International Consensus on Diagnostic Criteria and Clinical Considerations of Myofascial Trigger Points: A Delphi Study-猫眼课题宝

DOI：

10.1093/pm/pnx207

发表时间：

2018-01-01

期刊：

PAIN MEDICINE

影响因子：

3.1

通讯作者：

中科院分区：

医学3区

文献类型：

--

作者：

Fernandez-de-las-Penas, Cesar;Dommerholt, Jan

Objective.对于诊断触发点（TrP）的基本诊断标准尚未达成共识。事实上，目前正在使用各种诊断标准。我们的目的是进行一个德尔菲小组，以实现一个国际共识的集群标准需要的TrP诊断达成共识的定义，积极和潜伏的TrPs和澄清不同的临床考虑有关TrPs.Methods。根据国际准则，进行了三轮国际德尔菲调查。根据TrPs.Results.诊断标准的系统文献检索创建问题。来自12个国家的60名专家完成了所有各轮调查。一组三个诊断标准被认为是必不可少的TrP诊断：一个拉紧带，一个过敏点，并涉及疼痛。80%的专家同意，由TrP引起的牵涉痛可以包括不同的感觉，而不仅仅是疼痛，即疼痛扩散到远处，深度疼痛，钝痛，刺痛或烧灼痛。84%的国际专家一致回答说，活动性和潜伏性TrPs之间的主要临床差异是患者经历的任何症状的再现和对疼痛的识别。疼痛参考区和TrP的位置没有特定的位置。这个德尔菲小组已经产生了一个基于专家的标准化定义的TrP与临床组成部分的讨论，包括涉及疼痛的定义和活动性和潜伏性TrP之间的差异，从而为未来的研究在MPS的基础。

Objective. There is no consensus on the essential diagnostic criteria for diagnosing a trigger point (TrP). In fact, a variety of diagnostic criteria are currently being used. Our aim was to conduct a Delphi panel to achieve an international consensus on the cluster of criteria needed for the TrP diagnosis to reach a consensus on the definition of active and latent TrPs and to clarify different clinical considerations about TrPs.Methods. Following international guidelines, an international three-round Delphi survey was conducted. Questions were created based on a systematic literature search of the diagnostic criteria for TrPs.Results. Sixty experts from 12 countries completed all rounds of the survey. A cluster of three diagnostic criteria was proposed as essential for the TrP diagnosis: a taut band, a hypersensitive spot, and referred pain. Eighty percent of the experts agreed that the referred pain elicited by a TrP can include different sensory sensations and not just pain, that is, pain spreading to a distant area, deep pain, dull ache, tingling, or burning pain. Eighty-four percent of the international experts consistently answered that the main clinical differences between active and latent TrPs are the reproduction of any of the symptoms experienced by a patient and the recognition of pain. No specific location of the pain referral area and TrP location should be expected.Conclusions. This Delphi panel has produced an expert-based standardized definition of a TrP with a discussion of the clinical components, including the definition of referred pain and the difference between active and latent TrPs, thereby providing a foundation for future research in MPS.