湖南中医药大学学报2026，Vol.46Issue(5)：932-938,7.DOI:10.3969/j.issn.1674-070X.2026.05.008
基于Toll样受体信号通路探讨筋骨通脉汤联合肌肉能量技术对颈肩肌筋膜疼痛综合征的治疗作用
Therapeutic effects of Jingu Tongmai Decoction combined with muscle energy technique on neck and shoulder myofascial pain syndrome based on Toll-like receptor signaling pathway
摘要
Abstract
Objective To investigate the therapeutic effects of Jingu Tongmai Decoction(JGTMD)combined with muscle energy technique on neck and shoulder myofascial pain syndrome(MPS)based on the Toll-like receptor(TLR)signaling pathway.Methods A total of 150 patients with MPS admitted to the Fourth People's Hospital of Zigong,Sichuan Province from June 2021 to December 2024 were enrolled and randomly divided into control group and observation group,with 75 cases in each group.The control group was treated with muscle energy technique,and the observation group received Jingu Tongmai Decoction combined with muscle energy technique.Both groups were treated for 4 weeks.Clinical efficacy,visual analogue scale(VAS)score,cervical range of motion(CROM)score,neck disability index(NDI)score,inflammatory factors including TLR4,TLR9,myeloid differentiation factor 88(MyD88),nuclear factor-κB(NF-κB),interleukin(IL)-6,IL-1β,and tumor necrosis factor-α(TNF-α),pain mediators including 5-hydroxytryptamine(5-HT),β-endorphin(β-EP),and prostaglandin E2(PGE2),as well as safety were compared between the two groups before and after treatment.Results The total effective rate in the observation group was 93.33％,which was higher than 76.00％in the control group(P<0.01).After treatment,compared with the control group,the observation group showed increased CROM scores and decreased NDI and VAS scores(P<0.01).Serum β-EP levels in the observation group were higher than those in the control group,and the levels of IL-1β,TLR4,5-HT,PGE2,TLR9,TNF-α,MyD88,IL-6 and NF-κB were lower than those in the control group(P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Jingu Tongmai Decoction combined with muscle energy technique is effective and safe in the treatment of neck and shoulder MPS.It can regulate the expression levels of factors related to the TLR signaling pathway and inhibit the secretion of pain mediators,thus alleviating pain and improving neck and shoulder function.关键词
颈肩/肌筋膜疼痛综合征/筋骨通脉汤/肌肉能量技术/Toll样受体信号通路/疼痛Key words
neck and shoulder/myofascial pain syndrome/Jingu Tongmai Decoction/muscle energy technique/Toll-like receptor signaling pathway/pain分类
医药卫生引用本文复制引用
李富红,张杰,林霞,王翔奕..基于Toll样受体信号通路探讨筋骨通脉汤联合肌肉能量技术对颈肩肌筋膜疼痛综合征的治疗作用[J].湖南中医药大学学报,2026,46(5):932-938,7.基金项目
2023 年四川省医学卫生健康科研课题(23PJ293). （23PJ293）
