Therapeutic effect of duloxetine combined with ozone trigger point injection on fibromyalgia---A retrospective observational study
Authors: Chen Xiong , ZHOU Lizhi , Mu Jingping , LU Junti , XIE Jin , Wang Xi , Xie Xiaoyan , Pan Long , Chen Hongmei , LIU Lizhu , Ai Chunqi 
Published: October 2021

Abstract
ImportanceFibromyalgia (FM) is a common clinical chronic disease, mainly manifested as generalized chronic muscle pain and discomfort throughout the body, often accompanied by various emotional disorders such as depression, anxiety, cognitive impairment and sleep disorder, which seriously affects the quality of life of patients. However, there has not been adequately good treatment methods in clinically, so it is urgent to seek a better treatment method. In this study, duloxetine combined with ozone pain point injection was used to treat FM patients, and the clinical efficacy of the patients was observed.ObjectiveTo determine whether duloxetine combined with ozone pain point injection is safe and efficacious in the treatment of Fibromyalgia.MethodsAccording to the final treatment plan selection, the patients diagnosed with FM in the Pain Department of Shiyan Taihe Hospital, were selected from July 2017 to July 2020. After communication and written consent, 66 patients were injected with drugs and ozone pain point. Actually 60 cases finished the study procedure and follow-up. The age ranged from 22 to 57 years, and the course of the disease ranged from 2 to 8 years. In this study, a crossover design was adopted, and random number table method was used to enter the group. The patients were randomly divided into duloxetine group (group D), ozone injection group (group O) and duloxetine-ozone injection group (group D+O), with 20 patients in each group. Each group was given corresponding treatment. VAS, FIQ, PSQI and HAMD scales were used to evaluate and calculate the number of pain points, so as to observe and evaluate the clinical efficacy of patients.ResultsIn terms of pain, there was no significant difference among the groups before treatment. After 2 weeks and 4 weeks of treatment, the VAS scores in each group were significantly lower than before intervention (F=324.365 P < 0.05). The number of pain points in each group was significantly lower than before intervention, and the difference was statistically significant (F=514.046 P &lt; 0.05). It was observed that the analgesic effect of duloxetine combined with ozone pain point injection in the treatment of fibromyalgia was better than that of single therapy. There was no significant difference in quality of life among the groups before treatment. After 2 weeks and 4 weeks of treatment, the FIQ of each group was significantly lower than that before intervention, and the difference was statistically significant (F = 324.365, P<0.05). It was observed that duloxetine combined with ozone pain point injection for fibromyalgia significantly improved the quality of life of patients, especially in terms of improving sleep, compared with treatment alone. At the end of 4 weeks of treatment, HAMD scores for depressive symptoms were significantly lower in all 3 groups than before intervention (F=1079.961, P<0.05), and loxetine combined with ozone pain point injection for fibromyalgia had a more significant antidepressant effect (F=5.089, P <0.05).ConclusionThis study confirmed that duloxetine combined with ozone pain-point injection can effectively relieve pain in patients with FM, significantly improve the accompanying symptoms of sleep disorder and depression, and improve the quality of life of patients, which is worthy of clinical promotion.