改良圆利针疗法治疗腰部肌筋膜疼痛综合征对疼痛介质及腰部功能的影响

秦小怡; 颜思思; 洪涛

doi:10.16766/j.cnki.issn.1674-4152.003934

改良圆利针疗法治疗腰部肌筋膜疼痛综合征对疼痛介质及腰部功能的影响

doi: 10.16766/j.cnki.issn.1674-4152.003934

杭州市临平区第一人民医院中医康复科，浙江杭州 311100

基金项目:

浙江省中医药科技计划项目 2018ZB112

浙江省中医药科技计划项目 2022ZB302

详细信息

通讯作者:
秦小怡，E-mail：15372002207@163.com

中图分类号: R245.3R441.1
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- 文章访问数: 3
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出版历程
- 收稿日期: 2024-11-25
- 网络出版日期: 2025-05-14

Effect of modified round sharp needle therapy on pain mediators and lumbar function in the treatment of lumbar myofascial pain syndrome

Department of Traditional Chinese Medicine Rehabilitation, the First People's Hospital of Linping District, Hangzhou, Zhejiang 311100, China

摘要

摘要: 目的探讨改良圆利针疗法治疗腰部肌筋膜疼痛综合征(LMPS)的疗效，以及对患者疼痛介质及腰部功能的影响，为临床制定治疗方案提供借鉴。方法将2021年1月—2023年12月杭州市临平区第一人民医院门诊收治的112例LMPS患者采用随机数表法分成A组与B组，每组56例，A组给予常规西医治疗，B组给予改良圆利针疗法治疗。观察2组的临床疗效、疼痛程度(VAS评分)、疼痛介质[前列腺素E2(PGE2)、5-羟色胺(5-HT)]、炎症因子[白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)]、腰椎功能[Oswestry功能障碍指数(ODI)]。结果 B组的总有效率为96.43%(54/56)，高于A组的82.14%(46/56)，差异有统计学意义(χ²=5.973, P=0.015)。2组治疗后的VAS评分均降低(P<0.05)，且B组治疗后的VAS评分低于A组(P<0.05)。2组治疗后的PGE2、5-HT均降低(P<0.05)，且B组治疗后的PGE2、5-HT低于A组(P<0.05)。2组治疗后的IL-1β、TNF-α均降低(P<0.05)，且B组治疗后的IL-1β、TNF-α低于A组(P<0.05)。2组治疗后的ODI评分均降低(P<0.05)，且B组治疗后的ODI评分低于A组(P<0.05)。结论采用改良圆利针疗法治疗LMPS，不仅能够减轻患者疼痛症状，改善其腰椎活动度，还能够促进腰骶部肌肉张力的恢复与平衡，加速受损组织的修复进程，值得应用。
- 改良圆利针疗法 /
- 腰部肌筋膜疼痛综合征 /
- 疼痛介质 /
- 炎症因子 /
- 腰部功能
Abstract: Objective To explore the efficacy of modified round needle therapy in the treatment of lumbar myofascial pain syndrome (LMPS) and its impact on pain mediators and lumbar function, providing evidence for optimizing clinical treatment strategies. Methods A total of 112 LMPS patients admitted to the outpatient department of the First People's Hospital of Linping District, Hangzhou, from January 2021 to December 2023, were randomly divided into group A and group B. Group A (56 patients) received conventional Western medicine treatment, while group B (56 patients) received modified round needle therapy. Clinical efficacy, pain severity (VAS score), levels of pain mediators [prostaglandin E2 (PGE2) and 5-hydroxytryptamine (5-HT)], inflammatory factors [interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α)], and lumbar function [Oswestry disability index (ODI) score] were compared between the two groups. Results The total effective rate in the group B was 96.43% (54/56), significantly higher than the 82.14% (46/56) in the group A (χ²=5.973, P=0.015). The VAS scores of the two groups after treatment were decreased (P<0.05), with group B exhibiting significantly lower scores than group A (P<0.05). The levels of PGE2 and 5-HT of the two groups after treatment were decreased (P<0.05), with group B showing greater reductions compared to group A (P<0.05). The IL-1β and TNF-αlevels of the two groups after treatment were both decreased (P<0.05), with group B demonstrating lower levels than group A (P<0.05). The ODI scores of the two groups after treatment were also decreased (P<0.05), with group B showing lower scores than group A (P<0.05). Conclusion Modified round needle therapy is an effective treatment for LMPS, significantly alleviating pain symptoms, improving their lumbar mobility, and promoting the recovery of lumbosacral muscle tension. It also accelerates the repair process of damaged tissues and is highly beneficial for application.
- Modified round sharp needling therapy /
- Lumbar myofascial pain syndrome /
- Pain mediators /
- Inflammatory factors /
- Lumbar function

