小针刀结合温针治疗肩胛背部肌筋膜炎临床疗效比较

目的探讨小钟刀结合温针治疗肩胛背部肌筋膜炎临床疗效及安全性。方法肩胛背部肌筋膜炎门诊患者216例，治疗组150例，小针刀结合温针治疗，每7天施术1次，2次为1疗程，疗程间休息1周；对照组66例，温针治疗，15天为1疗程，疗程间休息1周，比较两组治愈率。结果治疗组痊愈132例，治愈率88.00％，对照组痊愈15例，治愈率22．73％，治疗组显著高于对照组（P〈0．05）。结论小针刀结合温针治疗肩胛背部肌筋膜炎较单纯温针治疗疗效好。     

两种方法治疗腰肌筋膜炎的疗效观察

腰肌筋膜炎是由于外伤、劳累及受寒等致病因子侵犯腰部的纤维组织使之产生损伤及无菌性炎症，主要表现为腰部弥漫性钝痛，以两侧腰肌及髂嵴上方更为明显[1]。本研究采用超短波、拔罐疗法治疗腰肌筋膜炎患者，临床疗效满意。现报告如下。     

内热针治疗颈肩肌筋膜炎的临床效果分析

目的观察内热针治疗颈肩肌筋膜炎的效果。方法收治的60例颈肩肌筋膜炎患者,以治疗方式分成研究组与参照组各30例,参照组行常规针灸治疗,研究组治疗前应用红外热成像技术明确原发病灶、布针范围,行内热针治疗,对两组治疗结果进行比较分析。结果两组治疗前VAS评分无显著差异(P0.05),研究组治疗后VAS评分比参照组更低(P0.05);研究组总有效率为96.67%,与参照组的76.67%相比,相对更高(P0.05)。结论红外热成像技术用于颈肩筋膜炎中可有效明确原发病灶、布针范围,为临床布针提供指导,对颈肩肌筋膜炎应用内热针治疗效果理想,可缓解临床症状,减轻患者疼痛程度,改善生活质量,值得推广应用。     

射频热凝与痛点阻滞治疗肌筋膜炎临床疗效比较

目的:对比研究射频热凝与痛点阻滞治疗肌筋膜炎的临床疗效。方法:20例肌筋膜炎患者分为射频热凝组和痛点阻滞组(每组n=10)进行治疗。采用视觉模拟评分法(VAS)记录患者治疗前,治疗后1周、1个月的疼痛评分,1个月后用VAS评价疼痛缓解优良率并观察副作用情况。结果:两组患者在治疗后均产生了良好的临床效果,与治疗前比较VAS评分显著下降(P<0.01)。两组患者在治疗前VAS评分比较差异无统计学意义(P>0.05);但在治疗后1周,痛点阻滞组VAS评分低于射频热凝组(P<0.01);而在治疗后1个月,射频热凝组VAS评分低于痛点阻滞组(P<0.01),两组在疼痛缓解优良率上无统计学意义(P>0.05)。结论:射频热凝和痛点阻滞在治疗肌筋膜炎均产生了良好的临床效果,但射频热凝在治疗1个月后未见复发,疗效优于痛点阻滞。     

平刺滞针弹拔法配合微波治疗颈肩背部肌筋膜炎的疗效观察

颈背部筋膜炎是以颈部弥漫性疼痛，为主要临床表现的一种病证，多为颈背肩部有筋膜，肌肉组织出现水肿，渗出及纤维变性所改，采用平刺滞针弹拔法配合微波治疗颈肩背部肌筋膜炎88例进行治疗，取得较好的治疗效果，现报道如下：     

