版社,2003:709.
[7] Cheng CH,Su HT,Yen LW,et al. Long-term effects of therapeutic exercise on nonspecific chronic neck pain:a literature review[J]. J Phys Ther Sci,2015,27(4):1271-1276.
[8] Vasavada AN,Peterson BW,Delp SL. Three-dimensional spatial tuning of neck muscle activation in humans[J]. EXP Brain Res,2002,147(4):437-448.
[9]于丁,林彩娜,栗晓,等.渐进抗阻肌力训练对与工作相关的慢性颈痛疗效的研究[J].中国康复医学杂志,2015,30(6):587-591.
[10]潘泳鸿,仲卫红,张俊新,等.肌肉疲劳与慢性颈痛的研究现状[J].中国康复理论与实践,2015,21(2):168-170.
[11] Halvorsen M,Abbott A,Peolsson A,et al. Endurance and fatigue characteristics in the neck muscles during sub-maximal isometric test in patients with cervical radiculopathy[J]. Eur Spine J,2014,23(3):590-598.
[12] Blanpied PR,Gross AR,Elliott JM,et al. Neck pain:clinical practice guidelines linked to the International Classification of Functioning Disability,and Health from the Orthopedic Section of the American Physical Therapy Association[J]. J Orthop Sports Phys Ther,2017,47(7):A1-A83.
[13] Leon Chaitow. Muscle Energy Techniques[M]. Holland:Elsevier Limited,2006:3-10.
[14] Lee JH,Park SJ,Na SS. The effect of proprioceptive neuromuscular facilitation therapy on pain and function[J]. J Phys Ther Sci,2013,26(6):713-716.
[15] Jull G,Trott P,Potter H,et al. A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache[J]. Spine,2002,27(17):1835-1843.
[16]黄强民,张雄文,王俊,等.腰臀肌筋膜触发点疼痛和其下肢牵涉痛的诊断与治疗[J].中国康复医学杂志,2005,20(3):193-195.