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表 1 2组LMPS患者治疗前后疼痛程度比较(x±s，分)

Table 1. Comparison of pain degree before and after treatment in two groups of LMPS patients (x±s, points)

组别	例数	VAS
组别	例数	治疗前	治疗后
A组	56	5.97±1.25	2.69±0.87^b
B组	56	6.08±1.16	1.75±0.68^b
统计量		0.483^a	5.963^c
P值		0.630	<0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP<0.05。

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表 2 2组LMPS患者治疗前后疼痛介质比较(x±s，ng/L)

Table 2. Comparison of pain mediators before and after treatment in two groups of LMPS patients (x±s, ng/L)

组别	例数	PGE2		5-HT
组别	例数	治疗前	治疗后	治疗前	治疗后
A组	56	116.35±20.47	80.64±15.23^b	0.79±0.21	0.52±0.15^b
B组	56	117.08±20.71	64.96±12.45^b	0.76±0.18	0.38±0.12^b
统计量		0.188^a	5.362^c	0.812^a	5.020^c
P值		0.852	<0.001	0.419	<0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP<0.05。

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表 3 2组LMPS患者治疗前后炎症因子比较(x±s，ng/L)

Table 3. Comparison of inflammatory factors before and after treatment in two groups of LMPS patients (x±s, ng/L)

组别	例数	IL-1β		TNF-α
组别	例数	治疗前	治疗后	治疗前	治疗后
A组	56	87.86±14.32	51.42±9.56^b	513.61±37.23	275.89±28.47^b
B组	56	86.91±13.85	41.23±7.91^b	517.86±37.62	246.54±24.58^b
统计量		0.357^a	5.840^c	0.601^a	5.473^c
P值		0.722	<0.001	0.549	<0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP<0.05。

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表 4 2组LMPS患者治疗前后腰椎功能比较(x±s，分)

Table 4. Comparison of lumbar spine function before and after treatment in two groups of LMPS patients (x±s, points)

组别	例数	ODI
组别	例数	治疗前	治疗后
A组	56	31.76±4.23	15.91±2.07^b
B组	56	32.52±4.09	13.42±1.85^b
统计量		0.967^a	6.265^c
P值		0.336	<0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP<0.05。

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参考文献(21)

