收稿日期: 2025-11-20
网络出版日期: 2026-03-09
Efficacy of ultrasound-guided trigger point dry needling combined with high-intensity laser therapy for neck type cervical spondylopathy
Received date: 2025-11-20
Online published: 2026-03-09
目的 探讨超声引导下触发点干针联合高能量激光(HILT)治疗颈型颈椎病(NTCS)的临床疗效。 方法 选取符合纳排标准的NTCS患者70例,将患者随机分配至观察组(T组)和对照组(C组),每组35例。T组行超声引导下触发点干针联合HILT治疗,C组行超声引导下触发点干针联合假激光治疗,住院期间治疗2次,间隔5 d。记录两组患者治疗前(T0)、首次针刺后即刻、24 h、48 h(T1—T3)及疗程结束后1、4、12周(T5—T7)时数字分级评分法(NRS)评分、简化McGill疼痛问卷-2(SF-MPQ-2)评分,T0及疗程结束后1 d(T4)时颈椎关节活动度(CROM),T0、T4、T5、T6、T7时颈椎功能障碍指数(NDI),T0、T6时阿森斯失眠量表(AIS)评分、医院焦虑抑郁量表(HADS)评分,同时记录治疗后患者满意度、治疗期间镇痛药物使用量及不良反应发生率。 结果 与T0相比,两组患者治疗后各时间点NRS、SF-MPQ-2及NDI评分均降低(P < 0.05),T4时CROM均增加(P < 0.05),T6时AIS及HADS评分均降低(P < 0.05)。与C组相比,T组T2、T3、T5、T6、T7时NRS及SF-MPQ-2评分较低(P < 0.05),T4时CROM(侧弯)较大(P < 0.05),T6、T7时NDI评分较低(P < 0.05),T6时AIS评分较低(P < 0.05)。T组治疗后患者满意度高于C组(P < 0.05),艾瑞昔布使用量少于C组(P < 0.05)。两组患者其余指标差异均无统计学意义(P > 0.05)。 结论 超声引导下触发点干针联合HILT可有效缓解NTCS患者针刺后酸胀痛(PNS),改善原发颈痛及颈椎侧弯活动度,减轻颈椎功能障碍程度,提高睡眠质量,减少治疗期间镇痛药物使用量。
刘畅 , 林玉莲 , 汤雨佳 , 周羽佳 , 孙梦 , 袁燕 . 超声引导下触发点干针联合高能量激光治疗颈型颈椎病的疗效[J]. 实用医学杂志, 2026 , 42(5) : 854 -860 . DOI: 10.3969/j.issn.1006-5725.2026.05.017
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.
| [1] | LV Y W, TIAN W, CHEN D F,et al. The prevalence and associated factors of symptomatic cervical Spondylosis in Chinese adults: A community-based cross-sectional study[J]. BMC Musculoskelet Disord, 2018,19(1):325.doi: 10.1186/s12891-018-2234-0 . |
| [2] | 中华外科杂志编辑部. 颈椎病的分型、诊断及非手术治疗专家共识(2018)[J]. 中华外科杂志, 2018,56(6):401-402.doi:10.3760/cma.j.issn.0529-5815.2018.06.001 . |
| [3] | 倪芝琳,金军,陈立平,等. 激痛点针刺疗法与外周神经阻滞治疗颈源性头痛疗效对比[J]. 国际麻醉学与复苏杂志, 2021,42(7):679-683.doi:10.3760/cma.j.cn321761-20201113-00319 . |
| [4] | 胡长馨,王佳佳,刘倩含,等. taVNS联合EDN治疗对颈型颈椎病患者睡眠、疼痛及焦虑抑郁的影响[J]. 国际麻醉学与复苏杂志, 2024,45(12):1243-1249.doi:10.3760/cma.j.cn321761-20240403-01165 . |
| [5] | CAO W, YIN L, SUN H,et al. Ultrasound features of myofascial trigger points: A multimodal study integrating preliminary histological findings from the upper trapezius[J]. Sci Rep, 2025,15(1):20510.doi: 10.1038/s41598-025-05869-2 . |
| [6] | VALERA-CALERO J A, PLAZA-MANZANO G, RABANAL-RODRíGUEZ G,et al. Current State of Dry Needling Practices: A Comprehensive Analysis on Use, Training, and Safety[J]. Medicina(Kaunas), 2024,60(11):1869.doi: 10.3390/medicina60111869 . |
| [7] | VEARSNAP A, SUKAREECHAI C. Effectiveness of Repetitive Peripheral Magnetic Stimulation (rPMS) in Relieving Post-Needling Soreness in Patient with Upper Trapezius Myofascial Pain Syndrome: A Double-Blind, Randomized Clinical Trial[J].J Pain Res, 2025,18:2541-2548.doi: 10.2147/JPR.S519318 . |
