超声引导下埋线治疗颈椎病的有效层次研究  

Effective anatomic structures of ultrasound-guide acupoint embedding therapy for cervical spondylosis

作　　者：孙文善[1] 楚宁宁[1] 马伊磊[1] 王余民[1] 王虹[1] 姜国芳[1] 

机构地区：[1]复旦大学附属上海市第五人民医院中医科,上海200240

出　　处：《中国针灸》2015年第10期1001-1004,共4页Chinese Acupuncture & Moxibustion

基　　金：上海市卫生局科研基金资助项目:20124077

摘　　要：目的:探讨微创埋线治疗颈椎病疗效与埋线材料植入层次深度的关系。方法:选择90例神经根型颈椎病患者,随机分为浅层埋线组(皮下)、中层埋线组(头半棘肌)和深层埋线组(多裂肌层)3组,每组30例,选择患侧C5、C6夹脊穴、大椎穴,在超声引导下进行埋线治疗,分别将材料植入相应的组织层次,3组均每周治疗1次,连续治疗3周,观察治疗前后的症状和体征变化,并进行麦-吉尔疼痛问卷(包括疼痛分级指数(PRI)、视觉模拟评分(VAS)和现有疼痛程度(PPI))和颈椎功能障碍指数(NDI)评定。结果:深层埋线组治疗后症状与功能评分较治疗前明显升高(P<0.05),深层埋线组治疗后症状与功能评分较浅、中层埋线组明显升高(均P<0.05);治疗后深层、中层埋线组PRI、VAS和PPI较治疗前明显降低(均P<0.05),深层、中层埋线组较浅层埋线组降低更明显(均P<0.05);治疗后深层埋线组、中层埋线组NDI评分均较治疗前明显降低(均P<0.05);深层埋线组治疗后较浅、中层埋线组降低更明显(均P<0.05)。结论:在神经根型颈椎病埋线治疗时,不同深度的埋线其疗效有明显差异,深层埋线即在多裂肌层次埋线更有利于颈椎病治疗。Objective To explore the relationship between the therapeutic effect of minimally invasive embedding therapy and the implanted depth for cervical spondylosis.Methods Ninety patients of cervical spondylosis of nerve root type were randomized into a shallow-layer embedding group（subcutaneous layer）,a middle-layer embedding group（semispinalis capitis muscle layer）and a deep-layer embedding group（multifidus muscle layer）,30 cases in each one.Jiaji（EX-B 2）of C5 and C6on the affected side and Dazhui（GV 14）were selected.Under the guide of ultrasound,the catgut was implanted to the corresponding tissue layers.The treatment was given once a week,continuously for 3weeks in the three groups.The symptoms and physical signs were observed before and after treatment.The pain rating index（PRI）,visual analogue scale（VAS）and present pain index（PPI）were assessed.The neck disability index（NDI）was compared.Results The score of symptoms and function after treatment was increased apparently in the deep-layer embedding group（P〈0.05）,which was increased more apparently as compared with those in the shallow-layer embedding group and the middle-layer embedding group（both P〈0.05）.PRI,VAS and PPI after treatment were all reduced apparently as compared with those before treatment in the deep-layer embedding group and the middle-layer embedding group（all P〈0.05）,which were reduced more remarkably than the shallow-layer embedding group（all P〈0.05）.After treatment,the scores of NDI in the deep-layer embedding group and the middle-layer embedding group were reduced apparently as compared with those before treatment（both P〈0.05）,and that in the deep-layer embedding group was reduced more remarkably as compared with the shallow-layer embedding group and the middle-layer embedding group after treatment（both P〈0.05）.Conclusion In the acupoint embedding treatment of cervical spondylosis of nerve root type,the efficacy is different apparently in terms of the implantation depth.The

关 键 词：颈椎病 超声引导 埋线疗法 埋线深度 

分 类 号：R246.2[医药卫生—针灸推拿学]