830 nm半导体微激光治疗背肌筋膜炎的临床研究

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探讨了830 nm半导体微激光光灸穴位和肌筋膜扳机点(MTrPs)治疗背肌筋膜炎患者的疗效.预实验收集背肌筋膜炎患者,分为光灸1组4例、光灸2组6例、光灸3组7例和针灸组6例,光灸组采用自主研发的半导体激光光灸仪治疗(中心波长为830 nm,功率密度0.335 W/cm2),时间分别为每次1、2和4 min对患者的养老穴、承山穴背部MTrPs进行照射;针刺组选用毫针对养老穴、承山穴常规针刺,MTrPs处斜刺进针贯穿结节得气后留针20 min,中间行针1次.光灸组和针刺组每周治疗3次,一周1个疗程,共治疗4个疗程.正式试验背肌筋膜炎患者38人,治疗方法如预实验光灸3组.采用视觉模糊量表评分(VAS)和简易麦吉尔量表-2(SFMPQ-2)对患者主观症状进行评定,手持式压力测痛仪测定MTrPs的压力疼痛阈值(PPT).预实验VAS评分结果表明,除光灸1 min外,其他三组治疗后均有显著减低(P<0.05),组间比较显示,针刺组疗效最好,其次为光灸3组;SFMPQ-评分显示,只有针刺组治疗后有显著减低(P<0.05).光灸组可显著提高MTrPs的PPT数值.正式试验结果发现,830 nm微激光可显著降低患者的VAS评分和SFMPQ-2评分,改善患者酸痛、轻压痛和疲惫无力感症状,且可提高肌筋膜扳机点的压力疼痛阈值.该课题组自主研发的半导体激光光灸仪对背肌筋膜炎患者无论从主观评分和半客观的压痛阈值改善方面均有良好的疗效,可被广泛应用于临床.“,”To explore the effect of 830 nm semiconductor low-level laser on the acupoints and myofascial trigger points (MTrPs) of patients with upper back myofascitis. In pre-experiment, 23 patients with upper back myofascitis were collected and divided into 4 groups including laser 1, laser 2, laser 3 and acupuncture group. In 3 laser groups, semiconductor laser therapeutic apparatus invented by our research team were used to treat patients(wavelength 830 nm, power density 0.335 W/cm2) for 1 min, 2 min and 4 min every time separately ; in acupuncture group, puncture at Yanglao point (SI6), Chengshan point (BL57) bilaterally, as well as MTrPs. All patients were treated 3 times per week and for 4 weeks. In formal clinical study, 38 patients with upper back pain were collected and treated with laser for 4 min. The visual analogue scale (VAS) and short-form Mcgill Pain questionnaire-2 (SFMPQ-2) were used to assess the symptoms of patients, and pressure pain threshold(PPT) was examined by hand-held algometry. Results In pre-experiment, except the laser 1 group, the VAS score reduced significantly after treatment in other three groups (P<0.05). Comparing the efficacy with each other of all the groups, the best is acupuncture group, followed by laser for 4 min group. As SFMPQ-2 was concerned, the score decreased significantly only in acupuncture group (P<0.05). Laser therapy can increase the PPT of MTrPs of patients. In formal research, the score of VAS and SFMPQ-2 were reduced significantly by 830 nm laser therapy. The symptoms of soreness, tenderness and sense of tired and powerlessness were improved by laser. The PPT of MTrPs were also improved. Conclusions semiconductor laser therapeutic apparatus invented by our research team can improve the subjective scoring and semi-objective PPT, can be used in clinical treatment widely.
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