“以痛为腧”治疗肌筋膜疼痛综合征针刺时间之临床研究

目的:观察"以痛为腧"治疗肌筋膜疼痛综合征(MPS)3种针刺时间之临床疗效差异。方法:与皮肤表面呈平行方向按压扳机点(条索状硬结),病患最感疼痛的方向定义为痛点方向。将90例确诊为背部肌筋膜疼痛综合征的患者随机分为针刺5min组、针刺15min组与针刺25min组等3组,每一组有30例患者。远离痛点方向平刺(15°),并进行疗效比较。按压力量值之测定:采用指针式拉压力计规范所有之按压力量,每一次试验前后,试验者使用指针式拉压力计之按压方式,包括按压位置、方向、力量等,必须严格规定其一致性。本试验均采用视觉模拟量表之数字量表评订疼痛缓解的临床疗效。结果:针刺5min组、针刺15min组与针刺25min组等3组针刺时间对肌筋膜疼痛之治疗前后疼痛改善均有显著性差异(P<0.05)。针刺后留针时间越久完全缓解率增加。针刺5min组、针刺15min组与针刺25min组等3组针刺时间之总有效率均相同,可达100%。针刺后留针时间越久平均减分率仅略为增加。3种针刺时间比较,疼痛缓解统计学上均无显著性差异(P>0.05)。结论:针刺得宜,针刺5min即有很好的疼痛缓解效果;针刺时间延长,疼痛再缓解有限。

Clinical Study on Needling time of Acupuncture at Pain Points for Treatment of Myofascial Pain Syndrome

Objective：To compare therapeutic effects of three needling time of myofascial pain syndrome （MPS）by acupuncture at pain points. Methods ：The direction of horizontal pressure to trigger point （taut - band） which patient felt most painful .was defined as the pain direction. 90 cases of back myofascial pain syndrome were divided randomly into three groups, needling 5 minutes , 15 minutes and 25minutes. Each group was consisted of thirty cases. All the patients were treated in condiction of horizon- tal needling（ 15° ） away from the pain direction and their therapeutic effects were compared. Handy Push - Pull Gauge was used to measure the pressure power on pain points in each experiment. The unified manipulations included pressure point, direction and power were set. All of these clinical experiments used Numerical Scale of Visual Analogue Scale （VAS）. Results ： All the analgesic effects of needling 5 minutes , 15 minutes and 25minutes have significant diffierences （P 〈 0. 05 ）. The longer the needling time, the more the complete pain reducing rate increase. The total effective rates of needling 5 minutes ,15 minutes and 25minutes are all 100 %. The longer the needling time ,only the little average painscale reducing rate increase. There are not significant differences of analgesic effect between the three methods （ P 〉 0.05 ）. Conclusion ： ff the needling method is appropriate, the analgesic effect is satisfying to needle only for 5 minutes. If the needling time increased, the further improvement of analgesic effect is finite.