• 沒有找到結果。

臨床上,肌激痛點是一種造成肌筋膜疼痛症肌肉疼痛的主要原因。

在肌激痛點區域中,肌電圖檢查可以記錄到終板雜訊電位。終板雜訊電 位的波振福大小與肌激痛點的活性有極大關聯,可以用來作為肌激痛點 治療療效的評估。藉由肌電圖機器的內建軟體計算上斜方肌筋激痛點中 終板雜訊電位平均振幅的變化足以客觀的代表受試者肌激痛點的興奮 度。終板雜訊電位確實會有個體之差異,所以我們也會將終板雜訊電位 平均振幅的變化比例當作比較指標。

在本實驗中,我們證實了肌激痛點的興奮性確實可以透過遠處針灸 治療來抑制。「改良式針灸組」(多處針刺、快速旋進旋出誘發局部抽 搐反應)遠處針灸穴位似乎比「留針組」在減少疼痛強度和終板電位之 平均振幅以及增加壓力疼痛閾值上有更好的效果。更進一步,證實了終 板電位的下降和疼痛的減低有很好的相關性。

在臨床上,單一的局部肌激痛點的針刺治療已不能滿足所有肌筋膜 疼痛症患者的需求,可能因為患者局部劇烈疼痛,不敢讓醫師局部針刺 治療,或害怕醫師注射的藥物有副作用,亦或是醫師技術不純熟,在找 尋肌激痛點時不確定,或怕局部針刺處較危險,出現氣胸或出血等副作 用,所以,遠處的針刺治療逐漸被應用且重視。

在完成本研究之實驗模組後,我們將可以逐步驗證單一穴位治療肌 激痛點的療效(例如:腰背委中求,遠處針刺委中穴治療下背痛的實證 醫學證據),並更進一步證實不同遠處穴位組治療疼痛之療效,從古籍 和臨床中醫師的經驗中,找出最有效的治療穴位。同時,在未來,希望 透過既有的兔子肌激痛點的動物實驗模組,以科學的方法、實證醫學的 角度來探討遠處取穴治療肌筋膜疼痛症的可能機轉。

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