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[1]顏炎,李泰賢,傅繁譽(yù),等.針刀刺激肌筋膜疼痛觸發(fā)點(diǎn)治療股骨頭壞死的療效觀察及作用機(jī)制探討[J].中醫(yī)正骨,2020,32(11):62-65.
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針刀刺激肌筋膜疼痛觸發(fā)點(diǎn)治療股骨頭壞死的療效觀察及作用機(jī)制探討()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期數(shù):
2020年11期
頁(yè)碼:
62-65
欄目:
臨床報(bào)道
出版日期:
2020-11-20

文章信息/Info

作者:
顏炎1李泰賢2傅繁譽(yù)1王榮田3韋偉3林娜2陳衛(wèi)衡3何海軍1
(1.中國(guó)中醫(yī)科學(xué)院望京醫(yī)院,北京 100102; 2.中國(guó)中醫(yī)科學(xué)院中藥研究所,北京 100700; 3.北京中醫(yī)藥大學(xué)第三附屬醫(yī)院,北京 100029)
關(guān)鍵詞:
股骨頭壞死 小刀針 白細(xì)胞介素1β 白細(xì)胞介素6 腫瘤壞死因子α 肌筋膜疼痛觸發(fā)點(diǎn)
摘要:
目的:觀察針刀刺激肌筋膜疼痛觸發(fā)點(diǎn)(myofascial trigger points,MTrPS)治療股骨頭壞死(osteonecrosis of femoral head,ONFH)的臨床療效,并探討其作用機(jī)制。方法:2018年8月至2019年11月,采用針刀刺激MTrPS治療ONFH患者26例。男19例,女7例; 年齡21~64歲,中位數(shù)44歲; 按照ONFH的國(guó)際骨循環(huán)研究會(huì)(Association Research Circulation Osseous,ARCO)分期標(biāo)準(zhǔn),ARCOⅡ期2例、ARCOⅢ期14例、ARCOⅣ期10例。分別于術(shù)前與術(shù)后1 d、7 d記錄髖關(guān)節(jié)疼痛視覺(jué)模擬量表(visual analogue scale,VAS)評(píng)分、髖關(guān)節(jié)活動(dòng)度(屈曲、外展、內(nèi)旋、外旋)、改良Ashworth評(píng)分、硬結(jié)條索狀物指數(shù)評(píng)分以及白細(xì)胞介素(interleukin,IL)-1β、IL-6和腫瘤壞死因子(tumor necrosis factor,TNF)-α的血清含量。結(jié)果:髖關(guān)節(jié)疼痛VAS評(píng)分,術(shù)前(5.27±1.62)分、術(shù)后1 d(4.56±1.20)分、術(shù)后7 d(3.08±1.09)分; 硬結(jié)條索狀物指數(shù)評(píng)分,術(shù)前(2.77±0.43)分、術(shù)后1 d(1.81±0.40)分、術(shù)后7 d(1.27±0.60)分; 改良Ashworth評(píng)分,術(shù)前(4.46±0.65)分、術(shù)后1 d(3.31±0.68)分、術(shù)后7 d(3.00±0.69)分; 髖關(guān)節(jié)屈曲角度,術(shù)前97.78°±17.34°、術(shù)后1 d 105.83°±15.27°、術(shù)后7 d 113.06°±15.45°; 髖關(guān)節(jié)內(nèi)旋角度,術(shù)前6.94°±5.98°、術(shù)后1 d 11.39°±6.60°、術(shù)后7 d 15.56°±7.45°; 髖關(guān)節(jié)外旋角度,術(shù)前20.83°±8.27°、術(shù)后1 d 23.61°±8.00°、術(shù)后7 d 27.50°±7.52°; 髖關(guān)節(jié)外展角度,術(shù)前23.33°±6.86°、術(shù)后1 d 27.22°±6.24°、術(shù)后7 d 30.56°±6.39°; IL-1β血清含量,術(shù)前(12.98±3.83)pg·mL-1、術(shù)后1 d(11.65±4.24)pg·mL-1、術(shù)后7 d(10.03±4.02)pg·mL-1; IL-6血清含量,術(shù)前(27.95±8.85)pg·mL-1、術(shù)后1 d(28.55±8.81)pg·mL-1、術(shù)后7 d(22.25±6.99)pg·mL-1; TNF-α血清含量,術(shù)前(47.07±9.74)pg·mL-1、術(shù)后1 d(45.79±9.78)pg·mL-1、術(shù)后7 d(40.02±9.24)pg·mL-1。結(jié)論:針刀刺激MTrPS治療ONFH,可以降低患者局部肌張力,緩解疼痛癥狀,改善髖關(guān)節(jié)活動(dòng)度; 其作用機(jī)制可能是通過(guò)降低TNF-α、IL-1β和IL-6血清含量,從而減輕了炎癥反應(yīng)。

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備注/Memo

備注/Memo:
基金項(xiàng)目:國(guó)家自然科學(xué)基金項(xiàng)目(81873322); 國(guó)家科技支撐計(jì)劃項(xiàng)目(2015BAI04B03); 北京市自然科學(xué)基金項(xiàng)目(7182186); 中國(guó)中醫(yī)科學(xué)院基本科研業(yè)務(wù)費(fèi)自主選題項(xiàng)目(ZZ070864)
通訊作者:何海軍 E-mail:[email protected]
更新日期/Last Update: 2020-11-20