针刺肌筋膜触发点治疗带状疱疹后遗神经痛55例效果观察

The Localization Of Myofascial Trigger Points For Acupuncture In The Treatment Of Postherpetic Neuralgin Of The Trunk – A Clinical 55 Patients Effective VerificationZHANG Yan-Ru¹, MA Yan-Tao², LIU Shou-Fang¹, ZHAO Jia-Min¹, HUANG Qiang-Min³

摘要:

目的：基于肌筋膜触发点(Myofascial trigger points, MTrPs)原理按牵涉痛思路进行定位治疗带状疱疹后遗神经痛(Postherpetic neuralgia, PHN)通常很有效,但是对于躯干间歇性或突发性疼痛常常效果欠佳,本文对发生在躯干部位的PHN患者进行MTrPs定位方法的修改,并观察其临床治疗效果。方法：选取55例患者参与治疗,利用牵涉痛思路结合神经思路定位躯干部位MTrPs,并进行针刺治疗。每次治疗前后均行VAS、简易McGill和PPI疼痛评分。结果：55例患者,给予1疗程即6次针刺触发点治疗,其中 15例患者因无法忍受扎针疼痛放弃治疗,40例患者通过6次治疗镇痛效果满意。治疗前的VAS、McGill和PPI评分以及触发点数量分别：7.5±0.7、16.3±0.5、3.3±0.4和36.9±6.2,6次治疗后：1.2±0.4、2.3±0.4、1.2±0.4和5.2±0.4,半年后随访：0.4±0.3、0.7±0.3、0.2±0.3,因电话随访,触发点数量未查,p<0.01,取得73%的治愈率。结论：临床结果表明从脊柱神经干、支到疱疹区的神经末梢周围有大量的触发点被活化,准确定位这些触发点并行针刺治疗,活化的触发点可以逐渐被灭活或消除。利用神经思路结合牵涉痛思路定位并给予针刺治疗PHN,临床效果满意,此方法可以在其他治疗措施无效时选择应用。

Abstract:

Objective: According to the principle of myofascial trigger point, it is usually very effective to locate the trigger point utilizing the routes of referred pain of MTrPs in the treatment of postherpetic neuralgin , however, it is often ineffective when encountering intermittent or sudden onset of trunk pain. In this paper, the method of MTrPs location for acupuncturing was modified in the patients with the postherpetic neuralgin of trunk, and observed the therapeutic effect. Methods: 55 patients participated in the treatment. The MTrPs were located by using the routes of both the referred pain and the nerve thinking, and then acupuncture was performed. The evaluations of VAS, McGill and PPI pain scores were performed before and after each treatment.