遠紅外線對腰椎術後肌筋膜疼痛症候群改善之成效

背景：肌筋膜疼痛症候群是腰椎術後常見的症狀之一，腰椎術後產生的背痛33.3%是肌筋膜疼痛症候群，疼痛會降低病人下床活動意願，增加術後背痛、下肢痛及深部靜脈血栓合併症的發生，延長住院天數、增加醫療成本。本研究旨在探討遠紅外線治療儀照射對腰椎術後肌筋膜的疼痛指數、壓痛閾值、最大壓痛忍受度及肌肉張力的影響。研究設計：採類實驗設計，自2019年1月1日至12月31日於北部某醫學中心神經外科病房，腰椎術後，理學檢查符合肌筋膜疼痛症候群的病人共116人，實驗組58人，對照組58人。研究方法：對照組採常規照護，實驗組除常規照護外再介入遠紅外線治療儀（波長4～12μm）照射40分鐘。資料收集時間為介入前及介入後第一至四日每日下午5點照射後即測量疼痛指數、壓痛閥值、最大壓痛忍受度、肌肉力量。研究發現疼痛指數、壓痛閾值、最大壓痛忍受度及肌肉張力兩組隨著時間推移，兩組差異量之差值也隨之增加，介入後第二天開始達到統計上顯著差異（p<.001），實驗組相較於對照組，疼痛指數降低，壓痛閾值、最大壓痛忍受度及肌肉張力增加。結果顯示遠紅外線照射能有效降低腰椎術後肌筋膜症候群臨床症狀，建議將「遠紅外線照射照護」納入腰椎術後肌筋膜疼痛症候群之常規使用。

關鍵字

腰椎術後；肌筋膜疼痛症候群；遠紅外線

並列摘要

Background: Myofascial pain syndrome is a common postoperative complication; 33.3% of back pain after lumbar surgery is due to myofascial pain syndrome. Pain can reduce a patient's willingness to get out of bed; myofascial pain syndrome can exacerbate symptoms of postoperative back pain and lower limb pain and lead to complications related to deep vein thrombosis, all of which can prolong hospitalization and increase medical costs. Purpose: This study explored the effects of far-infrared radiation therapy on myofascial pain scores, pressure pain thresholds, maximum pressure pain tolerance, and muscle tension after lumbar spine surgery. Research design: A quasi-experimental research design was adopted. From January 1 to December 31, 2019, 120 patients were non-randomly recruited from the neurosurgery ward of a medical center in northern Taiwan. Research method: A control group received routine care, including the administration of oral analgesics, muscle relaxants, local injections, and hot and cold compression. An experimental group received routine care alongside far-infrared radiation therapy (wavelength: 4000-12000 nm). The skin of trigger points located at the quadriceps, gluteus maximus, and gluteus medius was targeted, and the irradiation site was 30 cm away from the skin. Each round of irradiation lasted 40 minutes. Irradiation was performed twice a day at 9 a.m. and 5 p.m. on four consecutive days. Before the intervention and on the first to fourth days after the intervention, at 5 p.m., pain level, pressure pain threshold, maximum pressure pain tolerance, and muscle strength were measured. Results and conclusion: The differences in the pain scores between the groups increased over time, reaching statistical significance (p<.001) on the second day after the intervention; the experimental group experienced a more marked reduction in pain, indicated by a lower average pain score, compared with the control group. In addition, the differences in pressure pain threshold, maximum pressure pain tolerance, and muscle tension between the groups also increased over time, reaching statistical significance on the second day after the intervention (p<.001); the experimental group had lower mean scores for each of these items compared with the control group. The present research results revealed that far-infrared radiation therapy can effectively reduce the clinical symptoms of myofascial pain syndrome after lumbar spine surgery. Accordingly, this paper recommends that such therapy be included in routine clinical care for treating myofascial pain syndrome after lumbar spine surgery.

並列關鍵字

lumbar spine surgery ； myofascial pain syndrome ； far infrared radiation

參考文獻

周立偉、洪章仁(2019)．下背肌筋膜疼痛症之針刺治療．台灣醫學，23(3)，335-345。

林頌凱、曾愷平、張煥禎(2007)．肌筋膜疼痛症候群．基層醫學，22(4)．140-146。

許聖宗、劉于詮、黃琮濱(2016)．遠紅外線照射對骨骼肌之影響．中華體育季刊，30(3)，185-191。

周立偉、洪章仁 (2019)．下背肌筋膜疼痛症之針刺治療．台灣醫學，23(3)，335-345。https:// doi.org/10.6320/FJM.201905_23(3).0006

林頌凱、曾愷平、張煥禎 (2007)．肌筋膜疼痛症候群．基層醫學，22(4)．140-146。https://doi.org/10.6965/PMCFM.200704.0140

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