針刺對頸部慢性肌筋膜疼痛症候群之療效：一單盲隨機對照試驗;
The therapeutic effects of acupuncture on patients with chronic neck myofascial pain syndrome: A single-blind randomized controlled trial

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题名:	針刺對頸部慢性肌筋膜疼痛症候群之療效：一單盲隨機對照試驗;The therapeutic effects of acupuncture on patients with chronic neck myofascial pain syndrome: A single-blind randomized controlled trial
作者:	孫美緣;Mei-Yuan Sun
贡献者:	中國醫藥大學：中西醫結合研究所碩士班
关键词:	針刺;慢性肌筋膜疼痛症候群;生活品質量表;Acupuncture;Chronic neck myofascial pain;Short Form-36
日期:	2009-06-27
上传时间:	2009-08-06 11:02:38 (UTC+8)
摘要:	頸部肌筋膜疼痛症候群是相當常見的疾病，病患除了會感覺頸部僵硬疼痛外，也常會感到疲憊、工作機能變差及生活品質降低，目前臨床上並無最佳治療方式，而傳統針灸可用於疼痛的治療，因此本研究設計一個單盲隨機對照試驗，探討針刺對於慢性頸部肌筋膜疼痛症候群的療效。總共研究了35位慢性頸部肌筋膜疼痛症候群病患，他們經過詳細說明試驗目的和過程後同意進入研究並簽署同意書，之後隨機分配至針刺組和假針刺組，接受每週2次持續3週針刺治療。主要療效指標是評估生活品質量表（SF-36），次要指標則評估頸部活動角度、活動引致疼痛以及疼痛問卷(Short-Form McGill Pain Questionnaire)。由一位不知組別的研究員於治療前、六次針刺治療後、治療結束後4週時及12週時分別評估一次。其中一位針刺組病患因同時服用中藥而退出，最後共有34位病患完成試驗。結果顯示在針刺治療結束後12週時，針刺組在生活品質量表中的身體生理功能（physical functioning, PF）（p＝0.013）以及情緒角色受限（role emotional, RE）（p＝0.049）分數大於假針刺組；次要指標方面，兩組於針刺治療結束時及針刺治療結束後4週時和12週時，皆有明顯頸部活動程度改善以及相關疼痛減少，但是改善的結果兩組間並未達到顯著差異。結論是針灸治療可用於緩解慢性肩頸肌筋膜疼痛症候群病患之肩頸部位疼痛並改善頸部活動角度，針刺得氣更有利於生活品質的改善。 Purpose: Chronic neck myofascial pain syndrome (MPS) is a common disorder in clinics which impacts patients on physiological and psychologic aspects. No gold standard method is suggested and acupuncture is often used to treat patients with pain. The aim of this study was to evaluate the therapeutic efficacy of acupuncture on patients with chronic neck myofascial pain syndrome. Method: We investigated the effects of acupuncture on patients with chronic neck MPS by means of a single-blind randomized controlled trial. Thirty-five patients were randomly allocated to an acupuncture group or a sham acupuncture group. Each subject received acupuncture treatment two times per week for 3 consecutive weeks. The primary outcome measure was quality of life as assessed with the Medical Outcomes 36-Item Short Form Health Survey, and secondary outcome measures were neck range of motion, and results of the Short-Form McGill Pain Questionnaire, as determined by a blinded investigator. The clinical assessments were made before treatment (BT) and after six acupuncture treatments (AT), as well as at 4 weeks (F1) and 12 weeks (F2) after the end of treatment. Total 34 patients completed the trial. Results: The results indicated that both groups had increased ROM scores and decreased VAS and SF-MPQ scores (P < 0.05) at AT, and there were no significant differences in these measures between the two groups at F1 and F2; at F2, patients in the acupuncture group showed greater improvements on the physical functioning and role emotional subscales for quality of life than did patients in the sham acupuncture group (P = 0.013 and P = 0.049, respectively). Conclusions: We conclude that acupuncture may be used for pain relief in patients with chronic neck MPS, and acupuncture stimulation with achievement of qi is more effective in improving quality of life.
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