Effects of trigger point acupuncture treatment on temporomandibular disorders: a preliminary randomized clinical trial

We compared the effects of trigger point acupuncture with that of sham acupuncture treatments on pain and oral function in patients with temporomandibular disorders (TMDs). This 10-week study included 16 volunteers from an acupuncture school with complaints of chronic temporomandibular joint myofascial pain for at least 6 months. The participants were randomized to one of two groups, each receiving five acupuncture treatment sessions. The trigger point acupuncture group received treatment at trigger points for the same muscle, while the other acupuncture group received sham treatment on the trigger points. Outcome measures were pain intensity (visual analogue scale) and oral function (maximal mouth opening). After treatment, pain intensity was less in the trigger point acupuncture group than in the sham treatment group, but oral function remained unchanged in both groups. Pain intensity decreased significantly between pretreatment and 5 weeks after trigger point (p<0.001) and sham acupunctures (p<0.050). Group comparison using the area under the curve demonstrated a significant difference between groups (p=0.0152). Compared with sham acupuncture therapy, trigger point acupuncture therapy may be more effective for chronic temporomandibular joint myofascial pain.     

针刺结合经皮穴位电刺激治疗颈椎病颈痛的临床研究

目的：对比观察针刺、经皮穴位电刺激及针刺结合经皮穴位电刺激对颈椎病颈痛的疗效。方法：将58例颈椎病颈痛患者随机分为针刺组、经皮组和结合组,治疗后用NPQ颈痛量表进行疗效评价,观察治疗前、治疗结束和治疗结束随访1个月时的组间评分差异。结果：针刺组、经皮组与结合组有效率分别为94.74%、89.47%与100%,各组治疗后较治疗前NPQ评分均明显降低,差异具有统计学意义（P〈0.01）,在治疗结束时,结合组与经皮组NPQ评分差异有统计学意义（P〈0.01）,结合组均数低于经皮组;结合组与针刺组NPQ评分差异有统计学意义（P〈0.05）,结合组均数低于针刺组;随访1个月时,各组间差异有统计学意义（P〈0.01）。结论：针刺和经皮穴位电刺激是治疗颈椎病颈痛安全且有效的方法,将针刺与经皮穴位电刺激联合应用,可获得更好的疗效。     

独刺后溪穴配合颈肩运动治疗肩胛提肌劳损

目的：观察独刺后溪穴配合颈肩运动治疗肩胛提肌劳损的疗效。方法：40例肩胛提肌劳损患者随机分为独刺组和对照组各20例,独刺组针刺肩胛提肌劳损所在侧的后溪穴,并配合颈椎各方向活动和颈肩部龟缩运动,对照组穴位指压肩胛提肌走行部位的阿是穴,VAS量表评价两组治疗前后疼痛变化及疗效。结果：独刺组5次内治愈率为60%,明显高于对照组的30%（P〈0.05）;治疗后独刺组VAS评分显著低于对照组（P〈0.05）;独刺组治愈率及总有效率分别为70%及100%,显著高于对照组的35%及90%（P〈0.05）。结论：独刺后溪穴配合颈肩运动能有效缓解肩胛提肌劳损的疼痛,提高治愈率,缩短治愈时间。     

椎动脉型颈椎病经颈夹脊穴温针灸+手法治疗的临床效果研究

目的:评价椎动脉型颈椎病经颈夹脊穴温针灸+手法治疗的临床效果.方法:选取2016年5月～2018年6月在我院进行治疗的116例椎动脉型颈椎病患者,按随机数表法分为两组,各58例.对照组采用颈夹脊穴温针灸治疗,观察组采用颈夹脊穴温针灸+手法治疗.对比两组治疗前后眩晕问卷调查表评分(DHI)、各临床症状评分以及椎动脉血管相...     

