Objective: To observe the clinical efficacy of acupuncture combined with tuina therapy for stiff neck with levator scapula injury type.
Methods: A total of 162 patients with stiff neck of levator scapula injury type were randomly divided into an acupuncture combined with tuina group (combined group, 52 patients), a tuina group (55 patients), and an acupuncture group (55 patients). The patients in the acupuncture group received acupuncture on the affected side's Houxi (SI 3), inserting the needle 10 to 20 mm towards Laogong (PC 8) with strong or moderate stimulation, and patients were instructed to move their neck, shoulders, and upper limbs during the process, with the needle retained for 2 to 3 min. The patients in the tuina group received strong stimulation pressing on tender points to release the starting and ending points of the trapezius muscle with modified techniques. The combined group first received tuina therapy, followed immediately by acupuncture treatment at the Houxi (SI 3). Treatments were administered every other day for a total of three sessions. Before treatment and on 1, 3, and 7 days after treatment, the simple McGill pain questionnaire (SF-MPQ) scores [including the pain rating index (PRI), visual analogue scale (VAS), and present pain intensity (PPI) scores] of the head, neck and shoulder, cervical spine mobility scores were observed, and the clinical efficacy and safety of each group were evaluated.
Results: On the 1, 3, and 7 days after treatment, the SF-MPQ, PRI, VAS, and PPI scores of the head, neck, and shoulder in all groups were significantly reduced (P<0.01). On the 1 and 3 days after treatment, the above scores in the combined group were lower than those in the tuina group and the acupuncture group (P<0.05, P<0.01). On the 7 days after treatment, the above scores in the combined group were lower than those in the acupuncture group (P<0.01). On the 3 days after treatment, the SF-MPQ, PRI, and VAS scores in the tuina group were lower than those in the acupuncture group (P<0.01). On the 7 days after treatment, the SF-MPQ, PRI, VAS, and PPI scores in the tuina group were lower than those in the acupuncture group (P<0.01, P<0.05). On the 1, 3, and 7 days after treatment, the cervical spine mobility scores in each group were decreased compared to those before treatment (P<0.01). On the 3 days after treatment, the cervical spine mobility score in the combined group was lower than that in the acupuncture group and the tuina group (P<0.01). On the 1, 3, and 7 days after treatment, the cured rate in the combined group was higher than that in the tuina group and the acupuncture group (P<0.01). During the treatment period, no serious adverse reactions occurred in any group.
Conclusion: Acupuncture combined with tuina therapy could effectively improve stiff neck with levator scapula injury type, alleviate patient pain, restore cervical spine mobility, and clinically outperform both tuina and acupuncture therapy alone.
目的：观察针刺联合推拿治疗肩胛提肌损伤型落枕的临床疗效。方法：将162例肩胛提肌型落枕患者随机分为针刺联合推拿组（针推联合组，52例）、推拿组（55例）和针刺组（55例）。针刺组予针刺患侧后溪，由后溪向劳宫方向刺入10~20 mm，予以强刺激或中强刺激手法，行针过程中患者活动颈肩部及上肢，留针2~3 min；推拿组予以压痛点强刺激按压手法松解肩胛提肌起止点的改良手法；针推联合组先予推拿治疗，结束后立即行针刺后溪治疗。各组均隔日治疗1次，共治疗3次。治疗前及治疗第1、3、7天，观察各组患者头颈肩部简式McGill疼痛问卷量表（SF-MPQ）评分[包括疼痛评估指数（PRI）、疼痛视觉模拟量表（VAS）、现时疼痛强度（PPI）评分3部分]、颈椎活动度评分，并评定各组临床疗效及安全性。结果：治疗第1、3、7天后，各组患者头颈肩部SF-MPQ、PRI、VAS、PPI评分较治疗前降低（P<0.01）。治疗第1、3天后，针推联合组以上评分均低于推拿组及针刺组（P<0.05，P<0.01）；治疗第7天后，针推联合组以上评分均低于针刺组（P<0.01）。治疗第3天后，推拿组SF-MPQ、PRI、VAS评分低于针刺组（P<0.01）；治疗第7天后，推拿组SF-MPQ、PRI、VAS、PPI评分均低于针刺组（P<0.01，P<0.05）。治疗第1、3、7天后，各组患者颈椎活动度评分均较治疗前降低（P<0.01）；治疗第3天后，针推联合组颈椎活动度评分低于针刺组及推拿组（P<0.01）。治疗第1、3、7天后，针推联合组治愈率均高于推拿组及针刺组（P<0.01）。治疗期间，各组均未发生严重不良反应。结论：针刺联合推拿治疗可有效改善肩胛提肌损伤型落枕，缓解患者疼痛，恢复颈椎活动度，且临床疗效优于单纯推拿和针刺治疗。.
Keywords: Point SI 3 (Houxi); acupuncture; levator scapula injury; randomized controlled trial (RCT); stiff neck; tender point strong stimulation and pressing technique; tuina therapy.