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激痛点针刺治疗梨状肌综合征的临床研究

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目的:比较激痛点针刺与糖皮质激素注射治疗梨状肌综合征(PS)的临床疗效差异.方法:PS患者随机分为针刺组(30例)行激痛点针刺治疗,对照组(30例)行糖皮质激素注射治疗.两组均每周治疗1次,共治疗 2次.采集患者治疗前,治疗后 1周、1个月、2个月、3个月的疼痛数字等级量表(NRS)评分,Oswestry功能障碍指数问卷表(ODI)评分,髋关节被动活动度(PROM);评价患者治疗后3个月的36项健康调查简表(SF-36)评分;记录患者镇痛药物的服用情况及不良反应的发生情况.结果:两组患者治疗后各时间点的NRS、ODI评分较治疗前下降,PROM较治疗前升高(P<0.05).与对照组相比,在治疗后的2个月、3个月,针刺组NRS、ODI评分降低(P<0.01,P<0.05),髋关节内旋活动度增加(P<0.01);在治疗后3个月,针刺组SF-36的生理机能、躯体疼痛及活力评分高于对照组(P<0.05).针刺组在治疗后2个月、3个月镇痛药物的使用人数显著少于对照组(P<0.05).治疗和随访期间所有患者均未发生严重的不良反应.结论:在治疗后1个月激痛点针刺治疗PS的临床疗效与糖皮质激素注射相当,在2个月后,激痛点针刺较糖皮质激素注射可更显著缓解疼痛和下肢功能障碍,提高生活质量,减少镇痛药物的使用.
Clinical study of piriformis syndrome treated with trigger-point acupuncture
Objective To compare the difference in the clinical efficacy on piriformis syndrome between trigger-point(TrP)acupuncture and glucocorticoid injection.Methods Sixty patients with piriformis syndrome were randomly allocated to an acupuncture group(30 cases,treated with TrP acupuncture)and a control group(30 cases,treated with glucocorticoid injection).In the two groups,the intervention was delivered once weekly and 2 treatments were required.Before treatment and 1 week,1 month,2 months and 3 months after treatment,the scores of the numerical rating scale(NRS)and Oswestry dysfunction index questionnaire(ODI),and the passive hip range of motion(PROM)were collected separately;the score of the 36-item short form of health survey(SF-36)was observed 3 months after treatment;and the administration of analgesic medication and the occurrence of adverse effects were recorded in the patients of 2 groups.Results The scores of NRS and ODI were decreased,and PROM was increased at each time point compared with the baseline(before treatment)in both groups(P<0.05).In comparison with the control group,the scores of NRS and ODI were decreased(P<0.01,P<0.05)and the range of hip internal rotation(HIR)was increased in the acupuncture group 2 and 3 months after treatment(P<0.01).Three months after treatment,the scores for physiological function,body pain,and vitality of SF-36 in the acupuncture group were higher than those of the control group(P<0.05).The number of patients with analgesic drugs was less(P<0.05)in the acupuncture group than that in the control group in 2 and 3 months after treatment.During treatment and in follow-up stage,no serious adverse reactions occurred in the patients of 2 groups.Conclusion The clinical effect of TrP acupuncture is similar to that of glucocorticoid injection on piriformis syndrome in 1 month after treatment.In 2 months after treatment,TrP acupuncture is markedly effective for attenuating pain and the functional impairment of the lower limbs,improving the quality of life and reducing the use of analgesic drugs in comparison with glucocorticoid injection.

Piriformis syndromeTrigger-pointAcupunctureGlucocorticoid

刘莉雪、申苗苗、王钦阁、申文、袁燕

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徐州医科大学附属医院疼痛科,江苏徐州 221000

梨状肌综合征 激痛点 针刺 糖皮质激素

徐州市科学技术局资助项目

KC22235

2024

针刺研究
中国中医研究院针灸研究所,中国针灸学会

针刺研究

CSTPCD北大核心
影响因子:1.656
ISSN:1000-0607
年,卷(期):2024.49(9)