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女性肌筋膜盆腔疼痛综合征的治疗

Authors
Leah K Moynihan, RNC, MSN
Eman Elkadry, MD, FACOG
Section Editor
Linda Brubaker, MD, FACOG
Deputy Editor
Kristen Eckler, MD, FACOG
Translators
陈正琼, 副主任医师，副教授

引言

肌筋膜盆腔疼痛综合征(myofascial pelvic pain syndrome, MPPS)的治疗方法具有多种模式，并需针对不同患者采取个体化的治疗方案。一般治疗方法是确定导致疼痛的触发点，阻止并减少引起疼痛的持续刺激。大多数女性患者需要一个正规化的治疗程序，包括药物治疗、物理治疗及心理治疗[1]。

本专题将讨论MPPS的治疗。目前鲜有大型随机试验对本病的治疗进行了评价。我们的方法根据的是来自几项小型试验和观察性研究的数据，以及临床经验。这些研究中有许多评估了非骨盆肌筋膜疼痛的治疗，例如与背、颈、肩及颌相关的肌筋膜疼痛的治疗。关于疼痛治疗的观察性研究存在一个局限性，即患者症状的改善可能因为真正的治疗效果，或因为疾病的自然病程包括症状随着时间而改善，或由于霍索恩效应(即，患者症状改善只因患者在临床试验中)[2]。

MPPS的临床表现和诊断见其他专题。 (参见“女性骨盆肌筋膜疼痛综合征的临床表现和诊断”)

辅助治疗

由于鉴别并消除一个特定的触发点可能不太可能，所以旨在缓解症状的辅助治疗在打破止痛与泌尿生殖功能障碍方面的循环方面也是很重要的。一些简单的干预措施，例如冥想、渐进式肌肉放松及注意睡眠卫生，可有助于缓解身心紧张。

盆底理疗

MPPS的主要治疗包括通过盆底理疗(pelvic floor physical therapy, PFPT)手法放松肌筋膜、拉伸及强化受累区域。理想情况下，PEPT应由受过软组织推拿与骨盆康复专业培训的理疗师进行。 (参见“女性盆腔肌筋膜疼痛综合征的盆底物理治疗”)

                           

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Literature review current through: 2017-07 . | This topic last updated: 2017-05-22.
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