拔罐联合针刺激痛点治疗腰背肌筋膜疼痛综合征临床观察

目的:观察拔罐联合针刺激痛点治疗腰背肌筋膜疼痛综合征的疗效。方法:腰背肌筋膜疼痛综合征患者60例,随机分为针刺组和观察组,每组30例。针刺组给予激痛点针刺加TDP常规治疗;观察组根据肌肉紧张带位置,在肌筋膜线上密集拔罐,同时针刺。两组均隔天治疗1次,共治疗5次。以简化麦吉尔疼痛量表为观察指标,进行疼痛评定指数(pain rating index,PRI)、视觉模拟评分(visual analog score,VAS)和现时疼痛强度(present pain intensity,PPI)评定,观察治疗前、治疗结束时以及1个月后的评分变化并观察临床疗效。结果:治疗后,观察组总有效率为96.6%(29/30),高于针刺组的83.3%(25/30),总有效率比较差异没有统计学意义(P0.05);1个月后,针刺组的疗效减退,总有效率为40.0%(12/30),而观察组总有效率90.0%(27/30),两组差异有统计学意义(P0.05)。两组治疗后的PRI、VAS及PPI评分较治疗前均明显下降(P0.05),但两组比较差异无统计学意义(P0.05);1个月后,两组评分有所上升,但观察组的评分较针刺组低(P0.05)。结论:针刺激痛点对肌筋膜疼痛综合征有较好疗效,联合肌筋膜线拔罐可有更好的远期镇痛效果。

Clinical Observation on Therapeutic Effect of Cupping Combined with Acupuncture Stimulation at Trigger Points for Lumbar Myofascial Pain Syndrome

Objective To observe the clinical effect of cupping combined with acupuncture stimulation of trigger points on lumbar myofascial pain syndrome(MPS).Methods Sixty MPS patients were randomly divided into acupuncture+TDP group(n=30),and cupping+acupuncture group(n=30).Patients in the acupuncture+TDP group were treated by acupuncture stimulation of trigger points and local TDP irradiation,and patients of the cupping+acupuncture group treated by intensive cupping applied to the myofascial band and acupuncture stimulation of the locus according to the position of muscular tension band.The therapeutic effects were assessed according to the score of the McGill pain questionnaire composing of pain rating index(PRI),visual analogue scale(VAS)and present pain intensity(PPI)before,immediately and 1month after the treatment.Results After the treatment,the total effective rates of the acupuncture+TDP and cupping+acupuncture groups were 83.3%(25/30)and96.6%(29/30),respectively,without significant difference between the two groups(P>0.05).One month's follow-up showed that the total effective rates of the acupuncture+TDP and cupping+acupuncture groups were 40.0% and 90.0%respectively,and the latter group was significantly better than the acupuncture+TDP group in the therapeutic effect(P<0.05).The scores of PRI,VAS,PPI after the treatment were markedly decreased in both groups(P<0.05).One month later,the scores of PRI,VAS and PPI in the cupping+acupuncture group were obviously lower than those of the acupuncture group(P<0.05).ConclusionBoth acupuncture stimulation of trigger points plus TDP and cupping plus acupuncture can effectively relieve pain in MPS patients,while the therapeutic effect of cupping plus acupuncture treatment lasts longer analgesic effect.