肌筋膜疼痛综合征疗效评定方法的临床应用概况
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摘要
目的:总结肌筋膜疼痛综合征疗效评定方法的临床应用概况,为临床疗效评估提供参考。方法:查阅肌筋膜疼痛征疗效评定方法的相关文献,并进行分析总结。结果:用于肌筋膜疼痛征疗效评定方法较多,疼痛强度方面的评定主要有单维度疼痛评估疼痛量表以及疼痛强度评定的辅助检查,多采用疼痛视觉模拟评分(VAS)、口述分级评分法(VRS)、痛阈测定、表面肌电图、红外热像图及肌电阻测量仪测定;综合疼痛强度及性质的多维度评定方法多用McGill疼痛问卷法,此外健康状况评定多采用健康状况调查问卷(SF-36)。结论:深入研究各种评定方法的优缺点及其临床应用,让多种方法有机结合,建立规范化的肌筋膜疼痛综合征疗效评定方法很有必要。
Objective:To summarize the clinical application of evaluation methods of myofascial pain syndrome and provide a reference for clinical evaluation.Methods:The literature on the effectiveness evaluation method of myofascial pain syndrome was reviewed and summarized.Results:Many scoring systems were used to assess the treatment for myofascial pain syndrome.The assessments of pain intensity were mainly single-dimensional pain scale and pain intensity assessment of the auxiliary examination.Currently the most widely used evaluation systems were as follows:visual analogue scale(VAS),oral rating scale(VRS),pain threshold assessment,surface electromyography,infrared thermography and muscle resistance meter.Comprehensive multi-dimensional assessment of pain intensity often uses McGill pain questionnaire,in addition,health status assessment uses health questionnaire(SF-36).Conclusion:In-depth study of the advantages and disadvantages of various assessment methods and its clinical application,it is necessary to establish a standardized evaluation method of myofascial pain syndrome to let a variety of ways organic combination.
Objective:To summarize the clinical application of evaluation methods of myofascial pain syndrome and provide a reference for clinical evaluation.Methods:The literature on the effectiveness evaluation method of myofascial pain syndrome was reviewed and summarized.Results:Many scoring systems were used to assess the treatment for myofascial pain syndrome.The assessments of pain intensity were mainly single-dimensional pain scale and pain intensity assessment of the auxiliary examination.Currently the most widely used evaluation systems were as follows:visual analogue scale(VAS),oral rating scale(VRS),pain threshold assessment,surface electromyography,infrared thermography and muscle resistance meter.Comprehensive multi-dimensional assessment of pain intensity often uses McGill pain questionnaire,in addition,health status assessment uses health questionnaire(SF-36).Conclusion:In-depth study of the advantages and disadvantages of various assessment methods and its clinical application,it is necessary to establish a standardized evaluation method of myofascial pain syndrome to let a variety of ways organic combination.
引文
[1] 周秉文.腰背痛[M].2版.北京:人民卫生出版社,2005:145-195.
[2] Saxena A,Chansoria M,Tomar G,et al.Myofascial Pain Syndrome:An Overview[J].J Pain Palliat Care Pharmacother,2015,29:16-21.
[3] Gerwin RD.Diagnosis of myofascial pain syndrome[J].Phys Med Rehabil Clin N Am,2014,25(2):341-355.
[4] 高巍巍,邹德生,王伍超,等.肌筋膜疼痛综合征的研究进展[J].中国疼痛医学杂志,2017,23(6):455-458.
[5] Tunks E.Tender points in fibromy algia[J].Pain,1988,(34):11-19.
[6] 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].Journal of Oral Rehab,1995(22):549-556.
[7] ten Klooster PM,Vlaar AP,Taal E,et al.The validity and reliability of the graphic rating scale and verbal rating scale for measuring pain across cultures:a study in Egyptian and Dutch women with rheumatoid arthritis[J].Clin J Pain,2006,22(9):827-830.
[8] Phan NQ,Blome C,Fritz F,et al.Assessment of pruritus intensity:prospective study on validity and reliability of the visual analogue scale,numerical rating scale and verbal rating scale in 471 patients with chronic pruritus[J].Acta Derm Venereol,2012,92(5):502-507.
[9] 李春蕊,张雯,樊碧发.数字评分法(NRS)与口述评分法(VRS)在老年慢性疼痛患者中的比较[J].中国疼痛医学杂志,2016,22(9):683-686.
[10] Connelly M,Neville K.Comparative Prospective Evaluation of the Responsiveness of Single-Item Pediatric Pain-Intensity Self-Report Scales and Their Uniqueness From Negative Affect in a Hospital Setting[J].Pain,2010,11(12):1451-1460.
