表面肌电信号评估神经松动术治疗神经根型颈椎病效果的应用  

Application of surface electromyography to evaluate the efficacy of nerve mobilization in the treatment of cervical radiculopathy

作　　者：施少云[1] 叶国标 方倩颖 梁杰[1] 陈婧姈 卢惠苹[1] Shi Shaoyun;Ye Guobiao;Fang Qianying;Liang Jie;Chen Jingling;Lu Huiping(Department of Rehabilitation Medicine,Fuzhou Second Hospital,Fujian Province,350007,China)

机构地区：[1]福州市第二医院康复医学科,福建省350007

出　　处：《现代电生理学杂志》2021年第3期159-163,共5页Journal of Modern Electrophysiology

基　　金：福州市科技计划项目(2019-S-75)。

摘　　要：目的:探讨表面肌电信号评估神经松动术对神经根型颈椎病治疗效果的应用。方法:选取福州市第二医院康复医学科2019年3月至2021年2月收治的神经根型颈椎病患者80例,性别不限,年龄18~70岁,采用随机数字表法分为对照组与观察组,各40例。对照组采取常规牵引及针刺治疗,观察组在常规牵引及针刺治疗的基础上,根据疼痛的不同位置,采取不同的神经松动术治疗。采用颈椎病临床评价量表(CASCS)及视觉模拟评分(VAS)评价患者症状改善程度及疼痛程度,并对其尺侧屈腕肌、尺侧伸腕肌进行表面肌电图检查,比较两组积分肌电值(IEMG)、均方根值(RMS)、中位频率值(MF)。结果:治疗后两组CASCS量表各项评分及总分均升高(P<0.05),观察组各项评分及总分较对照组更高(P<0.05)。治疗后两组IEMG、RMS、MF水平明显升高(P<0.05),观察组IEMG、RMS、MF水平较对照组更高(P<0.05)。治疗后2周、4周,观察组VAS评分明显低于对照组(P<0.05)。结论:表面肌电信号应用在神经松动术治疗神经根型颈椎病的效果评估中,能准确反映肌肉功能的改善情况,对于临床诊断和疗效评价有着不可替代的作用。Objective: To investigate the application of surface electromyography to evaluate the efficacy of nerve mobilization in the treatment of cervical radiculopathy. Methods: Eighty patients with cervical radiculopathy in Fuzhou Second Hospital from March 2019 to February 2021, both of sexes, 18-70 years old, were randomly divided into control group and observation group, with 40 cases in each group. Patients was treated with conventional traction and acupuncture in the control group, with different nerve mobilization according to different pain positions on the basis of conventional traction and acupuncture in the observation group. Clinical assessment scale for cervical spondylosis(CASCS) and visual analogue scale(VAS) were used to evaluate the degree of symptom improvement and pain, and surface electromyography was performed on flexor carpi ulnaris and extensor carpi ulnaris. The integral electromyography(IEMG), root mean square(RMS) and median frequency(MF) of the two groups were compared. Results: After the treatment, the scores of each item and total score of CASCS in the two groups were increased(P<0.05), and the scores in the observation group were higher than those in the control group(P<0.05). After the treatment, the levels of IEMG, RMS and MF in the two groups increased significantly(P<0.05), more obviously in the observation group(P<0.05). After 2 and 4 weeks of treatment, the VAS in the observation group was significantly lower than that in the control group(P<0.05). Conclusion: The application of surface electromyography signals in the evaluation of the effects of nerve mobilization in the treatment of cervical radiculopathy can accurately reflect the improvement of muscle function, which plays an irreplaceable role in clinical diagnosis and curative effect evaluation.

关 键 词：肌电描记术 颈椎骨 椎间盘移位 神经根病 神经松动术 

分 类 号：R687.3[医药卫生—骨科学]