踩跷调衡法治疗原发性纤维肌痛综合征的疗效及改善睡眠的临床研究

Clinical study of treading and balancing manipulation on fibromyalgia syndrome and insomnia

关键词:  踩跷  电针  纤维肌痛综合征  推拿  足太阳膀胱经

Key words:  treading manipulation  electro-acupuncture  fibromyalgia syndrome  tuina  the bladder meridian of foot-taiyang

摘要:

[目的] 观察踩跷调衡法治疗原发性纤维肌痛综合征的疗效及对患者睡眠质量的改善。[方法] 将60例原发性纤维肌痛综合征患者随机分为踩跷调衡法组（治疗组）和电针组（对照组）。治疗组于患者腰背及下肢后部实施以足部踩、踏、按、揉等为主要技法的踩跷推拿法；对照组采用电针疗法，穴位取肩井、肩髃、曲垣、颈（C）4夹脊、C6夹脊、曲池、阳陵泉、阴陵泉、腰（L）5夹脊、秩边、环跳，皆双侧取穴。两组患者均每3日治疗1次，治疗10次为1个疗程，共治疗1个疗程。分别于治疗前后评定并比较两组患者的改良纤维肌痛影响调查表（FIQR）及匹兹堡睡眠质量指数评分量表（PSQI）评分，同时评价两组总体临床疗效及安全性。[结果] 1）FIQR评分：治疗前，两组FIQR评分比较，差异无统计学意义（P>0.05）；治疗后，两组患者FIQR评分均较治疗前下降，差异有统计学意义（P<0.05），但两组比较差异无统计学意义（P>0.05）。2）PSQI评分：治疗前，两组PSQI评分比较，差异无统计学意义（P>0.05）；治疗后，治疗组的PSQI评分较治疗前下降，差异有统计学意义（P<0.01），对照组PSQI评分虽较前下降，但差异无统计学意义（P>0.05）。3）有效率：治疗组临床总有效率为96.4%，对照组为78.6%，两组比较差异具有统计学意义（P<0.05）。4）安全性：两组患者治疗过程中均未观察到不良事件。[结论] 踩跷调衡法及电针疗法均能安全有效地改善原发性纤维肌痛综合征患者的躯体疼痛程度、日常生活活动能力及睡眠质量。虽然两组治疗后的FIQR评分统计学差异不显著，可能是由于样本量不足、观察时间不够所致，但总体而言，踩跷调衡法在改善患者睡眠质量及总有效率的比较中均优于电针法，提示踩跷调衡法的总体疗效更优。

Abstract:

[Objective] To verify the efficacy of treading and balancing manipulation on primary fibromyalgia syndrome (FMS) and its improvement on insomnia.[Methods] A total of 60 patients with primary FMS were randomly divided into a treading and balancing manipulation group(treatment group), and an electro-acupuncture group(control group). Patients in treatment group received treading and balancing manipulation on their back, which manifested as treading and pressing using practitioners feet. Patients in control group were treated with electro-acupuncture at Jianjing(GB21), Jianyu(LI15), Quyuan(SI13), C4, C6, L5 Jiaji (EX-B2, C4, C6, L5), Quchi(LI11), Yanglingquan(GB34), Yinglingquan(SP9), Zhibian(BL54), Huantiao(GB30) on both sides. When achieving Deqi (soreness and tenderness), a disperse-dense wave with frequency of 4/20 Hz was attached to the needle. Both groups were treated once every three days, with ten times treatment as one course and one course in total. The scores of Revised Fibromyalgia Impact Questionnaire(FIQR) and Pittsburgh Sleep Quality Index(PSQI) of both groups were obtained and compared before and after treatment.[Results] After treatment, the scores of FIQR of both groups were lower than before(P<0.05), but had no significance between each other(P>0.05). The scores of PSQI of treatment group declined significantly(P<0.01) after treatment, while the scores of PSQI of control group had no significance before and after treatment(P>0.05). After treatment, the total efficacy of treatment group was 96.4%, while 78.6% of control group, which had significance when compared.[Conclusion] Treading and balancing manipulation could improve patients with FMS their widespread pain and tenderness and daily life ability, and its efficacy was close to electro-acupuncture. However, treading and balancing manipulation could also improve patients' sleeping problem, which was not seen in group treated with electro-acupuncture.