[11] Joos E,Peretz A,Beguin S,et al.Reliability and reproducibility of visual analogue scale and numeric rating scale for therapeutic evaluation of pain in rheumatic patients[J].J Rheumatol,1991,18(8):1269-1270.
[12] Taylor LJ,Herr K.Pain intensity assessment:a comparison of selected pain intensity scales for use in cognitively intact and cognitively impaired African American older adults[J].Pain Manag Nurs,2003,4(2):87-95.
[13] Persson AL,Brogardh C,Sjolund BH.Tender or not tender:test-retest repeatability of pressure pain thresholds in the trapezius and deltoid muscles of healthywomen[J].J Rehabil Med,2004,36(1):17-27.
[14] Brennum J.Measurement of human pressure pain threshold on fingers and toes[J].Pain,1989,38(2):211-217.
[15] Petersen-Felix S,Arendt-Nielsen L,Bak P,et al.Analgesic effect in human of subanaesthetic isofulurane concen-trations evaluated by experimentally induced pain[J].Br J Anaesth,1995,75(1):55-60.
[16] Jensen R.Mechanisms of spontaneous tension typeheadaches:an analysis of tenderness,pain thresholds and EMG[J].Pain,1995,64(2):251-256.
[17] Brennum J,Arendt-Nielsen L,Secher NH,et al.Quantitative sensory examination in humanepidural anaesthesia and analgesia:effects of lidocaine[J].Pain,1992,51(1):27-34.
[18] Moraska AF,Stenerson L,Butryn N,et al.Myofascial Trigger Point-focused Head and Neck Massage for Recurrent Tension-type Headache A Randomized,Placebo-controlled Clinical Trial[J].Clin J Pain,2015,31(2):159-168.
[19] Alburquerque-Sendín F,Camargo PR,Vieira A,et al.Bilateral Myofascial Trigger Points and Pressure Pain Thresholds in the Shoulder Muscles in Patients With Unilateral Shoulder Impingement Syndrome A Blinded,Controlled Study[J].Clin J Pain,2013,29(6):478-486.
[20] 恽晓平.康复疗法评定学[M].北京:人民卫生出版社,2014:308-309.
[21] Yu SH,Kim HJ.Electrophysiological characteristics according to activity level of myofascial trigger points[J].Journal of Physical Therapy Science,2015,27(9):2841-2843.
[22] 黄强民,敖丽娟,刘燕.肌筋膜触发点疼痛特征的要点分析[J].中国组织工程研究,2004,8(23):4822-4824.
[23] Celik D,Mutlu E K.Clinical implication of latent myofascial trigger point[J].Curr Pain Headache Rep 2013,17(8):353.
[24] 柳围堤,杨卫新.肌筋膜激痛点形成机制的研究进展[J].航空航天医学杂志,2010,21(1):95 -97.
[25] 乔杰,张军,刘强.表面肌电在非特异性腰痛肌肉功能评价中的应用[J].中国中医骨伤科杂志,2014,22(3):71-73.
[26] 穆景颂,倪朝民.下背痛表面肌电的应用研究[J].安徽医学,2010,31(3):287-289.
[27] 马剑雄,冯睿,王颖.表面肌电检测技术在骨科的运用[J].中国中西医结合外科杂志,2014,20(4):444-446.
[28] 韩琤琤,张金声,周维金,等.肌筋膜疼痛综合征的诊断[J].中国民康医学,2013,25(10):103-104.
[29] 王福根,吴士明.颈腰背痛诊治与红外热像技术[M].重庆:重庆出版社,2009:285-286.
[30] Travell,Simons,著.肌筋膜疼痛与机能障碍-激痛点手册[M].郭芳娟,高文彬,译.台湾:合记图书出版社,2004:22-27.
[31] Kruse RA Jr,Christiansen JA.Thermographic imaging of myofascial trigger points:a follow-up study[J].Arch PhysMed Rehabil,1992,73(9):819-823.
[32] Merla A1,Ciuffolo F,D'Attilio M,et al.Functional infrared imaging in the diagnosis of the myofascial pain[J].Conf Proc IEEE Eng Med Biol Soc,2004,2:1188-1191.
[33] 高巍巍,邹德生,王伍超,等.红外热像图定位冲击波疗法治疗肌筋膜疼痛综合征的临床分析[J].中国疼痛医学杂志,2016,22(4):312-314,318.
