摘要
目的:观察内热针对颈肩肌筋膜疼痛综合征患者的镇痛作用,并探讨其改善颈肩肌筋膜疼痛综合征的机制。方法:在2021年12月至2023年12月期间,临床选取符合纳入标准的颈肩肌筋膜疼痛综合征患者100例,按随机数字表法分为对照组和观察组各50例,对照组在患者肌筋膜触发点注射0.5%利多卡因,观察组使用内热针针刺肌筋膜触发点治疗。采用视觉模拟评分(VAS),疼痛分级指数(PRI)和现有疼痛指数(PPI)评定疼痛程度,检测治疗前后患者外周血中线粒体功能相关分子线粒体转录因子A(mtTFA)表达水平。结果:治疗4周后,2组VAS、PRI和PPI评分均较治疗前明显下降(P<0.05),且观察组低于对照组(P<0.05);2组mtTFA表达水平均较治疗前明显升高(P<0.05),且观察组高于对照组(P<0.05);治疗后观察组总有效率明显高于对照组(88.0%、80.0%,P<0.05)。结论:利多卡因的注射和内热针对颈肩肌筋膜疼痛综合征的治疗均有良好的临床疗效,内热针的临床疗效优于利多卡因注射治疗。内热针可能通过改善线粒体功能障碍治疗颈肩肌筋膜疼痛综合征。
Objective:To evaluate the analgesic effect of internal heat-type acupuncture needle on patients with cervicoshoulder myofascial pain syndrome and to explore the underlying mechanism through which it exerts therapeutic effects.Methods:A total of 100 patients diagnosed with cervicoshoulder myofascial pain syndrome who met the inclusion criteria were enrolled in the study between December 2021 and December 2023.Participants were randomly divided into two groups—control group and treatment group—using a random number table method.Patients in the control group received myofascial trigger point injections of 0.5%lidocaine,and those in the treatment group underwent internal heat-type acupuncture needle at the myofascial trigger points.Treatments were administered every two days,with 5 sessions comprising one treatment course;a total of two courses were conducted.The Visual Analogue Scale(VAS),Pain Rating Index(PRI),and Present Pain Intensity(PPI)scores were compared between the two groups before and after treatment.Furthermore,the expression levels of mitochondrial transcription factor A(mtTFA),a key molecule associated with mitochondrial function,were measured in peripheral blood samples collected from all participants pre-and post-treatment.Results:Following treatment,both groups exhibited significant improvements in VAS,PRI,and PPI scores compared to pre-treatment values(P<0.05),along with an increase in mtTFA expression levels(P<0.05).However,the internal heat-type acupuncture needle group demonstrated significantly reductions in pain scores and more pronounced increases in mtTFA expression compared to the control group(P<0.05).Therapeutic efficacy was further evaluated using the nimodipine method,revealing a total effective rate of 80%in the lidocaine group and 88%in the internal heat-type acupuncture needle group.These results indicate a statistically significant difference in treatment effectiveness between the two groups(P<0.05).Conclus-ion:Both lidocaine injection and internal heat-type acupuncture needle demonstrate favorable clinical efficacy in treating cervicoshoulder myofascial pain syndrome.However,internal heat-type acupuncture needle exhibits superior therapeutic effects compared to lidocaine injection.Moreover,the mechanism of action may involve the modulation of mitochondrial dysfunction via upregulation of mtTFA expression.
作者
陈建军
詹力
李石乔
成曦
王泉
常旭升
毛健宇
姚潇麟
杨清胥
Chen Jianjun;Zhan Li;Li Shiqiao;Cheng Xi;Wang Quan;Chang Xusheng;Mao Jianyu;Yao Xiaolin;Yang Qingxu(Department of Pain Clinic,Yunnan Provincial Hospital Traditional Chinese Medicine,Kunming 650021,China)
出处
《中国康复》
2025年第12期737-741,共5页
Chinese Journal of Rehabilitation
基金
云南省科学技术厅中医联合专项-面上项目(202101AZ070001-083)
云南省科学技术厅中医联合专项-面上项目(202401AZ070001-045)。
关键词
内热针
肌筋膜疼痛综合征
肌筋膜触发点
线粒体功能
internal heat-type acupuncture needle
myofascial pain syndrome
myofascial trigger point
mitochondrial function
