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。

Preliminary study on the effect of real-time tissue elastography guided needle stimulation of myofascial trigger points in treatment of myofascial pain syndrome

Objective To investigate the value of real-time tissue elastography(RTE)guided needle stimulation of myofascial trigger points(MTrPs)in the treatment of myofascial pain syndrome(MPS).Methods A total of 60 patients with trapezius muscle MPS admitted to our hospital were randomly divided into RTE group and traditional stimulation group(each group 30 patients)according to the random number table method.The difference of elastic score of MTrPs and pain scores before and after treatment were compared between the two groups.The patients were followed up for 1 year.The treatment effects and long-term prognosis of the two groups were compared.Results There was statistically significant difference in the elasticity scores of MTrPs between the two groups after treatment(P<0.05).After treatment,the visual analogue scale(VAS)and pain assessment index(PRI)of the RTE group(3.02±0.54,3.34±0.62)were significantly lower than those in the traditional stimulation group(3.89±0.36,3.76±0.34),and the differences were statistically significant(both P<0.05).The follow-up results showed that the apparent efficiency and cumulative no-recurrence rate of the RTE group were 86.7%and 93.33%.The apparent efficiency and cumulative no-recurrence rate of the traditional stimulation were 60.0%and 57.1%,and the differences were statistically significant(both P<0.05).Conclusion The therapeutic effect and prognosis of RTE guided needle stimulation of MTrPs are significantly better than traditional palpation needle stimulation,which has important clinical value.