Objectives: To explore the therapeutic effect of Fu's subcutaneous needling at myofascial trigger points (MTrPs) on pain, lumbar mobility and the quality of life in patients with lumbar disc herniation (LDH), so as to provide clinicians with new ideas and methods in treating LDH.
Methods: One hundred patients with LDH admitted to department of rehabilitation medicine of the affiliated hospital of Chengdu University of Traditional Chinese Medicine from January 2022 to January 2023 were collected as the subjects, and they were randomly divided into an observation group and a control group, 50 cases in each one. In the observation group, the spreading technique of Fu's subcutaneous needling was delivered at MTrP. In the control group, the routine acupuncture was applied to Shenshu (BL23), Weizhong (BL40) and MTrP. The treatment was given 3 times weekly, for 2 weeks in the two groups. The score of visual analogue scale (VAS) was evaluated before treatment, at the moment after the 1st treatment completion and after 2 weeks of treatment, separately, and the inclinometer was adopted to measure the range of motion (ROM) of the lumbar flexion, extension and lateral flexion. The numbers of MTrPs and their distribution were recorded before treatment and after the completion of a 2-week treatment in the two groups. Before treatment and in 4 weeks of follow-up, using SF-36 scale, the score of the quality of life was evaluated. The incidence of adverse effects was recorded.
Results: At the moment of the 1st treatment completion and after 2 weeks of treatment, VAS score and ROM of the lumbar region were significantly improved in comparison with those before treatment in the two groups and the improvement was superior in the observation group compared with the control group (P<0.05, P<0.01). After 2 weeks of treatment, the total number of MTrPs and the counts of MTrPs in each muscle zone were reduced when compared with those before treatment (P<0.05). In the observation group, the total number of MTrPs and numbers of MTrPs in the zones of quadratus lumborum, musculi multifidus and musculi iliocostalis lumborum decreased significantly when compared with the control group (P<0.05), while the difference was not significant in the numbers in the zone of musculi glutaeus medius between the two groups. In 4 weeks of follow-up, the scores of SF-36 scale were improved in comparison with those before treatment in each group and the result in the observation was better (P<0.05). No any adverse events occurred during treatment in the two groups.
Conclusions: Fu's subcutaneous needling is effective for reducing the numbers of MTrPs and improving analgesia, ROM of the lumbar region, as well as the long-term quality of life in the patients with LDH.
目的: 探讨筋膜触发点（MTrP）浮针疗法对腰椎间盘突出症（LDH）患者的疗效及对疼痛、腰部活动与生活质量的影响，为临床治疗LDH提供新的思路与方法。方法: 选取2022年1月至2023年1月成都中医药大学附属医院康复科门诊收治的100例LDH患者作为研究对象，采用随机数字表法将其分为观察组和对照组各50例。观察组采用浮针扫刺MTrP治疗，对照组采用常规针刺肾俞、委中、MTrP，两组均联合运动康复治疗，3次/周，共治疗2周。评价治疗前、第1次治疗后即刻、治疗2周后的视觉模拟量尺（VAS）评分，并采用关节活动度测旋尺测量腰部屈曲、伸展、侧屈活动度，记录治疗前与治疗2周后两组患者MTrP数量及分布范围。治疗前及治疗结束后4周随访，采用SF-36量表进行生活质量评分。观察并记录不良反应发生情况。结果: 两组患者第1次治疗后即刻与治疗2周后VAS评分较同组治疗前显著降低（P<0.05，P<0.01），且观察组低于对照组（P<0.01）。治疗2周后两组患者MTrP总数及各肌肉区MTrP数目均较治疗前减少（P<0.05），观察组MTrP总数及腰方肌区、多裂肌区、腰髂肋肌区的MTrP数目较对照组明显减少（P<0.05），臀中肌区两组差异无统计学意义。两组患者第1次治疗后即刻与治疗2周后腰部活动度均较同组治疗前显著升高（P<0.01），且观察组高于对照组（P<0.01）。治疗结束后4周随访两组患者SF-36评分较治疗前显著升高（P<0.05），且观察组高于对照组（P<0.05）。两组在治疗期间均无任何治疗相关不良事件发生。结论: 浮针疗法减少LDH患者疼痛、MTrP，改善腰部活动度和患者长期生活质量的疗效较好。.
Keywords: Acupuncture; Fu’s subcutaneous needling; Lumbar disc herniation; Myofascial trigger points; Pain.