| 引用本文: |
李富红, 张杰, 林霞, 王翔奕.基于Toll样受体信号通路探讨筋骨通脉汤联合肌肉能量技术对颈肩肌筋膜疼痛综合征的治疗作用[J].湖南中医药大学学报,2026,46(5):932-938[点击复制] |
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| 基于Toll样受体信号通路探讨筋骨通脉汤联合肌肉能量技术对颈肩肌筋膜疼痛综合征的治疗作用 |
| 李富红,张杰,林霞,王翔奕 |
| (四川省自贡市第四人民医院, 四川 自贡 643000) |
| 摘要: |
| 目的 基于Toll样受体（TLR）信号通路探讨筋骨通脉汤联合肌肉能量技术对颈肩肌筋膜疼痛综合征（MPS）的治疗作用。方法 选取2021年6月至2024年12月就诊于四川省自贡市第四人民医院的150例MPS患者，随机分为对照组及观察组，各75例。对照组予以肌肉能量技术治疗，观察组在对照组基础上联合筋骨通脉汤治疗。两组均连续治疗4周。评估两组临床疗效，比较两组治疗前后疼痛视觉模拟量表（VAS）评分、颈椎关节活动度（CROM）评分、颈部残障指数（NDI）评分、炎症因子[TLR4、TLR9、髓样分化因子88（MyD88）、核因子κB（NF-κB）、白细胞介素（IL）-6、IL-1β、肿瘤坏死因子-α（TNF-α）]水平、疼痛介质[5-羟色胺（5-HT）、β-内啡肽（β-EP）、前列腺素E2（PGE2）]水平及安全性。结果 观察组治疗总有效率为93.33%，高于对照组的76.00%（P＜0.01）。治疗后，与对照组比较，观察组CROM评分升高，NDI、VAS评分降低（P＜0.01）；观察组血清β-EP水平高于对照组，IL-1β、TLR4、5-HT、PGE2、TLR9、TNF-α、MyD88、IL-6、NF-κB水平低于对照组（P＜0.01）。两组不良反应发生率差异无统计学意义（P＞0.05）。结论 筋骨通脉汤联合肌肉能量技术治疗颈肩MPS患者具有良好的效果及安全性，可调控TLR信号通路相关因子表达水平，抑制疼痛介质的分泌，从而减轻患者疼痛感，促进颈肩功能好转。 |
| 关键词: 颈肩|肌筋膜疼痛综合征|筋骨通脉汤|肌肉能量技术|Toll样受体信号通路|疼痛 |
| DOI：10.3969/j.issn.1674-070X.2026.05.008 |
| 投稿时间：2025-11-19 |
| 基金项目:2023年四川省医学卫生健康科研课题（23PJ293）。 |
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| Therapeutic effects of Jingu Tongmai Decoction combined with muscle energy technique on neck and shoulder myofascial pain syndrome based on Toll-like receptor signaling pathway |
| LI Fuhong, ZHANG Jie, LIN Xia, WANG Xiangyi |
| (The Fourth People's Hospital of Zigong, Zigong, Sichuan 643000, China) |
| Abstract: |
| Objective To investigate the therapeutic effects of Jingu Tongmai Decoction (JGTMD) combined with muscle energy technique on neck and shoulder myofascial pain syndrome (MPS) based on the Toll-like receptor (TLR) signaling pathway. Methods A total of 150 patients with MPS admitted to the Fourth People's Hospital of Zigong, Sichuan Province from June 2021 to December 2024 were enrolled and randomly divided into control group and observation group, with 75 cases in each group. The control group was treated with muscle energy technique, and the observation group received Jingu Tongmai Decoction combined with muscle energy technique. Both groups were treated for 4 weeks. Clinical efficacy, visual analogue scale (VAS) score, cervical range of motion (CROM) score, neck disability index (NDI) score, inflammatory factors including TLR4, TLR9, myeloid differentiation factor 88 (MyD88), nuclear factor-κB (NF-κB), interleukin (IL)-6, IL-1β, and tumor necrosis factor-α (TNF-α), pain mediators including 5-hydroxytryptamine (5-HT), β-endorphin (β-EP), and prostaglandin E2 (PGE2), as well as safety were compared between the two groups before and after treatment. Results The total effective rate in the observation group was 93.33%, which was higher than 76.00% in the control group (P<0.01). After treatment, compared with the control group, the observation group showed increased CROM scores and decreased NDI and VAS scores (P<0.01). Serum β-EP levels in the observation group were higher than those in the control group, and the levels of IL-1β, TLR4, 5-HT, PGE2, TLR9, TNF-α, MyD88, IL-6 and NF-κB were lower than those in the control group (P<0.01). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Jingu Tongmai Decoction combined with muscle energy technique is effective and safe in the treatment of neck and shoulder MPS. It can regulate the expression levels of factors related to the TLR signaling pathway and inhibit the secretion of pain mediators, thus alleviating pain and improving neck and shoulder function. |
| Key words: neck and shoulder|myofascial pain syndrome|Jingu Tongmai Decoction|muscle energy technique|Toll-like receptor signaling pathway|pain |
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