| [8] | SHARMA D, SAINI V, SRIVASTAV A K,et al. Comparative efficacy of high intensity laser therapy (Class IV) and ibuprofen gel phonophoresis in the treatment of knee osteoarthritis among people living in hilly terrain: A randomized controlled study[J].Lasers Med Sci, 2025,40(1):440.doi: 10.1007/s10103-025-04613-6 . |
| [9] | AKBA? A, ?ZDEMI M, AKBA? E,et al. Effect of high-intensity laser therapy on supraspinatus tendon elasticity in subacromial impingement syndrome: A double-blind randomized controlled study[J]. Lasers Med Sci, 2025,40(1):337.doi: 10.1007/s10103-025-04582-w . |
| [10] | KELINI K I S, SALEH M S M, ABBAS M A M,et al. High-intensity laser therapy can improve pain, health status and quality of life in women with fibromyalgia: A single blinded-randomized controlled trial[J]. Lasers Med Sci, 2025,40(1):123.doi:10.1007/s10103-025-04351-9 . |
| [11] | BENITO-DE-PEDRO A I, BECERRO-DE-BENGOA-VALLEJO R, LOSA-IGLESIAS M E,et al. Efficacy of Deep Dry Needling versus Percutaneous Electrolysis in Ultrasound-Guided Treatment of Active Myofascial Trigger Points of the Levator Scapulae in Short-Term: A Randomized Controlled Trial[J]. Life (Basel), 2023,13(4):939.doi: 10.3390/life13040939 . |
| [12] | BALL A, PERREAULT T, FERNáNDEZ-DE-LAS-PE?AS C,et al. Ultrasound Confirmation of the Multiple Loci Hypothesis of the Myofascial Trigger Point and the Diagnostic Importance of Specificity in the Elicitation of the Local Twitch Response[J]. Diagnostics(Basel), 2022,12(2):321.doi:10.3390/diagnostics12020321 . |
| [13] | STEEN J P, JAISWAL K S, KUMBHARE D. Myofascial Pain Syndrome: An Update on Clinical Characteristics, Etiopathogenesis, Diagnosis, and Treatment[J]. Muscle Nerve, 2025,71(5):889-910.doi: 10.1002/mus.28377 . |
| [14] | ZHAI T J, JIANG F Y, CHEN Y P,et al. Advancing musculoskeletal diagnosis and therapy: a comprehensive review of trigger point theory and muscle pain patterns[J]. Front Med(Lausanne), 2024,11:1433070.doi: 10.3389/fmed.2024.1433070 . |
| [15] | 李友华,孙凡,林玉莲,等. 触发点体外冲击波联合肩周类固醇注射对原发性冻结肩患者恢复质量的影响[J]. 实用医学杂志, 2025,41(9):1387-1393.doi:10.3969/j.issn.1006-5725. 2025. 09.017 . |
| [16] | MORO M Z, VIDAL E I O, MóDOLO N S P,et al. Dry needling, trigger point electroacupuncture and motor point electroacupuncture for the treatment of myofascial pain syndrome involving the trapezius: A randomised clinical trial[J]. Acupunct Med, 2024,42(1):3-13.doi:10.1177/09645284231207865 . |
| [17] | ALATTAR S S, ALZAHRANI H. Effectiveness of adding dry needling of the upper trapezius muscle to the usual physiotherapy for managing chronic neck pain: A randomized controlled trial with a 7-week follow-up[J]. Musculoskelet Sci Pract, 2024,74:103155.doi:10.1016/j.msksp.2024.103155 . |
