刃針干預(yù)上斜方肌肌筋膜激痛點對頸肩肌筋膜疼痛綜合征臨床療效觀察

刃針干預(yù)上斜方肌肌筋膜激痛點對頸肩肌筋膜疼痛綜合征臨床療效觀察摘要：

目的：探究刃針干預(yù)上斜方肌肌筋膜激痛點對頸肩肌筋膜疼痛綜合征的臨床療效。

方法：選取2018年6月至2020年6月間，本院收治的80例頸肩肌筋膜疼痛患者為研究對象，隨機分為觀察組和對照組，每組40例。對照組實施常規(guī)理療；觀察組在常規(guī)理療的基礎(chǔ)上執(zhí)行刃針干預(yù)上斜方肌肌筋膜激痛點。在治療前后，記錄患者疼痛程度，肩頸功能障礙指數(shù)（NDI指數(shù)）以及生活質(zhì)量（SF-36問卷）。

結(jié)果：治療后，兩組疼痛水平均明顯降低；觀察組NDI指數(shù)顯著下降，SF-36問卷分值升高，差異具有統(tǒng)計學(xué)意義（P<0.05）。和對照組相比，觀察組治療后疾病緩解率更高（P<0.05）。

結(jié)論：刃針干預(yù)上斜方肌肌筋膜激痛點可改善頸肩肌筋膜疼痛綜合征的臨床療效，顯著減輕疼痛、增加肩頸功能及生活質(zhì)量。

關(guān)鍵詞：刃針；頸肩肌筋膜疼痛綜合征；上斜方肌肌筋膜激痛點；肩頸功能障礙指數(shù)；生活質(zhì)量。

Abstract:

Objectives:Toinvestigatetheclinicalefficacyofbladeneedleinterventiononthetriggerpointsoftheuppertrapeziusfasciainpatientswithcervicalshouldermyofascialpainsyndrome(CSMPS).

Methods:Atotalof80CSMPSpatientstreatedinourhospitalfromJune2018toJune2020wererandomlydividedintoanobservationgroupandacontrolgroup,with40casesineachgroup.Thecontrolgroupreceivedroutinephysicaltherapy,whiletheobservationgroupreceivedbladeneedleinterventiononthetriggerpointsoftheuppertrapeziusfasciabasedonroutinephysicaltherapy.Painlevel,neckdisabilityindex(NDI),andqualityoflife(SF-36questionnaire)wererecordedbeforeandaftertreatment.

Results:Aftertreatment,thepainlevelofbothgroupssignificantlydecreased.TheNDIindexoftheobservationgroupsignificantlydecreasedandtheSF-36questionnairescoreincreased,andthedifferencewasstatisticallysignificant(P<0.05).Comparedwiththecontrolgroup,theobservationgrouphadahigherremissionrateaftertreatment(P<0.05).

Conclusions:BladeneedleinterventiononthetriggerpointsoftheuppertrapeziusfasciacanimprovetheclinicalefficacyofCSMPS,significantlyrelievepain,andincreaseshoulderandneckfunctionandqualityoflife.

Keywords:Bladeneedle;cervicalshouldermyofascialpainsyndrome;triggerpointsoftheuppertrapeziusfascia;neckdisabilityindex;qualityoflife。Inrecentyears,bladeneedleinterventionhasreceivedgrowingattentioninthetreatmentofmusculoskeletalpain.Basedontheresultsofourstudy,bladeneedleinterventiononthetriggerpointsoftheuppertrapeziusfasciaiseffectiveinimprovingtheclinicalefficacyofCSMPS.Thisfindingisconsistentwithpreviousstudiesthathaveshownthatbladeneedleinterventionontriggerpointscaneffectivelyrelievepainandimprovefunctioninvariousmusculoskeletaldisorders.

Themechanismofbladeneedleinterventionisnotyetclear,butitisthoughttoinvolvethestimulationofAdeltaandCnervefibers,leadingtothereleaseofneurotransmittersandneuropeptides,aswellastheactivationofthebody'sownpaininhibitionsystem.Inaddition,bladeneedleinterventionmayalsopromotetheregenerationofinjuredtissueandincreaselocalbloodflow.

Intermsofitsclinicalimplications,bladeneedleinterventionmaybeaviablealternativeoradjuncttoexistingtreatmentsforCSMPS.Thisisparticularlyrelevantconsideringthehighprevalenceofthisconditionandthelimitedoptionsavailableforitsmanagement.Bladeneedleinterventionisminimallyinvasive,relativelylowcost,andhasalowriskofadverseeffects.Itmayalsohelptoreducetherelianceonmedicationandotherinterventionswithpotentialsideeffects.

Overall,ourstudyprovidespreliminaryevidencefortheefficacyofbladeneedleinterventiononthetriggerpointsoftheuppertrapeziusfasciainthetreatmentofCSMPS.Furtherresearchisneededtoconfirmandextendthesefindings,aswellastoinvestigatetheoptimalparametersandprotocolsforbladeneedleinterventioninthiscontext.Nevertheless,ourresultssuggestthatbladeneedleinterventionhasthepotentialtobeapromisingandvaluabletoolinthemanagementofCSMPSandothermusculoskeletaldisorders。InadditiontothepotentialbenefitsofbladeneedleinterventioninthetreatmentofCSMPS,thereareseveralotherconsiderationsthatshouldbetakenintoaccountwhenconsideringthismodalityforuseinclinicalpractice.

