[1]颜炎,李泰贤,傅繁誉,等.针刀刺激肌筋膜疼痛触发点治疗股骨头坏死的疗效观察及作用机制探讨[J].中医正骨,2020,32(11):62-65.
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针刀刺激肌筋膜疼痛触发点治疗股骨头坏死的疗效观察及作用机制探讨()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期数:
2020年11期
页码:
62-65
栏目:
临床报道
出版日期:
2020-11-20

文章信息/Info

作者:
颜炎1; 李泰贤2; 傅繁誉1; 王荣田3; 韦伟3; 林娜2; 陈卫衡3; 何海军1
(1.中国中医科学院望京医院,北京 100102; 2.中国中医科学院中药研究所,北京 100700; 3.北京中医药大学第三附属医院,北京 100029)
关键词:
股骨头坏死;  小刀针;  白细胞介素1β;  白细胞介素6;  肿瘤坏死因子α;  肌筋膜疼痛触发点
摘要:
目的:观察针刀刺激肌筋膜疼痛触发点(myofascial trigger points,MTrPS)治疗股骨头坏死(osteonecrosis of femoral head,ONFH)的临床疗效,并探讨其作用机制。方法:2018年8月至2019年11月,采用针刀刺激MTrPS治疗ONFH患者26例。男19例,女7例; 年龄21～64岁,中位数44岁; 按照ONFH的国际骨循环研究会(Association Research Circulation Osseous,ARCO)分期标准,ARCOⅡ期2例、ARCOⅢ期14例、ARCOⅣ期10例。分别于术前与术后1 d、7 d记录髋关节疼痛视觉模拟量表(visual analogue scale,VAS)评分、髋关节活动度(屈曲、外展、内旋、外旋)、改良Ashworth评分、硬结条索状物指数评分以及白细胞介素(interleukin,IL)-1β、IL-6和肿瘤坏死因子(tumor necrosis factor,TNF)-α的血清含量。结果:髋关节疼痛VAS评分,术前(5.27±1.62)分、术后1 d(4.56±1.20)分、术后7 d(3.08±1.09)分; 硬结条索状物指数评分,术前(2.77±0.43)分、术后1 d(1.81±0.40)分、术后7 d(1.27±0.60)分; 改良Ashworth评分,术前(4.46±0.65)分、术后1 d(3.31±0.68)分、术后7 d(3.00±0.69)分; 髋关节屈曲角度,术前97.78°±17.34°、术后1 d 105.83°±15.27°、术后7 d 113.06°±15.45°; 髋关节内旋角度,术前6.94°±5.98°、术后1 d 11.39°±6.60°、术后7 d 15.56°±7.45°; 髋关节外旋角度,术前20.83°±8.27°、术后1 d 23.61°±8.00°、术后7 d 27.50°±7.52°; 髋关节外展角度,术前23.33°±6.86°、术后1 d 27.22°±6.24°、术后7 d 30.56°±6.39°; IL-1β血清含量,术前(12.98±3.83)pg·mL-1、术后1 d(11.65±4.24)pg·mL-1、术后7 d(10.03±4.02)pg·mL-1; IL-6血清含量,术前(27.95±8.85)pg·mL-1、术后1 d(28.55±8.81)pg·mL-1、术后7 d(22.25±6.99)pg·mL-1; TNF-α血清含量,术前(47.07±9.74)pg·mL-1、术后1 d(45.79±9.78)pg·mL-1、术后7 d(40.02±9.24)pg·mL-1。结论:针刀刺激MTrPS治疗ONFH,可以降低患者局部肌张力,缓解疼痛症状,改善髋关节活动度; 其作用机制可能是通过降低TNF-α、IL-1β和IL-6血清含量,从而减轻了炎症反应。

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金项目(81873322); 国家科技支撑计划项目(2015BAI04B03); 北京市自然科学基金项目(7182186); 中国中医科学院基本科研业务费自主选题项目(ZZ070864)
通讯作者:何海军 E-mail:drhjhe@126.com
更新日期/Last Update: 2020-11-20