| Objective:1.Clinical Research:Exploring the short-term, medium and long term efficacy and treatment efficiency for the patients with myofascial syndrome of the neck by drug injection therapy.2.Basic Research:Exploring the trigger points’pathomorphology of the patients with myofascial pain syndrome and the expression or not of EphrinB2ligand, and then speculated the relationship between Eph/Ephrin signaling system and myofascial pain syndrome.Methods:1.Clinical Research:Selecting24cases of the patients with myofascial pain syndrome(MPS)of the neck, of which12males and12females, aged21-53years old, duration of2-10years. Demanding the patients to sit at his desk bit and checking the trigger points (TrPs) by acupressure. Disinfecting and drape. Diluting lml of limethason,1mg of vitamin B12and5ml of2%lidocaine to20ml with0.9%physiological saline and injecting the mixture into their symptomatic TrPs, about3-4ml.Observing and following up the visual analog scale of the local pain in the time before treatment and the time after treatment1st week,1st month and3rd month and comparing their treatment effects dynamically. Analyzing the clinical efficacy and calculating its treatment efficiency according to the suggest from Han Jisheng academicians of Chinese Pain Society with the amplitude of the change in pain VAS weighted value.2.Basic Research:After the examination and approbation by the Ethics Committee of Qilu Hospital of Shandong University and the consent of the patients, acquiring the biopsy specimens of the TrPs from the7patients.Fixing the biopsy specimens with4%paraformaldehyde, and embedding the biopsy specimens into paraffin. After the techniques of routine HE and immunohistochemical staining, observing its pathomorphology and the expression of EphrinB2ligand.Results:1.Clinical Research:Follow up all of the24cases of the patients with MPS of the neck, the scores of VAS in the time before treatment and the time after treatment1st week,1st month and3rd month respectively were7.38±1.11,4.12±1.40,3.47±1.04,3.12±0.95,the degree of tenderness in the time after treatment1st week,1st month and3rd month has eased significantly than before treatment (P<0.01),and the treatment efficiency respectively was83.3%,91.7%and95.8%,and the pain of neck, referred pain and associated symptoms patients complained of having eased significantly or even disappear in the time after treatment1st week,1st month and3rd month.2.Basic Research:The pathomorphology of the TrPs by HE staining technique displays mild inflammatory changes which can be seen around the blood vessels and between the muscle tissues,in which the monocyte-macrophage cells mainly and a small amount of red blood cells occasionally; part atrophic muscle fibers appear within the musule organization.The trigger point tissue after immunohistochemical technique can be seen EphrinB2ligand positive expression, mainly located in cytoplasm or membrane,the expression of muscle fibers are generally differences in intensity and distribution, which is in a high level in atrophic muscle fibers. In addition, the expression of EphrinB2ligand can be seen in vascular endothelial cells, but the staining intensity and distribution of parts is relatively consistent.Conclusion:1.Clinical Research:Drug injection therapy can eliminate or significantly alleviate the pain, referred pain and associated symptoms of MPS of the neck with the exact short-term, medium-and long-term efficacy and treatment efficiency, and this treatment method is simple and security,deserving further promote the implementation.2.Basic Research:The trigger point of MPS patients is changed inflammatory,with the positive expression of Eph/Ephrin signaling system,suggesting that the incidence of MPS is in relation to Eph/Ephrin signaling system.In addition,the expression of EphrinB2ligand in vascular endothelial cells supports most scholars’conclusions in the past about Eph/Ephrin signaling system which is involved in the development process of the physiologic or pathologic angiogenesis. |
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