热敏灸结合颈夹脊穴针刺治疗颈型颈椎病疗效对照观察

目的观察颈夹脊穴针刺配合热敏灸与常规针刺治疗颈型颈椎病的临床疗效差异。方法将154例颈型颈椎病患者分为热敏组(92例)和针刺组(62例),热敏组采用热敏灸配合夹脊穴针刺治疗,每日1次;针刺组选用风池、天柱、大椎等穴进行常规针刺,每天1次,治疗14次。两组患者采用视觉模拟评分法(VAS)评分,观察两组临床疗效。结果两组治疗方法 VAS评分均明显降低(P0.01),治疗后热敏组VAS评分低于针刺组P0.05。热敏组治愈58例,显效32例,无效2例,针刺组分别为26例、28例、8例,热敏组总体疗效优于针刺组。结论热敏灸结合夹脊穴针刺治疗颈型颈椎病可明显缓解疼痛,疗效优于单纯针刺治疗。     

温针灸配合坐位拔伸手法治疗椎动脉型颈椎病随机对照研究

目的观察颈夹脊穴温针灸配合坐位拔伸手法治疗椎动脉型颈椎病(CSA)的疗效。方法将200例CSA患者随机分为治疗组和对照组,每组100例。治疗组在颈夹脊穴和风池穴温针灸后,配合坐位拔伸手法治疗。对照组口服盐酸氟桂嗪胶囊。采用CSA症状评分标准和眩晕问卷调查表(DHI)在治疗前后进行记录,获得治疗前后眩晕、头痛、视物模糊、耳鸣、颈痛、旋颈试验等症状评分及DHI评分。结果两组患者治疗后眩晕、头痛、视物模糊、耳鸣、旋颈试验评分均较治疗前升高,治疗后DHI评分较治疗前下降,差异均有统计学意义(治疗组P<0.01,对照组P<0.05),两组治疗后颈痛评分均较治疗前升高,但治疗组差异有统计学意义(P<0.01),对照组差异没有统计学意义(P>0.05);治疗后组间比较,治疗组眩晕、头痛、视物模糊、旋颈试验、颈痛评分及DHI评分较对照组改善更明显(P<0.05,P<0.01)。结论颈夹脊穴温针灸配合坐位拔伸手法治疗椎动脉型颈椎病的疗效显著。     

针刺肌筋膜疼痛触发点治疗颈椎病疗效观察

目的:探讨针刺肌筋膜疼痛触发点与常规的穴位针刺治疗颈椎病的临床疗效差异。方法:将符合条件的363例颈椎病患者随机分为治疗组(191例)和对照组(172例)。对照组患者用毫针针刺风池、颈夹脊、肩井、天宗、肩贞、外关等穴,接G6805电针仪治疗,同时配合推拿、颈椎牵引,静滴扩张血管药物;治疗组在上述疗法的基础上,针刺风池、颈夹脊、肩井、天宗、肩贞时,用毫针破坏相应的肌筋膜疼痛触发点后再留针通电。结果:两组病例治疗前后颈椎功能障碍指数变化均有统计学意义(P<0.05),治疗组和对照组治疗后比较差异有统计学意义(P<0.05);两组综合疗效以治疗组为优(P<0.05)。结论:针刺肌筋膜疼痛触发点能有效缓解疼痛和功能障碍,提高临床治愈率。     

手法治疗椎动脉型颈椎病

由于颈椎的病变而导致的颈枕痛，颈肩痛，头痛头晕，颈后伸或侧弯时眩晕加重，改变方位时，症状明显减轻或消失，可有视物不清，恶心呕吐，耳呜等症状，称之为椎动脉型颈椎病。我们应用按摩加卧位成角定点复位法治疗该病，共观察10例，疗效满意，现具体介绍如下。     

针灸联合推拿治疗颈椎小关节错缝随机平行对照研究

[目的]观察针灸联合推拿治疗颈椎小关节错缝疗效。[方法]使用随机平行对照方法,将64例门诊及住院患者按抽签法简单随机分为两组。对照组32例推拿:取坐位,肩、颈、背、腰打直,身体放松。先揉、捏、压,放松肌肉、活络经脉,保持适中力度,有疼痛感为佳,过程中,需随时力度调整,20min/次,1次/d。治疗组32例针灸:取坐位,选穴风池、肩井、肩贞、肩骨禺、百会、天宗、晴明、头维、列缺、大椎;头晕、头痛加天宗和百会;耳鸣加听会和合谷;穴位颈部两侧进行,40mm毫针,时间30min~45min/次,深度0.7寸~1寸,2次/d;痛感处时间可延长,也可减少扎针力度;推拿治疗同对照组。连续治疗7d为1疗程。观测临床症状、颈肩背疼痛、不良反应。连续治疗3疗程,疗程间间隔5d,判定疗效。[结果]治疗组痊愈18例,有效11例,无效3例,总有效率90.63%。对照组痊愈13例,有效10例,无效9例,总有效率71.88%。治疗组疗效优于对照组(P0.05)。[结论]针灸联合推拿治疗颈椎小关节错缝效果显著,值得推广。     

