目的 探讨盆底筋膜痛综合征的临床评估体系,以及手法按摩结合生物反馈治疗盆底筋膜痛综合征的疗效.方法 前瞻性分析2015年12月至2017年7月在北京协和医院诊断盆底肌筋膜痛综合征的17例患者,对比该组患者治疗前后主观疼痛的视觉模拟评分(VAS)、盆底肌肉压痛VAS评分以及盆底表面肌电测量指标的变化情况.结果 17例患者中位年龄51岁(24～65岁),病程时间2年(8个月至6年).治疗前后疼痛感觉的VAS评分分别为(7.9± 1.5)分和(3.6±1.6)分,治疗前后盆底肌筋膜压痛VAS评分分别为(8.2±1.7)分和(3.8±2.0)分,均有明显下降(P＜0.05).配对样本t 检验提示治疗后静息电位值明显下降,前、后静息电位差值分别为(5.45,95％CI 3.04～7.86,P＜0.01)和 (3.94,95％CI 1.43～6.46,P=0.004).结论 手法按摩结合生物反馈技术是治疗盆底肌筋膜痛的有效方法.%Objective To evaluate the clinical assessment system and the effectiveness of transvaginal manual therapy combined with biofeedback treatment for the female myofascial pelvic pain syndrome.Methods A total of 17 women with documented myofascial pelvic pain syndrome were enrolled in Peking Union Medical College Hospital from December,2015 to July,2017.The response to treatment was evaluated through the Visual Analogue Scales for self-perceived pain,pelvic floor tenderness in the physical examination and the parameters of surface electromyography by Glazers protocol.Results The median age of patients was 51yrs(range 24-65 years),and the duration was 2 yrs(range 8 months-6 years).A statistically significant improvement was seen in the Visual Analogue Scales of both self-perceived pain[(7.9± 1.5)vs.(3.6±1.6)]and pelvic floor tenderness[(8.2±1.7)vs.(3.8±2.0)](P＜0.05).Paired sample t test showed that after treatment,there was significant decrease in resting tone of pelvic floor muscle,with pre-resting baseline being(5.45,95％ CI 3.04-7.86,P＜0.01)and post-resting baseline being(3.94,95％CI 1.43-6.46,P=0.004)respectively.Conclusion Manual massage combined with biofeedback treatment is effective in relieving pain in patients with myofacial pelvic pain syndrome.
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