肌筋膜触发点电刺激对下肢截肢后幻肢痛的效果

doi:10.3969/j.issn.1006-9771.2021.11.016

《中国康复理论与实践》 ›› 2021, Vol. 27 ›› Issue (11): 1340-1345.doi: 10.3969/j.issn.1006-9771.2021.11.016

肌筋膜触发点电刺激对下肢截肢后幻肢痛的效果

李雅茜,费若楠,秦秀男,王亚平,肖艳英()

中南大学湘雅二医院麻醉科,湖南长沙市 410011

收稿日期:2021-05-13 修回日期:2021-09-01 出版日期:2021-11-25 发布日期:2021-12-03
通讯作者: 肖艳英 E-mail:xiaoyanying192@csu.edu.cn
作者简介:李雅茜(1995-),女,汉族,山西晋城市人,硕士研究生,主要研究方向：疼痛与康复。|肖艳英(1983-),女,汉族,湖南邵阳市人,主治医师,主要研究方向：疼痛康复。
基金资助:
1.湖南省残疾人联合会康复科研项目(2019xk009);2.湖南省自然科学青年基金项目(2018JJ3769)

Effect of Myofascial Trigger Points Electric Stimulation on Phantom Limb Pain after Lower Limb Amputation

LI Ya-xi,FEI Ruo-nan,QIN Xiu-nan,WANG Ya-ping,XIAO Yan-ying()

Department of Anesthesiology, the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China

Received:2021-05-13 Revised:2021-09-01 Published:2021-11-25 Online:2021-12-03
Contact: XIAO Yan-ying E-mail:xiaoyanying192@csu.edu.cn
Supported by:
Hunan Disabled Persons Federation Rehabilitation Research Project(2019xk009);Hunan Natural Science Foundation Youth(2018JJ3769)

摘要/Abstract

摘要：

目的观察镜像疗法基础上肌筋膜触发点电刺激对下肢截肢后幻肢痛的临床疗效。方法 2020年5月至11月,本院下肢截肢后幻肢痛患者50例随机分为对照组(n = 25)和试验组(n = 25)。对照组采用镜像疗法,试验组于镜像疗法治疗前行肌筋膜触发点电刺激,共4周。治疗前后采用简化McGill疼痛问卷(SF-MPQ)、匹兹堡睡眠质量指数(PSQI)、汉密尔顿焦虑量表(HAMA)、计时“起立-行走”测试(TUGT)和6分钟步行测试(6MWT)进行评估。结果治疗后,两组各项评定成绩均有显著改善(|t| > 8.210, P < 0.001);除SF-MPQ中现有疼痛强度外,试验组各项评分显著优于对照组(|t| > 5.103, P < 0.001)。结论单纯镜像疗法可以减轻下肢截肢后幻肢痛患者的疼痛,提高睡眠质量,减轻焦虑,提高行走能力;加用肌筋膜触发点电刺激可进一步提高疗效。

关键词: 幻肢痛, 截肢, 镜像疗法, 肌筋膜触发点, 经皮神经电刺激

Abstract:

Objective To explore the clinical efficacy of myofascial trigger point electric stimulation based on mirror therapy on phantom limb pain after lower limb amputation.Methods From May to November, 2020, 50 patients with phantom limb pain after lower limb amputation were randomly divided into control group (n = 25) and experiment group (n = 25). Both groups accepted mirror therapy, while the experiment group received myofascial trigger point electric stimulation before mirror therapy, for four weeks. They were assessed with short-form of McGill Pain Questionnaire (SF-MPQ), Pittsburgh Sleep Quality Index (PSQI), Hamilton Anxiety Scale (HAMA), Timed 'Up & Go' Test (TUGT) and 6-minute walk test (6MWT) before and after treatment.Results All the indexes improved in both groups after treatment (|t| > 8.210, P < 0.001), and improved more in the experiment group than in the control group (|t| > 5.103, P < 0.001), except the present pain intensity of SF-MPQ.Conclusion Mirror therapy is effective on phantom limb pain after lower limb amputation in terms of pain, sleep, anxiety and walking, and the effect could be stronger after myofascial trigger point electric stimulation.

Key words: phantom limb pain, amputation, mirror therapy, myofascial trigger point, transcutaneous electric nerve stimulation

李雅茜,费若楠,秦秀男,王亚平,肖艳英. 肌筋膜触发点电刺激对下肢截肢后幻肢痛的效果[J]. 《中国康复理论与实践》, 2021, 27(11): 1340-1345.

LI Ya-xi,FEI Ruo-nan,QIN Xiu-nan,WANG Ya-ping,XIAO Yan-ying. Effect of Myofascial Trigger Points Electric Stimulation on Phantom Limb Pain after Lower Limb Amputation[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(11): 1340-1345.

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组别	n	性别(男/女, n)	年龄(岁)	病程(月)	截肢位置(大腿/小腿, n)
对照组	25	18/7	54.6±13.7	2.5±1.4	8/17
试验组	25	16/9	56.1±15.6	2.3±1.2	10/15
χ²/t值		0.368	-0.357	0.439	0.347
P值		0.544	0.723	0.663	0.556

组别	n	治疗前	治疗后	t值	P值
对照组	25	18.4±4.1	9.0±2.7	16.948	< 0.001
试验组	25	17.1±3.9	5.7±1.9	14.794	< 0.001
t值		1.133	5.103
P值		0.263	< 0.001

组别	n	治疗前	治疗后	t值	P值
对照组	25	7.4±0.9	3.4±1.4	10.445	< 0.001
试验组	25	7.5±1.0	1.5±0.9	22.573	< 0.001
t值		-0.442	5.693
P值		0.661	< 0.001

组别	n	治疗前	治疗后	t值	P值
对照组	25	3.2±0.7	1.0±0.6	10.461	< 0.001
试验组	25	3.3±0.7	0.8±0.5	16.098	< 0.001
t值		-0.757	1.295
P值		0.453	0.202

组别	n	治疗前	治疗后	t值	P值
对照组	25	13.2±2.8	8.3±1.8	11.068	< 0.001
试验组	25	13.5±3.9	5.3±2.0	12.653	< 0.001
t值		-0.376	5.521
P值		0.708	< 0.001

肌筋膜触发点电刺激对下肢截肢后幻肢痛的效果

Effect of Myofascial Trigger Points Electric Stimulation on Phantom Limb Pain after Lower Limb Amputation

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组别	n	治疗前	治疗后	t值	P值
对照组	25	17.4±4.4	12.1±3.7	8.210	< 0.001
试验组	25	16.9±4.0	7.2±1.9	13.372	< 0.001
t值		0.436	5.862
P值		0.665	< 0.001

组别	n	治疗前	治疗后	t值	P值
对照组	25	62.3±10.4	31.4±9.6	22.981	< 0.001
试验组	25	60.0±8.7	16.8±5.6	23.535	< 0.001
t值		0.840	6.544
P值		0.405	< 0.001

组别	n	治疗前	治疗后	t值	P值
对照组	25	117.4±15.1	224.2±33.7	-14.642	< 0.001
试验组	25	121.2±15.7	329.9±26.2	-38.517	< 0.001
t值		-0.872	-12.385
P值		0.387	< 0.001

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