[34] 苏彩霞,林枫,江钟立.温针灸治疗颈背部肌筋膜疼痛综合征疗效观察[J].上海针灸杂志,2015,34(11):1102-1105.
[35]吴雏燕,詹玉明,江钟立.红外线联合中频电疗治疗腰背部肌筋膜炎临床疗效量化的研究[J].中国医学前沿杂志(电子版),2016,8(12):126-129.
[36] Patton HD. Textbook of physiology[M]. USA:WB Saunders Company 21st edition Vol 1,1989:347.
[37] Melzack R. The Mc Gill Pain Questionnaire:major properties and scoring methods[J]. Pain,1975,1(3):277-299.
[38]李君,冯艺,韩济生,等.中文版简版Mc Gill疼痛问卷-2的制定与多中心验证[J].中国疼痛医学杂志,2013,19(1):42-46.
[39] Ware JE Jr,Sherbourne CD. The MOS 36-item short-form health survey(SF-36). I. Conceptual framework and item selection[J].Med Care,1992,30(6):473-483.
[40] Fujita T,Ohue M,Nakajima M,et al. Comparison of the effects of elcatonin and risedronate on back and knee pain by electroalgometry using fall of skin impedance and quality of life assessment using SF-36[J]. J Bone Miner Metab,2011,29(5):588-597.
[41]薛开禄,柳围堤,田苗,等.针刺激痛点对肌筋膜疼痛综合征患者生活质量的影响[J].上海针灸杂志,2017,36(8):991-994.
[2] Saxena A,Chansoria M,Tomar G,et al.Myofascial Pain Syndrome:An Overview[J].J Pain Palliat Care Pharmacother,2015,29:16-21.
[3] Gerwin RD.Diagnosis of myofascial pain syndrome[J].Phys Med Rehabil Clin N Am,2014,25(2):341-355.
[4] 高巍巍,邹德生,王伍超,等.肌筋膜疼痛综合征的研究进展[J].中国疼痛医学杂志,2017,23(6):455-458.
[5] Tunks E.Tender points in fibromy algia[J].Pain,1988,(34):11-19.
[6] 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].Journal of Oral Rehab,1995(22):549-556.
[7] ten Klooster PM,Vlaar AP,Taal E,et al.The validity and reliability of the graphic rating scale and verbal rating scale for measuring pain across cultures:a study in Egyptian and Dutch women with rheumatoid arthritis[J].Clin J Pain,2006,22(9):827-830.
[8] Phan NQ,Blome C,Fritz F,et al.Assessment of pruritus intensity:prospective study on validity and reliability of the visual analogue scale,numerical rating scale and verbal rating scale in 471 patients with chronic pruritus[J].Acta Derm Venereol,2012,92(5):502-507.
[9] 李春蕊,张雯,樊碧发.数字评分法(NRS)与口述评分法(VRS)在老年慢性疼痛患者中的比较[J].中国疼痛医学杂志,2016,22(9):683-686.
[10] Connelly M,Neville K.Comparative Prospective Evaluation of the Responsiveness of Single-Item Pediatric Pain-Intensity Self-Report Scales and Their Uniqueness From Negative Affect in a Hospital Setting[J].Pain,2010,11(12):1451-1460.
[11] Joos E,Peretz A,Beguin S,et al.Reliability and reproducibility of visual analogue scale and numeric rating scale for therapeutic evaluation of pain in rheumatic patients[J].J Rheumatol,1991,18(8):1269-1270.
[12] Taylor LJ,Herr K.Pain intensity assessment:a comparison of selected pain intensity scales for use in cognitively intact and cognitively impaired African American older adults[J].Pain Manag Nurs,2003,4(2):87-95.
[13] Persson AL,Brogardh C,Sjolund BH.Tender or not tender:test-retest repeatability of pressure pain thresholds in the trapezius and deltoid muscles of healthywomen[J].J Rehabil Med,2004,36(1):17-27.
[14] Brennum J.Measurement of human pressure pain threshold on fingers and toes[J].Pain,1989,38(2):211-217.
[15] Petersen-Felix S,Arendt-Nielsen L,Bak P,et al.Analgesic effect in human of subanaesthetic isofulurane concen-trations evaluated by experimentally induced pain[J].Br J Anaesth,1995,75(1):55-60.
[16] Jensen R.Mechanisms of spontaneous tension typeheadaches:an analysis of tenderness,pain thresholds and EMG[J].Pain,1995,64(2):251-256.
