针刺激痛点治疗第三腰椎横突综合征的随机对照研究
|
摘要
目的:观察针刺激痛点治疗第三腰椎横突综合征的疗效与安全性。方法:采用随机单盲对照设计,选取78例第三腰椎横突综合征患者,随机分为激痛点组和经穴组,每组39例。激痛点组对患者进行激痛点触诊,依据患者疼痛部位,选取竖脊肌、多裂肌、腰方肌、髂腰肌、臀大肌、臀中肌、臀小肌、梨状肌等相应肌肉的激痛点进行针刺;经穴组取大肠俞、委中、腰三横突阿是穴。两组均1次/天,5天为1个疗程,中间休息2天,治疗4个疗程后进行评价。观察两组患者治疗前后和随访(只观察治愈患者,治愈后6月)Owestry功能指数与VAS分值,不良反应发生率和评价疗效。结果:(1)疗效评价方面,激痛点组优于经穴组(P<0.05);(2)两组治疗后Owestry功能指数较治疗前明显下降(均P<0.05),且激痛点组优于经穴组(P<0.05);但随访时Owestry功能指数经穴组却优于激痛点组(P<0.05);(3)两组治疗后VAS分值较治疗前明显下降(均P<0.05),且激痛点组优于经穴组(P<0.05);但随访时VAS分值经穴组却优于激痛点组(P<0.05);(4)激痛点组与经穴组针刺不良反应发生率分别为12.8%(5/39)和5.1%(2/39),差异有统计学意义,但均为一过性,对症处理后未再出现。结论:针刺激痛点能够有效治疗第三腰椎横突综合征,可以及时缓解疼痛、改善功能。
Objective: To observe the effect and security of acupuncturing MTrPs to treat the third lumbar transverse process syndrome.Methods: 78 cases of the third lumbar transverse process syndrome patients were selected in a single-blind RCT design,and randomly divided into groups that concluded MTrPs groups(39) and meridian group(39). First patients of MTrPs group were myofascial trigger point palpation,to acupuncture MTrPs according to the site of pain in patients' appropriate muscles which concluded erector spinae,multifidus,lumbar side muscle,iliopsoas,gluteus maximus,gluteus medius,gluteus minimus,pear-shaped muscle,etc.; Patients of meridian group were acupunctured Dachangshu,Venezuela,third lumbar transverse Ashi. Two groups were 1 times/day,5 days for a course of treatment,a break of two days,was evaluated after four courses of treatment and observed before and after treatment and follow-up(6 months after cure was observed only in patients cured) Owestry scores and VAS scores,incidence of adverse reactions and evaluated. Results:(1) MTrPs group was better than the meridian group in efficacy evaluation( P < 0. 05);(2) Owestry scores after treatment decreased significantly than before(P<0.05),and MTrP s group was more significant than meridian group(P<0.05);but Owestry scores of follow-up meridian group were better than the MTrP s group(P<0.05);(3)VAS scores of two groups decreased significantly than before(P<0.05),and MTrP group was more significant than meridian group(P<0.05);but VAS scores of follow-up meridian group were better than the MTrP s group(P<0.05);(4)The adverse reactions of MTrP s group and meridian group were 12.8%(5/39)and 5.1%(2/39),the difference was statistically significant,but the cases occurred once and never occur again after symptomatic treatment.Conclusion:Acupuncturing MTrP s can be an effective treatment to the third lumbar transverse process syndrome,and can promptly relieve pain and improve function.
