Abstract：【Objective】To explore the efficacy and safety of ultrasound-guided small needle knife in the treatment of myofascial pain syndrome (MPS). 【Methods】From December 2019 to January 2021, 73 patients diagnosed as MPS in the shoulder pain clinic of Hunan Provincial People's Hospital (the First Affiliated Hospital of Hunan Normal University) with neck and shoulder pain were prospectively collected. The subjects were randomly divided into experimental group (n=37) and control group (n=36). The experimental group was treated with small needle knife guided by visual ultrasound, and the control group was treated with traditional needle knife; The gray-scale ultrasonographic manifestations of myofascial trigger points (MTrPs), Young's modulus values of MTrPs and adjacent areas before and after treatment, visual analogue scale (VAS) before, during and after treatment of the two groups were recorded respectively, and whether there were needle syncope, pneumothorax, bleeding, pain, etc. in the whole treatment process of the two groups were recorded Nerve damage and other adverse events occurred. 【Results】The characteristics of MTrPs in gray-scale sonogram were mainly low echo area, and the young's modulus of MTrPs was higher than that of adjacent areas (P<0.05). The VAS of the two groups during and after treatment were lower than before treatment; The young's modulus after treatment was lower than that before treatment (P<0.05). There was no significant difference in VAS and Young's modulus before treatment between the two groups (P>0.05), but the VAS and Young's modulus after treatment in the experimental group were significantly lower than those in the control group (P<0.05). Pearson correlation analysis showed that MTrPs and Young's modulus were positively correlated with VAS (r=0.8, P<0.01). There were 3 cases of adverse events in the control group, which were manifested as the formation of local hematoma in the treatment area. There was no obvious bleeding in the experimental group, and there were no adverse events such as needle syncope, pneumothorax and nerve damage in the two groups. 【Conclusion】Compared with the traditional small needle knife, ultrasound-guided small needle knife in the treatment of neck and shoulder MPs has better curative effect and higher safety, which is worthy of clinical application and promotion.
胡文文, 付志远, 刘亮, 夏晓辉, 陈红天. 超声引导下小针刀治疗颈肩部肌筋膜疼痛综合征的临床研究[J]. 医学临床研究, 2021, 38(6): 838-842.
HU Wen-wen, FU Zhi-yuan, LIU Liang, et al. Clinical Study of Ultrasound-guided Small Needle Knife in the Treatment of Cervical Shoulder Myofascial Pain Syndrome. JOURNAL OF CLINICAL RESEARCH, 2021, 38(6): 838-842.
[1] CALVO-LOBO C, PACHECO-DA-COSTA S, HITA-HERRANZ E.Efficacy of deep dry needling on latent myofascial trigger points in older adults with nonspecific shoulder pain:a randomized, controlled clinical trial pilot study[J].J Geriatr Phys Ther,2017,40(2):63-73. [2] SOLLMANN N, MATHONIA N, WEIDLICH D,et al.Quantitative magnetic resonance imaging of the upper trapezius muscles-assessment of myofascial trigger points in patients with migraine[J].J Headache Pain,2019,20(1):8. [3] GERI T, GIZZI L, DI MARCO A,et al.Myofascial trigger points alter the modular control during the execution of a reaching task:a pilot study[J].Sci Rep,2019, 9(1):16065. [4] 林键杰,张翔.肌筋膜疼痛综合征诱因及外治手段研究进展[J].体育科技文献报,2020,28(4):28-31. [5] SAXENA A, CHANSORIA M, TOMAR G, et al.Myofascial pain syndrome:an overview[J].J Pain Palliat Care Pharmacother,2015,29(1):16-21. [6] Borg-Stein J, Iaccarino MA.Myofascial pain syndrome treatments[J].Phys Med Rehabil Clin N Am,2014,25(2):357-374. [7] 庞军,王雄将,杨立新,等.小针刀治疗肌筋膜疼痛综合征随机对照研究的Meta分析[J].时珍国医国药,2017,28(9):2282-2284. [8] FOGELMAN Y, KENT J.Efficacy of dry needling for treatment of myofascial pain syndrome[J].J Back Musculoskelet Rehabil,2015,28(1):173-179. [9] PATRZEK D W,RONALD M.疼痛学[M].赵宝昌,崔秀云,译.沈阳:辽宁教育出版社,2002:89. [10] MAGNUSSON T.Self-assessment of pain and discomfort in patients withtemporomandibular disorders:a comparison of fice different scales with respect to their precision and sensitivity as well as their capacity to register memory of pain and discomfort[J].J Oral Rehabil,1995,(22):549-556. [11] SHAH J P, THAKER N, HEIMUR J, et al.Myofascial trigger points then and now:a historical and scientific perspective[J].PM R,2015,7(7):746-761. [12] BORG-STEIN J, IACCARINO M A.Myofascial pain syndrome treatments[J].Phys Med Rehabil Clin N Am,2014,25(2):357-374. [13] ANNASWAMY T M, DE LUIGI A J, O'NEILL B J, et al.Emerging concepts in the treatment of myofascial pain:a review of medications, modalities, and needle-based interventions[J].PM R,2011,3(10):940-961. [14] STRAKOWSKI J A, VISCO C J.Diagnostic and therapeutic musculoskeletal ultrasound applications of the shoulder[J].Muscle Nerve,2019,60(1):1-6. [15] STRAKOWSKI J A.Ultrasound-guided peripheral nerve procedures[J].Phys Med Rehabil Clin N Am, 2016,27(3):687-715. [16] 尹莉,宓士军,马秀清,郭瑞君.肌筋膜疼痛触发点的超声研究进展[J].中华超声影像学杂志,2017,26(9):820-823. [17] RHA D W, SHIN J C, KIM Y K, et al.Detecting local twitch responses of myofascial trigger points in the lower-back muscles using ultrasonography[J].Arch Phys Med Rehabil,2011,92(10):1576-1580.
2021, Vol. 38 
