摘要
目的探讨砭石热熨推拿对比氟比洛芬凝胶贴膏在改善肩背部慢性肌肉骨骼疼痛方面的有效性,并通过中介作用分析其可能的作用机制。方法将120例肩背部慢性肌肉骨骼疼痛患者随机分为砭石热熨推拿组与氟比洛芬凝胶贴膏组,每组60例。砭石热熨推拿组给予砭石热熨推拿,每次30 min,每周3次;氟比洛芬凝胶贴膏组给予氟比洛芬凝胶贴膏每日2次。两组均治疗2周。主要疗效指标:使用整体疼痛评估量表(GPS)评估治疗结束2周后疼痛改善程度。中介作用测量:使用肌骨超声评价治疗前、治疗2周后浅层与深层肌肉弹性的改变。结果砭石热熨推拿组与氟比洛芬凝胶贴膏组在治疗结束2周后改善肌肉骨骼疼痛方面差异具有统计学意义,对疼痛病程的混杂因素校正后,两组间均值差为-8.8[95%CI(-18.2,-0.7),P<0.05]。这一疗效部分通过改变深层肌肉弹性发挥作用,中介作用效应量为-1.5[95%CI(-2.0,-0.9),P=0.024],占总疗效的17.9%。结论砭石热熨推拿可有效缓解肩背部慢性肌肉骨骼疼痛患者的疼痛程度,并通过改变深层肌肉弹性对治疗效果发挥中介作用。
Objective To evaluate the effectiveness of stone needle thermocompression and massage compared to flurbiprofen gel patch in relieving chronic musculoskeletal pain in the shoulder and back,and to explore the potential mediating mechanism through muscle elasticity.Methods A total of 120 patients with chronic musculoskeletal pain in the shoulder and back were randomly assigned to either stone needle group or flurbiprofen group,with 60 patients in each.The stone needle group received stone needle thermocompression and massage for 30 minutes,three times per week;the flurbiprofen group received flurbiprofen gel patch twice daily.Both groups were treated for 2 weeks.Pain improvement,as the primary outcome,was assessed using the Global Pain Scale(GPS)at baseline,after 2 weeks of treatment,and again 2 weeks post-treatment.To explore potential mechanisms,a mediator analysis was conducted by measuring changes in superficial and deep muscle elasticity using musculoskeletal ultrasound at baseline and after the 2-week treatment period.Results The stone needle group showed significantly greater pain relief than the flurbiprofen group 2 weeks post-treatment.After adjusting for confounders related to pain duration,the between-group mean difference was-8.8[95%CI(-18.2,-0.7),P<0.05].Part of the therapeutic effect was mediated by changes in deep muscle elasticity,with a mediation effect size of-1.5[95%CI(-2.0,-0.9),P=0.024],accounting for 17.9%of the total effect.Conclusion Stone needle thermocompression and massage can effectively relieve chronic musculoskeletal pain in the shoulder and back,partly through a mediating effect of improved deep muscle elasticity.
作者
钱晶晶
李远竞
李莉
习亚炜
王颖
郭翠花
周佳焱
孙雅轩
刘姝
杨光静
袁娜
杨晓芳
QIAN Jingjing;LIYuanjing;LI Li;XI Yawei;WANG Ying;GUO Cuihua;ZHOU Jiayan;SUN Yaxuan;LIU Shu;YANG Guangjing;YUAN Na;YANG Xiaofang(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing,100053;School of Medicine,Stanford University,U.S.A.;School of Public Health,Harvard University,U.S.A.;The First Affiliated Hospital of Henan University of Chinese Medicine;Chongqing Traditional Chinese Medicine Hospital;Wangjing Hospital,China Academy of Chinese Medical Sciences)
出处
《中医杂志》
北大核心
2025年第9期935-940,共6页
Journal of Traditional Chinese Medicine
基金
中国中医科学院科技创新工程项目(CI2021A03002)
中国中医科学院广安门医院护航工程骨干人才培育项目(9323052)。
关键词
慢性肌肉骨骼疼痛
肩背痛
砭石热熨推拿
肌肉弹性
中介作用
随机对照试验
chronic musculoskeletal pain
shoulder and back pain
stone needle thermocompression and massage
muscle elasticity
mediator analysis
randomized controlled trial
作者简介
通讯作者:杨晓芳,779331683@qq.com,13552493040。