Objective: To observe the effect and security of acupuncturing MTrPs to treat the third lumbar transverse process syndrome.Methods: 78 cases of the third lumbar transverse process syndrome patients were selected in a single-blind RCT design,and randomly divided into groups that concluded MTrPs groups(39) and meridian group(39). First patients of MTrPs group were myofascial trigger point palpation,to acupuncture MTrPs according to the site of pain in patients' appropriate muscles which concluded erector spinae,multifidus,lumbar side muscle,iliopsoas,gluteus maximus,gluteus medius,gluteus minimus,pear-shaped muscle,etc.; Patients of meridian group were acupunctured Dachangshu,Venezuela,third lumbar transverse Ashi. Two groups were 1 times/day,5 days for a course of treatment,a break of two days,was evaluated after four courses of treatment and observed before and after treatment and follow-up(6 months after cure was observed only in patients cured) Owestry scores and VAS scores,incidence of adverse reactions and evaluated. Results:(1) MTrPs group was better than the meridian group in efficacy evaluation( P < 0. 05);(2) Owestry scores after treatment decreased significantly than before(P<0.05),and MTrP s group was more significant than meridian group(P<0.05);but Owestry scores of follow-up meridian group were better than the MTrP s group(P<0.05);(3)VAS scores of two groups decreased significantly than before(P<0.05),and MTrP group was more significant than meridian group(P<0.05);but VAS scores of follow-up meridian group were better than the MTrP s group(P<0.05);(4)The adverse reactions of MTrP s group and meridian group were 12.8%(5/39)and 5.1%(2/39),the difference was statistically significant,but the cases occurred once and never occur again after symptomatic treatment.Conclusion:Acupuncturing MTrP s can be an effective treatment to the third lumbar transverse process syndrome,and can promptly relieve pain and improve function.
引文
[1]王文德,王哗来.中国针刀临证精要[M].北京:人民卫生出版社,2009:287.
[2]马尧,布赫,贾纪荣,等.雀啄灸激痛点治疗肌筋膜疼痛综合征:随机对照研究[J].中国针灸,2014,34(11):1 073-1 075.
[3]黄艾,李里,谭朝坚,等.刃针针刺肌筋膜激痛点治疗颈心综合征30例[J].中医外治杂志,2013(1):38-39.
[4]蒋珊珊,初晓辉,杨佃会.恢刺配合排刺治疗颈肩肌筋膜疼痛综合征案[J].江西中医药,2015(5):55-55.
[5]国家中医药管理局.中医病症诊断疗效标准[S].南京:南京大学出版社,1994:216.
[6]石学敏主编.针灸学[M].北京:中国中医药出版社,2010:212.
[7]黄宇烽,黄山.针刀治疗第三腰椎横突综合征83例报告[J].右江民族医学院学报,2009,31(1):109.
[8]Simons D G,Travell J G,Simons L S.Travell&Simons'myofascial pain and dysfunction:the trigger point manual.2.The lower extremities[M].Williams&Wilkins,1999.
[9]Simons D G.Review of enigmatic MTr Ps as a common cause of enigmatic musculoskeletal pain and dysfunction[J].Journal of electromyography and kinesiology,2004,14(1):95-107.
[10]Travell J G,Simons D G.Myofascial pain and dysfunction:the trigger point manual[M].Lippincott Williams&Wilkins,1992.
[2]马尧,布赫,贾纪荣,等.雀啄灸激痛点治疗肌筋膜疼痛综合征:随机对照研究[J].中国针灸,2014,34(11):1 073-1 075.
[3]黄艾,李里,谭朝坚,等.刃针针刺肌筋膜激痛点治疗颈心综合征30例[J].中医外治杂志,2013(1):38-39.
[4]蒋珊珊,初晓辉,杨佃会.恢刺配合排刺治疗颈肩肌筋膜疼痛综合征案[J].江西中医药,2015(5):55-55.
[5]国家中医药管理局.中医病症诊断疗效标准[S].南京:南京大学出版社,1994:216.
[6]石学敏主编.针灸学[M].北京:中国中医药出版社,2010:212.
[7]黄宇烽,黄山.针刀治疗第三腰椎横突综合征83例报告[J].右江民族医学院学报,2009,31(1):109.
[8]Simons D G,Travell J G,Simons L S.Travell&Simons'myofascial pain and dysfunction:the trigger point manual.2.The lower extremities[M].Williams&Wilkins,1999.
[9]Simons D G.Review of enigmatic MTr Ps as a common cause of enigmatic musculoskeletal pain and dysfunction[J].Journal of electromyography and kinesiology,2004,14(1):95-107.
[10]Travell J G,Simons D G.Myofascial pain and dysfunction:the trigger point manual[M].Lippincott Williams&Wilkins,1992.