ANALGESIC SYSTEMIC EFFECTS OF ACUPUNCTURE ON TEMPOROMANDIBULAR DYSFUNCTION — CASE STUDIES

Introduction: Temporomandibular disorders(TMD) are consequences of biomechanical imbalances: muscle tension in the head and neck region leading to pain, tension headaches with changes in mastication, speech, swallowing, and sleep disorders.Acupuncture has an effect on musculoskeletal pain.However, there is lack of study in clinical applicability for TMD.Objective: To evaluate the analgesic effects of acupuncture and quality of life in patients with temporomandibular joint disorders.Methods: We performed 10 sessions of acupuncture in subjects with TMD.It was used as an evaluation tool to plug TMD adapted to Bianchini, the questionnaire on quality of life WHOQOL-Bref and the Visual Analogue Scale(VAS) of pain.Results: The data obtained in the initial evaluation by VAS showed average pain = 7.5 before the intervention and after the sessions = 1.16, in other words, 100% of the subjects showed improvement in analgesic effects of acupuncture resulting in decreasing pain(P0.000 1).The frequency of symptomsreported in the assessment decreased after the treatment, and the symptoms of crepitus, tinnitus, sensation of blocked ear and headaches were reduced to zero in the revaluation.The quality of life of the participants was improved, mainly related to sleep.Conclusion: Treatment with acupuncture showed significant improvement in pain reduction, and quality of life of the volunteers and therefore an improvement in sleep quality.     

针刺手三里穴力敏点配合主动运动治疗急性机械性颈痛的临床研究

目的 观察针刺手三里穴力敏点配合主动运动与常规针刺手三里配合主动运动治疗急性机械性颈痛的临床疗效.方法 回顾性分析2018年1月到2019年12月接受针刺治疗的急性机械性颈痛患者64例,分为针刺常规手三里组(对照组)21例与针刺手三里穴力敏点组(观察组)43例,两组患者接受针刺的同时都配合患者颈部主动运动.观测治疗前后...     

Randomized Trial of Trigger Point Acupuncture Treatment for Chronic Shoulder Pain: A Preliminary Study

There is evidence for the efficacy of acupuncture treatment for chronic shoulder pain, but it remains unclear which acupuncture modes are most effective. We compared the effect of trigger point acupuncture (TrP), with that of sham (SH) acupuncture treatments, on pain and shoulder function in patients with chronic shoulder pain. The participants were 18 patients (15 women, 3 men; aged 42–65 years) with nonradiating shoulder pain for at least 6 months and normal neurological findings. The participants were randomized into two groups, each receiving five treatment sessions. The TrP group received treatment at trigger points for the muscle, while the other group received SH acupuncture treatment on the same muscle. Outcome measures were pain intensity (visual analogue scale, VAS) and shoulder function (Constant–Murley Score: CMS). After treatment, pain intensity between pretreatment and 5 weeks after TrP decreased significantly (p < 0.001). Shoulder function also increased significantly between pretreatment and 5 weeks after TrP (p < 0.001). A comparison using the area under the outcome curves demonstrated a significant difference between groups (p = 0.024). Compared with SH acupuncture therapy, TrP therapy appears more effective for chronic shoulder pain.     

