桂枝新加汤联合恢刺对颈肩肌筋膜疼痛综合征患者颈椎活动、SWE参数的影响OA

Objective To investigate the effects of Guizhi Xinjia decoction combined with Huici needling on cervical spine activity,pain mediators,traditional Chinese medicine(TCM)syndrome scores,and shear wave elastography(SWE)parameters in patients with neck and shoulder myofascial pain syndrome(MPS).Methods A total of 122 patients with neck and shoulder MPS admitted from January 2021 to January 2024 were selected.They were divided into the observation group(n=40),the control group 1(n=41)and the control group 2(n=41)according to random number table method,and the three groups were treated with conventional Western medicine.On this basis,the observation group was supplemented with Guizhi Xinjia decoction combined with Huici needling,the control group 1 was treated with Guizhi Xinjia decoction,and the control group 2 was treated with Huici needling;the treatment cycle was 2 weeks.The TCM therapeutic efficacy,TCM syndrome score,SWE parameters,pain mediators[cyclooxygenase-2(COX-2),5-Hydroxytryptamine(5-HT),prostaglandin E2(PGE2),β-endorphin(β-EP)],cervical mobility,neck disability index(NDI)score,and safety were statistically analyzed in the three groups.Results In the control group 1,1 patient was lost to follow-up,1 patient was excluded in the control group 2,and no patient was excluded in the observation group.At 2 weeks after treatment,the total effective rate of the observation group was 92.50％(37/40),which was higher than 72.50％(29/40)of the control group 1 and 70.00％(28/40)of the control group 2(P＜0.05).At 2 weeks after treatment,the TCM syndrome score,NDI score,Young's modulus and shear wave velocity on the affected side in the observation group were lower than those in the control group 1 and the control group 2,while cervical range-of-motion scores for flexion-extension,left-right rotation,and lateral flexion were higher than those in the control group 1 and the control group 2(P＜0.05).At 2 weeks after treatment,COX-2,5-HT and PGE2 in the observation group were lower than those in the control group 1 and the control group 2,while β-EP was higher than that in the control group 1 and the control group 2(P＜0.05).There were no obvious adverse reactions in the three groups.Conclusion The combined treatment of Guizhi Xinjia decoction and Huici needling is effective and safe for patients with neck and shoulder MPS.It can regulate the expression levels of pain mediators,effectively improve the muscle function of the neck and shoulder,alleviate clinical symptoms,and restore the mobility of the shoulder and neck.