[1]	ISMAIL F, BOOYSEN N, YELVERTON C, et al. Characteristics of chiropractic patients treated at the University of Johannesburg chiropractic student clinic and relevance to the educational process[J]. J Chiropr Educ, 2021, 35(2): 215-221. doi: 10.7899/JCE-19-29
[2]	万方, 李小冬, 李子瑜. 浮针扫散法对腰背肌筋膜疼痛综合征临床疗效的影响研究[J]. 河北中医药学报, 2023, 38(5): 32-36. WAN F, LI X D, LI Z Y. Clinical efficacy of floating needle scanning and dispersing method in treating lumbar and back myofascial pain syndrome[J]. Journal of Hebei Traditional Chinese Medicine and Pharmacology, 2023, 38(5): 32-36.
[3]	张冉, 闻胜月, 詹红生, 等. 针刺治疗腰背肌筋膜炎: 系统评价与meta分析[J]. 中国针灸, 2023, 43(11): 1324-1332. ZHANG R, WEN S Y, ZHAN H S, et al. Acupuncture for lumbar myofascial pain syndrome: systematic review and meta-analysis[J]. Chinese Acupuncture & Moxibustion, 2023, 43(11): 1324-1332.
[4]	郭雨林, 高明, 李慧, 等. 针灸治疗肌筋膜疼痛综合征的现状与趋势: 基于CiteSpace和VOSviewer的知识图谱可视化分析[J]. 中国针灸, 2023, 43(9): 996-1005. GUO Y L, GAO M, LI H, et al. Current status and trend of acupuncture-moxibustion for myofascial pain syndrome: a visual analysis of knowledge graph based on CiteSpace and VOSviewer[J]. Chinese Acupuncture & Moxibustion, 2023, 43(9): 996-1005.
[5]	关烨欣, 张保球, 黄海梅. 无痛无感筋针与臭氧局部注射对腰肌筋膜疼痛综合征肌张力及腰椎关节活动影响的对比研究[J]. 湖北中医药大学学报, 2022, 24(6): 77-79. GUAN Y X, ZHANG B Q, HUANG H M. A comparative study on muscle tension and lumbar vertebral joint movement in psoas myofascial pain syndrome by painless and insensitive tendon acupuncture and local ozone injection[J]. Journal of Hubei University of Chinese Medicine, 2022, 24(6): 77-79.
[6]	张嘉, 杨保仲, 管晓东. 老年全髋关节置换术患者实施加速康复外科麻醉管理措施的临床研究[J]. 中华全科医学, 2023, 21(1): 62-65. doi: 10.16766/j.cnki.issn.1674-4152.002812 ZHANG J, YANG B Z, GUAN X D. Implementation of ERAS anaesthesia management measures in elderly patients undergoing total hip replacement[J]. Chinese Journal of General Practice, 2023, 21(1): 62-65. doi: 10.16766/j.cnki.issn.1674-4152.002812
[7]	龙抗胜, 叶勇, 孙梦龙, 等. 针刺激痛点结合脏腑推拿治疗慢性腰背肌筋膜疼痛综合征伴焦虑临床研究[J]. 针灸临床杂志, 2022, 38(9): 16-20. LONG K S, YE Y, SUN M L, et al. Clinical study of needling trigger points combined with visceral massage in treatment of chronic lumbar MPS with anxiety[J]. Journal of Clinical Acupuncture and Moxibustion, 2022, 38(9): 16-20.
[8]	陈旭丰, 崔小燕, 余丽芬. 针刺扳机点结合筋膜松解术治疗慢性腰部肌筋膜疼痛综合征的疗效及对TNF-α、IL-1β水平的影响[J]. 中华中医药学刊, 2021, 39(10): 236-238. CHEN X F, CUI X Y, YU L F. Effect of acupuncture at trigger point combined with fascia release on chronic lumbar myofascial pain syndrome and its effect on TNF-α and IL-1β[J]. Chinese Archives of Traditional Chinese Medicine, 2021, 39(10): 236-238.
[9]	庞智文, 刘宜军, 周方园. 浮针法治疗腰背肌筋膜疼痛综合征[J]. 中医学报, 2021, 36(2): 430-434. PANG Z W, LIU Y J, ZHOU F Y. Clinical research of fu needling in treatment of lumbodorsal myofascial pain syndrome[J]. Acta Chinese Medicine, 2021, 36(2): 430-434.
[10]	吴宝贤, 黄睿, 伍惠惠, 等. 毫钝针疗法治疗腰肌筋膜疼痛综合征的临床研究[J]. 中国中医急症, 2022, 31(1): 42-45. WU B X, HUANG R, WU H H, et al. Efficacy observation of blunt needling acupuncture therapy in treating lumbar myofascial pain syndrome[J]. Journal of Emergency in Traditional Chinese Medicine, 2022, 31(1): 42-45.
