The Clinical Study On The Neck And Shoulder Myofascial Pain Syndrome Treated By The Round-Pointed Needle With Filiform Needle

Objective To investigate the clinical efficacy of the round-pointed needle combined with filiform needle in the treatment of the neck and shoulder pain symptoms,we compared the treatment group and contorl group by the assessment of SF-MPQ.And to observe the variation trend of muscle tension of the affected side by using shear wave elastography(SWE),so as to explore the possible approaches of the round-pointed needle.Methods In this clinical study,in accordance with the inclusion criteria,we acquainted 60 cases.The cases were divided randomly into 2 groups: treatment group and control group,30 cases in each group.During the study,5 cases were lost and 2 cases were excluded.Finally,27 cases in the test group and 26 cases in the control group. Intervening measure: The control group adopted the routine acupuncture treatment,and referred to Acupuncture Therapy selected Ayi point,Jiaji(EX-B2),Dazhu(BL11),Shenzhu(DU12),Jianyu(LI15),Jianliao(TE14),Jianzhen(SI9),Naoshu(SI10),Houxi(SI3)as filiform needle treatment points;the treatment group was treated with the round-pointed needle combined filiform needle,selecting one or two Ayi points as round-pointed needle treatment points,except Ayi points,the routine acupuncture points were consistent with the control group.Treatment was performed 3 times a week for 2weeks,with total 6 times acupuncture,only used the round-pointed needle in the first treatment. Therapeutic evaluation:The primary outcome indicator was the score of the SF-MPQ(Pain Rating Index PRI;Visual Analogue Pain Scale VAS;Existing Pain Intensity PPI)that was administered before the first treatment,after the first treatment,and after one treatment session;the secondary outcome indicator was the change in muscle tension of the affected superior trapezius,middle trapezius and infraspinatus muscles by shear wave elastography.The Young’s modulus values(E)of the muscles were assessed using shear wave elastography before the first treatment and after one treatment session. Shear wave elastography was performed by ultrasonographer and the data were analyzed by SPSS 25.0.During the study,adverse reactions were recorded and addressed in a timely manner,and safety analysis was performed at the end of the study.Results1.Comparison of baseline information By comparing gender,age,pain site,pain symptoms(SF-MPQ total score,PRI score,VAS score,PPI score),and muscle tension(superior trapezius E,middle trapezius E,and infraspinatus E)between two groups before treatment indicated that the differences were not statistically significant(P > 0.05).2.Comparison of the total effective rate between two groups The remission rate of SF-MPQ was used as the evaluation criteria of curative effect,and the results of the study indicated that the total effective rate of both the treatment and control groups was 100%,while the healing rate of the treatment group was 44.4% and the apparent rate was 25.9%;the healing rate was 11.5% and the apparent rate was 7.7%.Comparing between groups,there was a significant difference(P < 0.05).3.Comparison of pain symptoms(SF-MPQ total score,PRI score,VAS score,PPI score) In the comparison between groups,the SF-MPQ total scores and VAS scores of two groups after the first treatment and after one course of treatment was statistically significant difference(P < 0.05).PRI scores and PPI scores after the first treatment in both groups were not statistically different(P > 0.05),but after one course of treatment were significantly different(P < 0.05). In the intra-group comparison,the scores of SF-MPQ and its three subscales(PRI,VAS,PPI)of the two groups after one course of treatment were significantly different from those before treatment(P < 0.05),indicating that the pain and emotion of the two groups were improved before and after treatment.By further comparison showed that there was a significant difference(P < 0.05)in the SF-MPQ and its three subscale(PRI,VAS,PPI)between the three observation nodes(after one treatment session and before treatment,after one treatment session and after the first treatment,after the first treatment and before treatment)in the treatment group.And there was a significant difference(P < 0.05)in the SF-MPQ and its two subscale(PRI,VAS)between the three observation nodes(after and before the first treatment session,after and after the first treatment session,after and after the first treatment session)in the control group,and there was no statistically significant difference(P > 0.05)between the PPI score before treatment and after the first treatment and between the first treatment and after one course of treatment,and a significant difference(P < 0.05)between before treatment and after one course of treatment.4.Comparison of neck and shoulder muscle tension After two week of treatment,the Young’s modulus values(E)of the affected upper trapezius and infraspinatus muscles in the control group decreased,which was statistically significant(P<0.05);the Young’s modulus values(E)of the affected middle trapezius and infraspinatus muscles in the treatmnet group also decreased,which was statistically significant(P<0.05).In the comparison between groups,the Young’s modulus values(E)of the superior trapezius,middle trapezius and infraspinatus muscles on the affected side was not statistically significant(P > 0.05).After one course of treatment,there was a significant positive correlation between the improvement in the tension of the middle trapezius muscle and the relief of the score of VAS,which was a significant difference(P <0.05).5.Safety analysis No adverse reactions occurred in either group during this study.Conclusion1.Both groups had good clinical efficacy in the treatment of neck and shoulder myofascial pain syndrome.By comparing the changes of SF-MPQ,PRI,VAS and PPI scores between the two groups before and after treatment,it was confirmed that the effect of the round-pointed needle combined with filiform needle acupuncture treatment was better than that of filiform needle acupuncture treatment.2.By shear wave elastography analysis the Young’s modulus values(E)of the superior trapezius muscle,middle trapezius muscle,and infraspinatus muscle in the two groups, showed that there was a decrease in muscle tension in all three areas after treatment. Compared with the control group,the decrease in the Young’s modulus values(E)of the middle trapezius muscle in the observation group after treatment was positively correlated with the decrease in the VAS scores.