弹性成像引导下针刺激痛点治疗肌筋膜疼痛的疗效初探

目的 研究实时组织弹性成像（RTE）引导下针刺肌筋膜激痛点（MTrPs）治疗肌筋膜疼痛综合征（MPS）的应用价值。方法 研究对象为2017年8月至2018年8月在我院就诊的60例MPS患者,随机平均分为RTE组和传统针刺组,对患者进行随访1年,比较两组患者治疗前后MTrPs弹性评分、疼痛评分的差异并研究两者的相关性。比较两组患者的治疗效果及远期预后。结果 治疗后RTE组的弹性评分、视觉模拟评分(VAS) 和疼痛评定指数均明显低于传统针刺组（P＜0.05）,弹性评分与VAS、PRI、现时疼痛强度 (PPI)均呈正相关（均r＞0且P＜0.05）,其中弹性评分与VAS的相关程度最强（r=0.673, P=0.000）。MTrPs弹性评分与VAS在不同疗程中的变化趋势近似,均呈下降趋势（P＜0.05）。RTE组的显效率为86.7%,累计无复发率为93.33%,传统针刺组的显效率为60%,累计无复发率为57.14%,RTE组的显效率及累计无复发率均明显高于传统针刺组（P＜0.05）。结论 RTE引导下针刺MTrPs的治疗效果及预后均明显优于传统触诊法针刺。     

细银质针治疗腰肌筋膜炎的疗效及红外热成像的应用

目的明确细银质针疗法治疗部队官兵训练致腰部肌筋膜炎临床疗效以及红外热成像检查在疗效判定中的作用。方法 96例患者给予细银质针治疗,在针前及针后不同时间点观察针刺区热像图温度变化。结果 96例患者治愈28例,显效34例,有效33例,无效1例,总有效率99%。针刺部位温度在针后即刻上升,1 d后温度有所下降,但高于针前(P0.05),7 d后温度下降,低于针前(P0.05),21、30 d温度有所上升,但仍低于针前(P0.05)。结论细银质针疗法治疗腰肌筋膜炎患者,可以明显缓解症状,起效快,疗效持久,安全无副作用,红外热成像检查在辅助疗效判定方面有重要作用。     

实时组织弹性成像指导针刺激痛点治疗肌筋膜疼痛的疗效初探

目的应用实时组织弹性成像(RTE)确定肌筋膜激痛点(MTrPs),探讨其引导针刺治疗肌筋膜疼痛综合征(MPS)的应用价值。方法选择我院斜方肌MPS患者60例,按随机数字表法分为RTE组和传统针刺组各30例,比较两组患者治疗前后MTrPs弹性评分、疼痛评分的差异。对患者随访1年,比较两组患者的治疗效果及远期预后。结果两组治疗后MTrPs的弹性评分比较,差异有统计学意义(P<0.05)。RTE组治疗后视觉模拟评分(VAS)和疼痛评定指数(PRI)分别为(3.02±0.54)分、(3.34±0.62)分,均明显低于传统针刺组(3.89±0.36)分、(3.76±0.34)分,差异均有统计学意义(均P<0.05)。随访结果显示,RTE组的显效率为86.7%,累计无复发率为93.3%,传统针刺组的显效率为60.0%,累计无复发率为57.1%,两组比较差异均有统计学意义(均P<0.05)。结论RTE指导针刺MTrPs治疗MPS的疗效及预后均明显优于传统触诊法针刺,具有重要的临床价值。     

祛风止痛胶囊治疗腰背部肌筋膜炎的临床研究

目的：探讨祛风止痛胶囊治疗腰背肌筋膜炎的效果。方法将66例腰背肌筋膜炎患者随机分为治疗组和对照组各33例,治疗组采用口服祛风止痛胶囊和双氯芬酸钠治疗,对照组仅给以双氯芬酸钠口服。分别于治疗前,治疗后3天、7天和14天对两组患者进行VAS评分,并在治疗结束后进行两组疗效对比。结果治疗后2周患者的疼痛评分均比治疗前明显改善,治疗组的疗效明显优于对照组,差异有显著性。结论祛风止痛胶囊对腰背肌筋膜炎具有较好的治疗效果,不但能早期抑制肌筋膜组织的无菌性炎症,减轻腰背部疼痛,而且能够标本兼顾,改善患者体质,祛风通络,渗湿除痹。     