项排针治疗颈型颈椎病疗效观察

目的观察项排针治疗颈型颈椎病的临床疗效。方法将118例颈型颈椎病患者随机分为治疗组61例和对照组57例,治疗组采用项排针治疗,取风池穴,颈4⁷夹脊穴(47夹脊穴(4⁷颈椎棘突下旁开0.5寸)及其外侧旁开1寸。对照组采用普通针刺治疗,取风池穴和颈47颈椎棘突下旁开0.5寸)及其外侧旁开1寸。对照组采用普通针刺治疗,取风池穴和颈4⁷夹脊穴,1个疗程后观察评价2组临床疗效。结果治疗组总有效率为98.4%,对照组为89.5%,2组疗效比较差异有统计学意义(P<0.05)。结论项排针加强了颈部的针刺刺激量和效果,对颈部经脉气血的调节、颈部筋肉血运的改善,起着良好的治疗作用,从而加速损伤组织的修复,缓解肌肉痉挛,达到解除疼痛、通经活络、畅通气血的目的。     

仰卧位拔伸整复手法与针刺治疗颈椎病的对比临床研究

目的:评价仰卧位拔伸整复手法和针刺治疗颈椎病的疗效。方法:参照临床流行病学/DME原则,纳入符合既定标准的颈椎病患者220例,分为手法治疗组和针刺治疗组,其中治疗组为120例,对照组为100例。手法治疗组采用仰卧位拔伸整复手法进行治疗,针刺治疗组采用在颈部的压痛点作针刺治疗,留针30min。对颈椎病的总体疗效和临床症状体征的积分进行治疗前后比较和组间比较。结果:手法治疗组的总有效率为97.75%,针刺治疗组的总有效率为93.0%,手法治疗对于颈部活动受限、颈项痛、头痛、头晕、上肢麻木、眩晕、恶心呕吐、耳鸣耳聋症状均有明显改善(P<0.01),针刺治疗对颈部活动受限、颈项痛、头痛、头晕、上肢麻木有明显改善(P<0.01)。结论:仰卧位拔伸整复手法和针刺治疗颈椎病有良好的疗效,可以明显改善颈项酸痛和上肢麻木等临床症状和体征,恢复患者的日常工作、生活能力。手法能够缓解颈部软组织痉挛,有助于颈部内外平衡的重建。手法可以调节椎体活动节段的对应关系,并松解椎体小关节的粘连。     

恢刺法合电针治疗神经根型颈椎病52例疗效分析

目的：观察恢刺合电针治疗神经根型颈椎病患者的疗效。方法：共收治52例患者,结合颈部X线或CT表现,用指切法在颈部病变棘突两侧寻找压痛点或阳性反应点为主穴1组,肩胛骨上角的压痛点或阳性反应点,肩井,天宗为主穴2组,采用恢刺合电针的方法,配合后溪及昆仑穴,隔日治疗1次,10次为1个疗程,1个疗程后观察疗效。结果：52例患者中,治愈31例,好转16例,未愈5例,总有效率为90.38%。治疗1个疗程后VAS评分为（3.87±2.03）,明显优于治疗前（7.75±1.15）。结论：恢刺合电针是治疗神经根型颈椎病的有效方法。     

Acupuncture--a therapeutic concept in the treatment of painful conditions and functional disorders. Report on 971 cases

The results in 971 outpatients who have been treated with acupuncture for different diseases are reported. The outcome of treatments and number of sessions are discussed in relation to the different diseases. Acupuncture treatment was regarded as successful when 1. the patients had no pain at all without medication and 2. there was a significant improvement (no long-term medication, only mild pain under unusual strain, minimal medication under such circumstances). We obtained positive results in cephalalgias , sinusitis, cervical spine syndrome, shoulder-arm syndrome, ischialgias , back pain, constipation, herpes zoster, allergic rhinitis and disturbances of peripheral blood flow. For the following ailments, in order to reduce the medication, we recommend acupuncture despite a high rate of recurrence: Trigeminal neuralgia, colitis ulcerosa, bronchial asthma and cancer pain. Results in the treatment of mental disturbances were unsatisfactory, and in cases of tinnitus results were negative.     

The effects of massage in patients with chronic tension headache

21 female patients suffering from chronic tension headache received 10 sessions of upper body massage consisting of deep tissue techniques in addition to softer techniques in the beginning. When found, trigger points were carefully and forcefully massaged. The range of cervical movements, surface ENMG on mm. frontalis and trapezius, visual analogue scale (VAS) and Finnish Pain Questionnaire (FPQ), and the incidence of neck pain during a two week period before and after the treatment, and at 3 and 6 months during the follow-up period together with Beck depression inventory were taken for evaluation and follow-up. The range of movement in all directions increased, and FPQ, VAS and the number of days with neck pain decreased significantly. There was a significant change in ENMG on the frontalis muscle whereas changes in trapezius remained insignificant. Beck inventory showed an improvement after the treatment. This study confirmed clinical and physiological effects of massage.     

