针刀治疗腰肌劳损前后MR影像变化  

Changes in MR images before and after acupuncture for lumbar muscle strain

作　　者：宋侠 吴芳 崔龙慷 樊树峰 郦妙尔 吴连国 SONG Xia;WU Fang;CUI Longkang;FAN Shufeng;LI Miao'er;WU Lianguo(Department of Radiology,the Second Affiliated Hospital of Zhejiang Chinese Medical University,Zhejiang,Hangzhou 310005,China;Department of Orthopaedics,the Second Affiliated Hospital of Zhejiang Chinese Medical University,Zhejiang,Hangzhou 310005,China)

机构地区：[1]浙江中医药大学附属第二医院放射科,浙江杭州310005 [2]浙江中医药大学附属第二医院骨科,浙江杭州310005

出　　处：《中国现代医生》2022年第35期5-9,共5页China Modern Doctor

基　　金：浙江省中医药科学研究基金项目(2021ZA072);国家中医临床研究基地支撑学科建设计划(2020-JDXK-ZC01)。

摘　　要：目的通过对比腰肌劳损磁共振(magnetic resonance,MR)表现阳性患者针刀治疗前后的影像表现,探讨针刀治疗腰肌劳损的效果。方法选取2020年9月至2021年11月浙江中医药大学附属第二医院收治的MR表现阳性的腰肌劳损患者52例进行回顾性研究。患者全部通过针刀治疗,选取压痛点的3~4点治疗,每周1次,连续3周。疗程结束后1个月复查磁共振,对治疗前后的MR表现[关节周围积液、椎旁肌水肿、浅筋膜水肿、棘间韧带水肿,肌肉(双侧多裂肌、竖脊肌)间隙脂肪浸润]进行比较。结果治疗后,关节周围积液7例、椎旁肌水肿5例、浅筋膜水肿3例、棘间韧带水肿8例,阳性率均低于治疗前,差异均有统计学意义(P<0.05)。肌肉间隙脂肪浸润程度较治疗前无下降,左右侧多裂肌、左右侧竖脊肌比较,差异无统计学意义(P>0.05)。治疗前后椎旁肌肌脂分数(muscle lipid fraction,MLF)、左右侧多裂肌、左右侧竖脊肌比较,差异无统计学意义(P>0.05)。结论MR检查对腰肌劳损患者的诊断、针刀治疗后的评估有重要指导作用。肌肉间隙脂肪异常浸润是否可逆需要更多样本、纵向研究方法加以证实。Objective To disscuss the effect of needle knife in the treatment of lumbar muscle strain by comparing the imaging performance before and after the treatment of needle knife in patients with positive magnetic resonance(MR)performance of lumbar muscle strain.Methods A total of 52 patients with positive MR manifestations of lumbar strain admitted to the Second Hospital of Zhejiang University of Chinese Medicine from September 2020 to November 2021 were selected for a retrospective study.Patients were all treated by acupuncture,selecting 3 to 4 points of the pressure pain points,once a week for 3 weeks.Magnetic resonance imaging was repeated 1 month after the course of treatment and MR manifestations[periarticular effusion,paravertebral muscle oedema,superficial fascial oedema,interspinous ligament oedema,and fatty infiltration in the interstitial spaces of the muscles(bilateral multifidus,erector spinae)]were compared before and after treatment.Results After treatment,there were 7 cases of periarticular effusion,5 cases of paravertebral muscle oedema,3 cases of superficial fascial oedema and 8 cases of interspinous ligament oedema,all of which had lower positive rates than before treatment,and the differences were statistically significant(P<0.05).There was no decrease in the degree of fat infiltration in the muscle interval compared with that before treatment,and the differences between the left and right lateral multifidus and the left and right lateral erector spinae muscles were not statistically significant(P>0.05).The difference in muscle lipid fraction(MLF)of the paravertebral muscles before and after treatment was not statistically significant(P>0.05)when comparing the right and left paravertebral muscles and the right and left paravertebral muscles.Conclusion MR examination is an important guide in the diagnosis of patients with lumbar strain and in the evaluation of patients after acupuncture treatment.Whether abnormal intermuscular fat infiltration is reversible needs to be confirmed by more sample-based

关 键 词：针刀治疗 腰肌劳损 磁共振 肌脂分数 

分 类 号：R445[医药卫生—影像医学与核医学] R685.4[医药卫生—诊断学]