First,itisimportanttonotethattheuseofbladeneedlesshouldbeperformedbyqualifiedhealthcareprofessionalswithappropriatetrainingandexperienceinthetechnique.Improperuseofbladeneedlescouldleadtopain,injury,orcomplicationssuchasinfection.

Second,furtherresearchisneededtoinvestigatethesafetyandpotentialrisksassociatedwithbladeneedleintervention.Whilethereiscurrentlylimitedevidenceofadverseeffectsassociatedwiththistechnique,itisimportanttoevaluateandmonitorpotentialrisksinordertoensurepatientsafety.

Third,bladeneedleinterventionshouldbeconsideredaspartofacomprehensivetreatmentplanforpatientswithCSMPS.Thismayincludeotherinterventionssuchasmanualtherapies,exercise,andmedication,aswellaspatienteducationandself-managementstrategies.

Finally,thecost-effectivenessofbladeneedleinterventioninthetreatmentofCSMPSshouldbeevaluatedinordertodetermineitsvalueinclinicalpractice.WhileinitialresearchsuggeststhatbladeneedleinterventionmaybeeffectiveinreducingpainandimprovingfunctioninpatientswithCSMPS,thepotentialcostsassociatedwiththistechniqueshouldbecarefullyconsidered.

Insummary,bladeneedleinterventionshowspromiseasapotentialtreatmentmodalityforCSMPS.However,furtherresearchisneededtoconfirmitsefficacy,safety,andoptimalprotocolsforuseinclinicalpractice.Aswithanynewintervention,bladeneedleinterventionshouldbeconsideredaspartofacomprehensivetreatmentapproachandshouldbeimplementedbyqualifiedhealthcareprofessionalswithappropriatetrainingandexperience。Moreover,itisimportanttonotethatbladeneedleinterventionisnotsuitableforallpatientswithCSMPS.Eachpatientshouldundergoathoroughassessmenttodeterminetheunderlyingcauseoftheirpainandwhetherbladeneedleinterventionisaviableoptionforthem.Patientswithbleedingdisordersorthosetakingblood-thinningmedicationsshouldavoidbladeneedleintervention,asitmayleadtocomplications.

Additionally,patientsmustbeawareoftherisksassociatedwithbladeneedleintervention,includinginfectionandnervedamage.Theprocedureshouldonlybeperformedbytrainedpractitionersinasterileenvironmentwithappropriateequipmentandprecautions.

Inconclusion,bladeneedleinterventionshowspromiseasaminimallyinvasivetreatmentoptionforpatientswithCSMPS.However,furtherresearchisneededtoestablishitsefficacy,safety,andoptimalprotocolsforuseinclinicalpractice.Aswithanynewintervention,patientsandhealthcareprofessionalsshouldcarefullyweightherisksandbenefitsbeforeoptingforbladeneedleintervention.Itshouldalwaysbeimplementedaspartofacomprehensivetreatmentapproachandconductedbyqualifiedpractitioners。Inadditiontobladeneedleintervention,arangeofotherminimallyinvasivetreatmentsmayprovidereliefforpatientswithCSMPS.Forexample,spinalcordstimulation(SCS)involvesimplantingelectrodesnearthespinalcordtodeliverelectricalimpulsesthatdisruptpainsignals.AlthoughSCSisgenerallyconsideredsafe,somepatientsmayexperiencecomplicationssuchasinfection,bleeding,ordevicemalfunction.

Anotherminimallyinvasiveoptionisnerveablation,whichinvolvesselectivelydamagingnervesthattransmitpainsignals.Thiscanbedoneusingheat,cold,orchemicals,andmayprovidelong-lastingpainrelief.However,nerveablationcarriessomerisks,includingnervedamage,infection,orunintendeddamagetonearbytissues.

Physicaltherapy,chiropracticcare,andmassagemayalsobeeffectiveformanagingCSMPS.Thesetreatmentsfocusonimprovingrangeofmotion,reducinginflammation,andpromotingrelaxation,allofwhichmayhelpalleviatepain.Additionally,acupuncture,yoga,andmindfulnessmeditationhaveshownpromiseformanagingchronicpaininclinicaltrials.

WhileminimallyinvasivetreatmentscanbehelpfulformanypatientswithCSMPS,notallpatientswillbenefitfromtheseapproaches.Insomecases,moreinvasivetreatmentssuchasspinalfusionordiscreplacementsurgerymaybenecessarytoprovidelastingpainrelief.Patientsshouldworkcloselywiththeirhealthcareproviderstodesignatreatmentplanthatmeetstheirspecificneedsandpreferences.

Overall,CSMPSisachallengingconditionthatcansignificantlyimpactapatient'squalityoflife.