Pelvic floor myofascial trigger points: Manual therapy for interstitial cystitis and the urgency-frequency syndrome
Pelvic floor myofascial trigger points: Manual therapy for interstitial cystitis and the urgency-frequency syndrome
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DOI：
10.1016/s0022-5347(05)65539-5
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发表时间：
2001-12-01
影响因子：
6.6
通讯作者：
Weiss, JM
中科院分区：
文献类型：
--
作者：
Weiss, JM
目的：评价手法理疗对间质性膀胱炎和尿路综合征患者的疗效，即有无盆腔疼痛的紧迫度频率。其基本原理是基于这样的假设：盆底肌肉筋膜触发点不仅是疼痛和排尿症状的来源，而且还通过逆向反射触发神经源性膀胱炎。材料和方法：1995年9月至2000年11月，45名女性和7名男性，包括10名间质性膀胱炎和42名紧急频率综合征患者，接受了盆底手动物理治疗，每周1~2次，连续8~12周。结果由患者完成的症状评分表确定，根据结果参数指示改善率，包括25%至50%-轻度、51%-75%-中度、76%-99%-显著和100%-完全消失。结果：42例伴有或不伴有疼痛的急频综合征患者中，35例(83%)好转或完全缓解；10例间质性膀胱炎患者中，7例(70%)好转。间质性膀胱炎和急频综合征患者治疗前的平均症状持续时间分别为14年(中位数12)和6年(中位数2.5)。在没有症状或短暂的低强度闪光的患者中，平均随访时间为1.5年。10例行肌电检查的患者静息盆底张力平均由9.73降至3.61，改善65%。结论：手法治疗盆底高张症能有效改善急频综合征和间质性膀胱炎的症状。
Purpose: The effectiveness of manual physical therapy was evaluated in patients with interstitial cystitis and the urethral syndrome, that is urgency-frequency with or without pelvic pain. The rationale was based on the hypothesis that pelvic floor myofascial trigger points are not only a source of pain and voiding symptoms, but also a trigger for neurogenic bladder inflammation via antidromic reflexes.Materials and Methods: From September 1995 to November 2000, 45 women and 7 men, including 10 with interstitial cystitis and 42 with the urgency-frequency syndrome, underwent manual physical therapy to the pelvic floor for 1 to 2 visits weekly for 8 to 12 weeks. Results were determined by patient completed symptom score sheets indicating the rate of improvement according to outcome parameters, including 25% to 50%-mild, 51% to 75%-moderate, 76% to 99%-marked and 100%-complete resolution. In 10 cases these subjective results were confirmed by measuring resting pelvic floor tension by electromyography before and after the treatment course.Results: Of the 42 patients with the urgency-frequency syndrome with or without pain 35 (83%) had moderate to marked improvement or complete resolution, while 7 of the 10 (70%) with interstitial cystitis had moderate to marked improvement. The mean duration of symptoms before treatment in those with interstitial cystitis and the urgency-frequency syndrome was 14 (median 12) and 6 years (median 2.5), respectively. In patients with no symptoms or brief, low intensity flares mean followup was 1.5 years. In 10 patients who underwent electromyography mean resting pelvic floor tension decreased from 9.73 to 3.61 muV., which was a 65% improvement.Conclusions: Pelvic floor manual therapy for decreasing pelvic floor hypertonus effectively ameliorates the symptoms of the urgency/frequency syndrome and interstitial cystitis.