[17] Brennum J,Arendt-Nielsen L,Secher NH,et al.Quantitative sensory examination in humanepidural anaesthesia and analgesia:effects of lidocaine[J].Pain,1992,51(1):27-34.
[18] Moraska AF,Stenerson L,Butryn N,et al.Myofascial Trigger Point-focused Head and Neck Massage for Recurrent Tension-type Headache A Randomized,Placebo-controlled Clinical Trial[J].Clin J Pain,2015,31(2):159-168.
[19] Alburquerque-Sendín F,Camargo PR,Vieira A,et al.Bilateral Myofascial Trigger Points and Pressure Pain Thresholds in the Shoulder Muscles in Patients With Unilateral Shoulder Impingement Syndrome A Blinded,Controlled Study[J].Clin J Pain,2013,29(6):478-486.
[20] 恽晓平.康复疗法评定学[M].北京:人民卫生出版社,2014:308-309.
[21] Yu SH,Kim HJ.Electrophysiological characteristics according to activity level of myofascial trigger points[J].Journal of Physical Therapy Science,2015,27(9):2841-2843.
[22] 黄强民,敖丽娟,刘燕.肌筋膜触发点疼痛特征的要点分析[J].中国组织工程研究,2004,8(23):4822-4824.
[23] Celik D,Mutlu E K.Clinical implication of latent myofascial trigger point[J].Curr Pain Headache Rep 2013,17(8):353.
[24] 柳围堤,杨卫新.肌筋膜激痛点形成机制的研究进展[J].航空航天医学杂志,2010,21(1):95 -97.
[25] 乔杰,张军,刘强.表面肌电在非特异性腰痛肌肉功能评价中的应用[J].中国中医骨伤科杂志,2014,22(3):71-73.
[26] 穆景颂,倪朝民.下背痛表面肌电的应用研究[J].安徽医学,2010,31(3):287-289.
[27] 马剑雄,冯睿,王颖.表面肌电检测技术在骨科的运用[J].中国中西医结合外科杂志,2014,20(4):444-446.
[28] 韩琤琤,张金声,周维金,等.肌筋膜疼痛综合征的诊断[J].中国民康医学,2013,25(10):103-104.
[29] 王福根,吴士明.颈腰背痛诊治与红外热像技术[M].重庆:重庆出版社,2009:285-286.
[30] Travell,Simons,著.肌筋膜疼痛与机能障碍-激痛点手册[M].郭芳娟,高文彬,译.台湾:合记图书出版社,2004:22-27.
[31] Kruse RA Jr,Christiansen JA.Thermographic imaging of myofascial trigger points:a follow-up study[J].Arch PhysMed Rehabil,1992,73(9):819-823.
[32] Merla A1,Ciuffolo F,D'Attilio M,et al.Functional infrared imaging in the diagnosis of the myofascial pain[J].Conf Proc IEEE Eng Med Biol Soc,2004,2:1188-1191.
[33] 高巍巍,邹德生,王伍超,等.红外热像图定位冲击波疗法治疗肌筋膜疼痛综合征的临床分析[J].中国疼痛医学杂志,2016,22(4):312-314,318.
[34] 苏彩霞,林枫,江钟立.温针灸治疗颈背部肌筋膜疼痛综合征疗效观察[J].上海针灸杂志,2015,34(11):1102-1105.
[35]吴雏燕,詹玉明,江钟立.红外线联合中频电疗治疗腰背部肌筋膜炎临床疗效量化的研究[J].中国医学前沿杂志(电子版),2016,8(12):126-129.
[36] Patton HD. Textbook of physiology[M]. USA:WB Saunders Company 21st edition Vol 1,1989:347.
[37] Melzack R. The Mc Gill Pain Questionnaire:major properties and scoring methods[J]. Pain,1975,1(3):277-299.
[38]李君,冯艺,韩济生,等.中文版简版Mc Gill疼痛问卷-2的制定与多中心验证[J].中国疼痛医学杂志,2013,19(1):42-46.
[39] Ware JE Jr,Sherbourne CD. The MOS 36-item short-form health survey(SF-36). I. Conceptual framework and item selection[J].Med Care,1992,30(6):473-483.
[40] Fujita T,Ohue M,Nakajima M,et al. Comparison of the effects of elcatonin and risedronate on back and knee pain by electroalgometry using fall of skin impedance and quality of life assessment using SF-36[J]. J Bone Miner Metab,2011,29(5):588-597.
[41]薛开禄,柳围堤,田苗,等.针刺激痛点对肌筋膜疼痛综合征患者生活质量的影响[J].上海针灸杂志,2017,36(8):991-994.