神经阻滞和偏振红外光治疗三叉神经痛的近期效果比较

目的通过对比观察单纯外周神经阻滞加偏振红外光照射患侧颈胸神经节治疗三叉神经痛近期效果,探讨不同方法治疗三叉神经痛的效果特征。方法38例三叉神经痛的患者,分为两组。A组(n=20)用20g/L利多卡因注射液5ml+维生素B120.5mg+生理盐水至10ml单纯外周神经阻滞治疗,间隔一两天重复1次,5次为1个疗程。B组(n=18)在上述阻滞后加偏振红外光照射患侧颈胸神经节,偏振红外光治疗功率60%～80%设置模式23,治疗时间10min。用视觉模拟评分法(VAS)于每次治疗前及治疗后10～15min对疼痛的程度进行评估。结果A组患者治疗前VAS为7.6±2.2,B组患者治疗前VAS为7.6±1.1,组间无明显差别(t=0.01,P>0.05)。每次阻滞前后疼痛明显减轻(t=15.48～43.71,P<0.001)。随着治疗次数的增加,疼痛逐渐减轻或消失。经过5次治疗后,A组VAS评分降为2.6±2.4,疼痛缓解率平均达到64%。B组VAS评分降为3.5±1.8,疼痛缓解率平均达到51%。每次治疗前后VAS的变化两组间比较无显著性差异。结论外周神经阻滞治疗三叉神经痛有效。三叉神经阻滞配伍同侧颈胸神经节偏振红外光照射没有显示出优越的近期镇痛效果。     

红外热成像在医学疼痛中的应用

红外热成像是一种无接触,无辐射,相对便宜的新型检查方式,它将人体对外辐射出的红外热转变为数字和图像信号,准确的表现身体各部位的温度高低,将主观化的疼痛转变为客观化的数据,尤其适用于慢性疼痛,痛敏感,游走性疼痛, 对疼痛的诊断和疗效评估均有一定的参考价值。本文综述了红外热成像的工作原理以及在医学疼痛中的应用,包括软组织疼痛、带状疱疹及带状疱疹性神经痛、关节炎、颈腰椎病、原发性骨质疏松等,并总结了红外热成像在临床应用中的优势和不足。在未来的疼痛诊疗过程中,红外热成像将发挥不可替代的作用。     

The needle effect in the relief of myofascial pain.

In reviewing techniques for therapeutic local anaesthesia of pain spots, it appeared that the common denominator was puncture by the needle and not the anaesthetic employed. The present study examines short- and long-term effects of dry needling in the treatment of chronic myofascial pain. 241 patients and 312 pain sites were treated by needling. When the most painful spot was touched by the needle, immediate analgesia without hypesthesia was observed in 86.8% of cases. Permanent relief of tenderness in the needled structure was obtained for 92 structures; relief for several months in 58; for several weeks in 63; and for several days in 32 out of 288 pain sites followed up. The effectiveness of treatment was related to the intensity of pain produced at the trigger zone, and to the precision with which the site of maximal tenderness was located by the needle. The immediate analgesia produced by needling the pain spot has been called the "needle effect".     

Pain behavior and pain coping strategies in low back pain and myofascial pain dysfunction syndrome patients

Pain behavior and pain coping strategies were systematically measured in a group of 32 chronic low back pain (LBP) and 32 myofascial pain dysfunction (MPD) syndrome patients. Both groups reported high levels of psychological distress on the SCL-90R. The LBP patients were significantly less active, took more narcotic and sedative-hypnotic medications, and showed higher levels of motor pain behavior (guarding, rubbing, and bracing) than the MPD patients. The LBP patients used attention diversion, and praying or hoping as pain coping skills to a much greater extent than the MPD patients. The relationship of these findings to prior research is described, and future research needs in this area are identified.     

