針刺合併貼紮術於肌筋膜疼痛症患者的治療一例

Dry Needle Injection Combined with Kinesio Taping Method for Treatment of Myofascial Pain Syndrome: A Case Report

林素祺(Su-Chi Lin) ； 周立偉(Li-Wei Chou) ； 洪章仁(Chang-Zern Hong) ； 張恆偉(Heng-Wei Chang) ； 黃明正(Ming-Cheng Huang) ； 吳威廷(Wei-Ting Wu)

《中華針灸醫學會雜誌》 18卷2-4期 (2015/12) Pp. 45-51

摘要

肌筋膜疼痛症所伴隨的緊繃帶、局限之壓痛點、引傳痛等往往會嚴重困擾著個案，Simons 提出的能量危機理論認為內部的血液循環會因創傷或長時過度使用，導致肌肉緊繃而變差。缺血的組織缺乏三磷酸腺苷來驅動鈣離子幫浦，故病灶內的肌肉持續收縮，阻斷血液循環使症狀持續。目前治療的選擇上往往必須使用多種方法複合治療，且成效不一。目前主流的介入性治療方式為乾針治療，但針刺治療治療後局部軟組織脹痛，容易造成病人不舒服。本個案於嵴下肌、小圓肌有肌激痛點，再給予針刺治療後合併抑制型貼法。治療後視覺疼痛量表由六分降為零分，且較無局部腫脹的不適感。故本個案報告認為合併乾針治療與肌能系貼紮術，能快速地改善上述症狀，且能減緩針刺治療後的局部因腫脹或出血，從而建立一種新的治療模式。

關鍵字

肌筋膜疼痛症 ； 肌能系貼紮術 ； 針刺治療

並列摘要

Myofascial pain syndrome would bother many people continually, defined as taut bands, regional pain with twitch sign and referred pain. Simons considered that circulation would become poor due to trauma or long term using. The muscle spasm would be noted, and then the ischemic tissues lack adenosine triphosphate to promote calcium pump. The muscle would contract continually and then block the circulation moreover. The main treatment until now was trigger points injection, but the regional swelling and pain after treatment was also bothersome. In this case, we used trigger points injection on infraspinatus and teres minor tendon for treatment. Then we immediately combined Kinesio Taping method on the target muscle with inhibitory method. The visual analogue scale was much improved from six to zero score, and no specific regional swelling and pain sensation was noted. We reported this case combined with dry needle injection and Kinesio Taping method. The symptoms could be rapidly improved and also the regional swelling, micro-bleeding and pain after injection. So we considered the combined treatment could become a new pattern for treatment of myofascial pain syndrome.

並列關鍵字

Myofascial pain syndrome ； Kinesio Taping Method ； dry needle injection

參考文獻

Ge HY, Nie H, Madeleine P, et al. Contribution of the local and referred pain from active myofascial trigger points in fibromyalgia syndrome. Pain 2009; 147: 233–240.

Simons DG, Hong CZ, Simons LS: Endplate potentials are common to midfiber myofacial trigger points. American Journal of Physical Medicine and Rehabilitation 2002, 81(3):212-222.

Simons DG, Travell JG, Simons LS. Myofascial pain and dysfunction: the trigger point manual. Volume 1. Upper half of body. 2nd ed. Baltimore:Williams & Wilkins; 1999.

Kao MJ, Han TI, Kuan TS, et al: Myofascial trigger points in early life. Arch Phys Med Rehabil 2007, 88(2):251-254.

Hagberg M, Kvarnstrom S: Muscular endurance and electromyographic fatigue in myofascial shoulder pain. Arch Phys Med Rehabil 1984, 65(9):522-525.