关键词: 颈型颈椎病, 肌筋膜触发点, 干针, 高能量激光, 针刺后酸胀痛

Abstract:

Objective To evaluate the clinical efficacy of ultrasound-guided trigger point dry needling combined with high-intensity laser therapy （HILT） in the treatment of neck type cervical spondylopathy （NTCS）. Methods Seventy NTCS patients meeting the inclusion criteria were randomly assigned to two groups （n = 35）. The experimental group （Group T） received ultrasound-guided trigger point dry needling combined with HILT， while the control group （Group C） received the same needling procedure combined with sham laser therapy. Both groups underwent two treatment sessions during hospitalization， with a 5-day interval. Outcomes were assessed at multiple time points： before treatment （T₀）， immediately after the first acupuncture （T₁）， 24 h （T₂） and 48 h （T₃） post-first acupuncture， and at 1 （T₅）， 4 （T₆）， and 12 （T₇） weeks after treatment completion. The primary pain outcomes were the Numerical Rating Scale （NRS） and the Short-Form McGill Pain Questionnaire-2 （SF-MPQ-2）. Secondary outcomes included cervical range of motion （CROM， assessed at T₀ and 1 day post-treatment ［T₄］）， the Neck Disability Index （NDI， at T₀， T₄， T₅， T₆， T₇）， the Athens Insomnia Scale （AIS） and Hospital Anxiety and Depression Scale （HADS） scores （at T0 and T6）. Patient satisfaction， analgesic consumption during treatment， and adverse events were also recorded. Results Compared to baseline （T₀）， both groups showed significant improvements in NRS， SF-MPQ-2， and NDI scores at all post-treatment time points （P < 0.05）， increased CROM at T₄ （P < 0.05）， and reduced AIS and HADS scores at T₆ （P < 0.05）. Compared to Group C， Group T demonstrated significantly lower NRS and SF-MPQ-2 scores at T₂， T₃， T₅， T₆， and T₇ （P < 0.05）； greater lateral bending CROM at T₄ （P < 0.05）； lower NDI scores at T₆ and T₇ （P < 0.05）； and a lower AIS score at T₆ （P < 0.05）. Furthermore， Group T reported higher post-treatment satisfaction （P < 0.05） and required less imrecoxib （P < 0.05）. No significant between-group differences were observed in other indicators （P > 0.05）， and no serious adverse reactions were reported. Conclusion For patients with NTCS， ultrasound-guided trigger point dry needling combined with HILT is more effective than needling combined with sham laser in alleviating post-needling soreness（PNS） and primary neck pain， improving cervical lateral bending range of motion and function， enhancing sleep quality， and reducing the need for analgesic medication.

Key words: neck type cervical spondylopathy, myofascial trigger points, dry needling, high-intensity laser therapy, post-needling soreness