盆腔肌筋膜疼痛介入治疗的综述

A. Lin, Hadeer Abbas, M. Sultan, Tony H Tzeng
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引用次数: 0

摘要

慢性骨盆疼痛影响6%至25%的女性。这是一种具有多因素病因的复杂疾病,包括但不限于妇科、泌尿系统、胃肠道、肌肉骨骼系统、神经系统和心理系统引起的疾病。在这篇文献综述中,我们检查并总结了介入治疗与保守治疗女性肌肉骨骼或肌筋膜骨盆疼痛的证据。检索在PubMed和Embase数据库中进行。如果研究是随机对照试验,包括物理治疗、干针、触发点注射(TPI)或肉毒杆菌毒素注射。共有106项研究与我们的搜索词一起返回,本综述中包括6篇文章。这些研究表明,盆底物理疗法、腹壁触发点的干刺以及腹壁和盆底触发点的TPI有一些证据表明对治疗骨盆疼痛是有效的。与其他干预措施相比,肉毒杆菌毒素治疗的证据并不充分,不良事件发生率也更高。这些研究中的大多数都受到小样本量和不同基线人口统计数据的限制,这使得很难将这些发现推广到不同的患者群体。一般来说,治疗肌筋膜性骨盆疼痛的风险较低,并且能有效减轻肌筋膜性盆腔疼痛。
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A critical review of interventional treatments for myofascial pelvic pain
Chronic pelvic pain affects between 6% and 25% of women. It is a complex condition that has multifactorial etiologies, including but not limited to conditions arising from the gynecologic, urologic, gastrointestinal, musculoskeletal, neurologic, and psychologic systems. In this literature review, we examine and summarize evidence for interventional treatments compared to conservative treatments for women with musculoskeletal or myofascial pelvic pain. Searches were performed in PubMed and Embase databases. Studies were included if they were randomized controlled trials with a treatment arm of physical therapy, dry needling, trigger point injection (TPI), or injection with botulinum toxin. A total of 106 studies were returned with our search terms, and six articles were included in this review. These studies suggest that pelvic floor physical therapy, dry needling of abdominal wall trigger points, and TPI to abdominal wall and pelvic floor trigger points have some evidence as being effective for treatment of pelvic pain. The evidence for treatment with botulinum toxin was not as robust and also had higher rates of adverse events when compared to other interventions. Most of these studies are limited by small sample sizes and varied baseline demographics, which makes generalization of these findings to different patient populations difficult. In general, treatments for myofascial pelvic pain are low-risk and are effective in reducing myofascial pelvic pain.
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