银质针和神经阻滞治疗背部肌筋膜炎的疗效比较:基于红外热成像结果

目的探讨如何根据红外热成像结果选择背部肌筋膜炎最佳治疗方式。方法将诊断为肌筋膜炎的100例患者行红外热成像检查后，测量患侧与相对健侧的温度（△T=患侧温度-相对健侧温度），根据患侧温度高低选出热组（W组, △T≥0.2 ℃）和冷组（C组, △T≤-0.2 ℃），50例/组，每组采用随机数字表法再各分2组，25例/组，分别行银质针导热治疗（S组）和神经阻滞治疗（N组），4组分别简称WS、WN、CS和CN组。银质针导热治疗组共治疗1次，神经阻滞治疗组每5 d 1次，根据患者疼痛缓解情况共行2~3次。在治疗前（0 d）、治疗第1、6、15、30、180天采用视觉模拟评分法（VAS）评估患者疼痛变化。结果随访期内，热组患者在第1、30、180天的VAS评分显示WS组明显高于WN组（P < 0.05）；冷组患者在第15、30、180天的VAS评分显示CS组明显低于CN组，两组数据之间差异均有统计学意义（P < 0.05）。结论利用红外热成像进行患区温度判断，热区（△T≥0.2 ℃）选择神经阻滞治疗，冷区（△T≤-0.2℃）选择银质针治疗疗效较好。 

Comparison of silver needle and nerve block in treatment of back myofascial pain based on infrared thermal imaging

ObjectiveTo measure the temperature in the affected area using infrared thermal imaging.The warm area and the cold area were divided into two groups for silver needle heat conduction and nerve block treatment, then the efficacy was compared to choose the best treatment method for back myofascial pain.MethodsAfter patients who diagnosed with myofascial pain had been examed by infrared thermal imaging, we measured the temperature of the affected side and the relative healthy side(△T=the temperature of affected area - the temperature of healthy area). Fifty cases were selected in both warm group (group W, △T≥0.2 ℃) and the cold group (group C, △T≤-0.2 ℃). Then each group was randomly divided into 2 groups (WS, WN, CS, CN) with 25 patients. Group WS and CS received silver needle thermal conduction therapy (S) once in a month, and group WN and CN received nerve block treatment (N) once every 5 days, 2-3 times in total depends on how much the pain relieved. The change of patients' pain were inquired and compared with Visual Analogue Scale (VAS) at day 0 (before treatment), 1, 6, 15, 30 and 180 after the treatment.ResultsDuring the follow-up period, VAS of patients in group W at day 1, 30 and 180 showed that group WS was significantly higher than group WN. VAS of patients in group C at day 15, 30 and 180 showed that group CS was significantly lower than group CN(P < 0.05).ConclusionInfrared thermal imaging is used to judge the temperature of affected area, nerve block therapy used in warm and silver needle therapy is used in cold.