导引术结合颈肌功能锻炼对颈型颈椎病的康复疗效及生存质量影响的研究

目的:探讨导引术结合颈肌功能锻炼对颈型颈椎病患者的康复疗效。方法:收集2018年11月~2019年9月遵义医科大学第三附属医院康复医学科门诊或住院的颈型颈椎病患者67例,随机分为治疗组35例和对照组32例。对照组在常规治疗基础上同时行颈部肌力训练,治疗组在常规治疗基础上进行导引术与颈部肌力训练结合的运动疗法。在治疗前、后以及随访3个月,分别采用VAS评分和SF-36量表进行疼痛和生活质量的评估,并比较两组疗效。结果:治疗组总有效率高于对照组(P<0.05)。治疗后及随访3个月后,两组患者的VAS评分均较治疗前降低(P<0.01),且治疗组治疗后及随访3个月后的VAS评分均低于对照组(P<0.01)。治疗后及随访3个月后,两组患者治疗后的躯体功能、躯体角色、躯体疼痛、活力、精神健康、社会功能维度评分均高于治疗前(P<0.05),随访3个月后,治疗组躯体疼痛、活力得分在明显高于对照组(P<0.05);治疗后及随访3个月,治疗组在躯体疼痛、社会功能、情感角色、精神健康方面得分高于对照组(P<0.05)。结论:导引术结合颈肌功能锻炼对颈型颈椎病患者的康复疗效显著,明显减轻患者疼痛、提高患者生存质量,值得在社区康复中推广锻炼。     

温和灸激痛点治疗肩背部肌筋膜疼痛综合征:随机对照研究

目的:比较温和灸与针刺激痛点治疗肩背部肌筋膜疼痛综合征(MPS)的疗效差异,为肩背部MPS的治疗提供参考。方法:60例肩背部MPS患者随机分为温和灸组和针刺组,每组30例,两组均选取疼痛部位的激痛点进行治疗。温和灸组采用温和灸疗法,每次艾灸因人而异,20~100min不等,以患者出现透热感为度;针刺组采用毫针与皮肤呈45°角斜刺入并贯穿激痛点结节,每次留针30min。两组每日均治疗1次,10次为一疗程,治疗1个疗程后,采用国际公认的简化麦吉尔疼痛量表(McGill)作为观察指标,以治疗前后疼痛分级指数(PRI)、视觉模拟评分(VAS)和现时疼痛强度(PPI)的变化来评价疗效。结果:温和灸组愈显率80.0%(24/30),优于针刺组愈显率40.0%(12/30,P0.001)。治疗后两组PRI、VAS、PPI评分较治疗前均降低(均P0.001);两组治疗后PRI、VAS、PPI评分比较,差异均无统计学意义(均P0.05)。结论:温和灸激痛点与针刺激痛点对肩背部MPS均具有良好的治疗效果,但温和灸治愈显效更为明显,且操作简便,易于推广。     

针刺配合麦粒灸对颈椎病颈痛患者颈部压痛阈的影响

目的客观评价针刺配合麦粒灸对颈椎病颈痛患者颈部压痛阈的影响。方法按照纳入和排除标准获得合格受试者共150例,按就诊顺序随机分配至针灸组、针刺组、灸法组。针灸组于针刺结束后予以麦粒灸治疗,针刺组只予针刺治疗,灸法组只予麦粒灸治疗。3组受试者均隔日治疗1次,10次为1个疗程。运用M-tone压痛测试仪,于每次治疗前、后对受试者的颈部压痛阈进行测量。结果 3组接受治疗后压痛阈均增加,自第6次治疗开始,针灸组患者压痛阈明显优于其余两组(P0.05);整个治疗过程中,针灸组压痛阈升高幅度最大,其后依次为针刺组和灸法组;每次干预前后压痛阈的差值比较,3组出现峰值的时间不等,针灸组出现最早,其次是针刺组和灸法组。结论针刺配合麦粒灸可明显升高颈椎病颈痛患者颈部压痛阈,具有较好的临床疗效。