[11]	JUN Y, JUN X, SHAOZHONG X U, et al. Effect and cerebral mechanism of moxibustion at heat-sensitized Yaoyangguan (GV3) in patients with lumbar disc herniation and myofascial pain syndrome by resting-state functionality magnetic resonance imaging: protocol for an observational study[J]. J Tradit Chin Med, 2023, 43(1): 175-180.
[12]	XIAO J, CAO B Y, XIE Z, et al. Clinical efficacy of electromagnetic field therapy combined with traditional Chinese pain-reducing paste in myofascial pain syndrome[J]. World J Clin Cases, 2022, 10(32): 11753-11765.
[13]	FREDY D M, HARPIN D, MIHARDJA H. The role of acupuncture for myofascial pain syndrome (MPS) in interventional pain management[J]. J Complement Integr Med, 2022, 19(2): 213-217.
[14]	DACH F, FERREIRA K S. Treating myofascial pain with dry needling: a systematic review for the best evidence-based practices in low back pain[J]. Arq Neuropsiquiatr, 2023, 81(12): 1169-1178.
[15]	梁波, 卜彩芳, 姚丽伟, 等. 雷火灸联合触发点中药膏外贴治疗寒湿凝滞型腰背肌筋膜疼痛综合征的效果观察[J]. 中国基层医药, 2023, 30(3): 346-351. LIANG B, BU C F, YAO L W, et al. Effects of thunder-fire moxibustion combined with external application of Chinese herbal ointment at the trigger point on lumbodorsal myofascial pain syndrome of cold-damp stagnation type[J]. Chinese Journal of Primary Medicine and Pharmacy, 2023, 30(3): 346-351.
[16]	黄洁, 简婵, 黄海城, 等. 毫火针治疗腰背部肌筋膜疼痛综合征的临床观察[J]. 广州中医药大学学报, 2023, 40(7): 1698-1703. HUANG J, JIAN C, HUANG H C, et al. Clinical observation on the filiform-heated needling for the treatment of lumbar myofascial pain syndrome[J]. Journal of Guangzhou University of Traditional Chinese Medicine, 2023, 40(7): 1698-1703.
[17]	LU F, REN P, ZHANG Q, et al. Research trends of acupuncture therapy on myofascial pain syndrome from 2000 to 2022: a bibliometric analysis[J]. J Pain Res, 2023, 16: 1025-1038.
[18]	谭同才, 刘勇, 余艳梅, 等. 圆利针合谷刺法治疗髌股疼痛综合征的临床观察[J]. 中国中西医结合杂志, 2022, 42(10): 1255-1258. TAN T C, LIU Y, YU Y M, et al. Effect of Yuanli Needling and Hegu Needling in the treatment of patellofemoral pain syndrome[J]. Chinese Journal of Integrated Traditional and Western Medicine, 2022, 42(10): 1255-1258.
[19]	戚艳, 许丙海, 胡玉, 等. 圆利针刺法治疗膝骨关节炎膝痛[J]. 长春中医药大学学报, 2022, 38(12): 1367-1370. QI Y, XU B H, HU Y, et al. Study on the effect of Yuanli acupuncture on knee osteoarthritis and knee pain[J]. Journal of Changchun University of Chinese Medicine, 2022, 38(12): 1367-1370.
[20]	李阳, 史欣怡, 何丽兰, 等. 恢刺联合温针灸治疗颈肩肌筋膜疼痛综合征疗效观察[J]. 浙江临床医学, 2024, 26(6): 834-836. LI Y, SHI X Y, HE L L, et al. Clinical effect of lateral acupuncture combined with warm acupuncture in the treatment of neck-shoulder myofascial pain syndrome[J]. Zhejiang Clinical Medical Journal, 2024, 26(6): 834-836.
[21]	曹磊, 陈美雄, 徐明奎, 等. 扳机点温和灸治疗颈肩肌筋膜痛综合征的疗效及对患者血清炎症因子的影响[J]. 海南医学, 2020, 31(5): 604-607. CAO L, CHEN M X, XU M K, et al. Clinical efficacy of mild moxibustion on myofascial trigger point in patients with myofascial pain syndrome and its effect on inflammatory factors[J]. Hainan Medical Journal, 2020, 31(5): 604-607.