银质针在慢性疼痛中的治疗体会与护理配合

目的探讨银质针在慢性疼痛中的治疗与护理效果。方法明确适应症,根据治疗部位安置好体位,术野暴露充分,皮肤消毒,铺巾完毕,局麻,选择长度适宜的银质针,以密集型将针刺入病灶的深部肌筋膜或骨膜附着点处,导热巡检仪加热,使针尖温度保持在42℃,达到治疗作用。结果银质针导热疗法治疗顽固性软组织疼痛320例,能显著消除炎症反应,增加局部血运,松解肌肉痉挛,温通经络、散寒止痛。有效率99%。结论采用银质针治疗,充分评估患者个体差异,采取不同的护理方式,术前、术中、术后护理方法得当,密切观察病情,确保治疗安全和成功。     

银质针治疗腰椎手术失败综合征的疗效观察

目的:探讨银质针针刺疗法对腰椎手术失败综合征的疗效。方法:将29例腰椎手术失败综合征患者随机数字表法分为银质针针刺疗法治疗组(15例)和常规疗法治疗组(14例),治疗前及治疗后7,14d,半年,应用《腰椎疾患治疗成绩评分表》对腰椎功能状态进行临床评定;应用Roland-morris失能问卷评价患者的生活质量。结果:银质针针刺疗法组14d及半年有效率均高于常规组(P<0.05),患者生活质量银质针治疗组比常规治疗组改善显著(P<0.05)。结论:银质针针刺疗法治疗腰椎手术失败综合征较常规治疗效果好。     

电刺激引导下神经阻滞治疗下背痛的临床研究

摘要 目的：观察电刺激引导下神经阻滞治疗对下背痛患者疼痛及功能改善的价值。 方法：78例下背痛患者,随机分为治疗组（40例）和对照组（38例）,治疗组在电刺激仪引导下行复方倍他米松2mg联合利多卡因2ml神经阻滞治疗,对照组给予物理因子治疗和运动疗法治疗。治疗前及治疗后第1天、第1周和第2周应用目测类比评分法（visual analogue scale,VAS）对疼痛进行评估,治疗前后应用腰椎疾患治疗成绩评分表对腰椎功能状态进行评定。 结果：治疗组有效率为100.0％,改善率为96.6%;对照组有效率为86.8％,改善率为64.3%;二组间疗效比较差异有显著性意义（P<0.01）。 结论：电刺激引导下神经阻滞治疗对改善下背痛及提高腰椎活动功能有明显的作用。     

Comparison of two different techniques of electrotherapy on myofascial pain

This study was designed to compare the effects of Transcutaneus Electrical Nerve Stimulation (TENS) and Electrical Muscle Stimulation (EMS) on myofascial trigger point (MTrP) of the upper trapezius muscle. A total of 40 patients were randomly divided into three groups. All patients had active MTrP in one side of the upper trapezius muscles. Group I was treated with TENS and trapezius-stretching exercises; Group II was treated with EMS and trapezius-stretching exercises and Group III, the control group, had only trapezius-stretching exercises. Subjective pain intensity with VAS, range of motion (ROM), and pain threshold (PT) were assessed before, immediately after two week treatment and 3 months after treatment. Group I had a statistically significant reduction in VAS (P<0.01), increase in PT and ROM (p<0.05) at end of the treatment when compared with the control group. Only VAS was significantly improved (p<0.05) in the Group II patients. At the end of the third month, both groups showed highly significant improvement (p<0.01) in VAS and PT (but not ROM). There was no statistical difference in none of parameters between EMS and TENS groups in any time (p>0.05). In conclusion, TENS seem to be more effective immediately after treatment but in long term evaluation there is no significant superiority of two electrotherapy techniques on each other.     

Effects of transcutaneous electrical nerve stimulation on myofascial pain and trigger point sensitivity

The effects of transcutaneous electrical nerve stimulation (TENS) on myofascial pain and trigger point sensitivity were assessed. Four modes of TENS and a no-stimulation control were compared in a double-blind design. Stimulation, carried out for 10 min on 60 subjects (12/group), showed significant pain reductions with 100 Hz, 250 msec stimulation followed by 100 Hz, 50 msec and then pain suppressor TENS. No pain reductions were found in the 2 Hz, 250 msec TENS or the control. No significant alteration in myofascial trigger point sensitivity, assessed with the pressure algometer, was found between the groups. The results suggest that high frequency, high intensity TENS is effective in reducing myofascial pain, and that these pain reductions do not reflect changes in local trigger point sensitivity.