| [18] | NAVARRO-SANTANA M J, VALERA-CALERO J A, ROMANOS-CASTILLO G,et al. Immediate Effects of Dry Needling on Central Pain Processing and Skin Conductance in Patients with Chronic Nonspecific Neck Pain: A Randomized Controlled Trial[J]. J Clin Med, 2022,11(22):6616.doi:10.3390/jcm11226616 . |
| [19] | CEREZO-TéLLEZ E, TORRES-LACOMBA M, FUENTES-GALLARDO I,et al. Effectiveness of dry needling for chronic nonspecific neck pain: A randomized, single-blinded, clinical trial[J]. Pain, 2016,157(9):1905-1917.doi: 10.1097/j.pain. 0000000000000591 . |
| [20] | OLANISZYN G, KUZDZAL A, TARADAJ J,et al. Comparative effects of static, classical, and sham dry needling on muscle properties and autonomic nervous system activity in cervical myofascial pain syndrome[J]. Complement Ther Med, 2025,96:103314.doi: 10.1016/j.ctim.2025.103314 . |
| [21] | BAEAJA-VEGAS L, MARTIN-RODRIGUEZ S, PIQUERAS-SANCHIZ F,et al. Localization of Muscle Edema and Changes on Muscle Contractility After Dry Needling of Latent Trigger Points in the Gastrocnemius Muscle[J]. Pain Med, 2019,20(7):1387-1394.doi:10.1093/pm/pnz359 . |
| [22] | DE LA BARRA ORTIZ H A, ARIAS AVILA M, LIEBANO R E.Quality appraisal of systematic reviews on high-intensity laser therapy for musculoskeletal pain management: An umbrella review[J]. Lasers Med Sci, 2024,39(1):290.doi: 10.1007/s10103-024-04241-6 . |
| [23] | HAO J, HE Z T, HUANG B Y,et al. Comparative effectiveness of six biophysical agents on neck pain rehabilitation: A systematic review and network meta-analysis[J]. Eur Spine J, 2025,34(6):2183-2200.doi: 10.1007/s00586-025-08812-1 . |
| [24] | XIE Y H, DIAO Y X, WU D Y,et al. Immediate effects of high-intensity laser therapy for nonspecific neck pain: A double-blind randomized controlled trial[J]. Front Med(Lausanne), 2025,12:1550047.doi:10.3389/fmed.2025.1550047 . |
| [25] | 覃雅庆,刘俊峰,张文忠,等. 光生物调节疗法在口腔正畸中的现状与展望[J]. 实用医学杂志, 2023,39(7):919-922.doi:10.3969/j.issn.1006-5725.2023.07.023 . |
| [26] | INCE S, EYVAZ N, DüNDAR ü,et al. Clinical Efficiency of High-Intensity Laser Therapy in Patients With Cervical Radiculopathy: A 12-Week Follow-up, Randomized, Placebo-Controlled Trial[J]. Am J Phys Med Rehabil, 2024,103(1):3-12.doi: 10.1097/PHM.0000000000002275 . |
| [27] | ABBOTT R, ELLIOTT J, MURPHEY T,et al. The role of the deep cervical extensor muscles in multi-directional isometric neck strength[J]. J Biomech, 2024,168:112096.doi: 10.1016/j.jbiomech.2024.112096 . |
| [28] | KAUB L, SCHMITZ C. Comparison of the Penetration Depth of 905 nm and 1064 nm Laser Light in Surface Layers of Biological Tissue Ex Vivo[J]. Biomedicines, 2023,11(5):1355. doi:10.3390/biomedicines11051355 . |
/
| 〈 |
|
〉 |