大椎穴浅筋膜厚度与颈椎病的相关性研究  

Study on the correlation between the thickness of superficial fascia at Dazhui(GV14) and cervical spondylosis

作　　者：王宁 牛茹[1,2] 常斯宇 孙超 贾海鹏[3] 岳公雷[2] 杜广中[2] WANG Ning;NIU Ru;CHANG Si-yu;SUN Chao;JIA Hai-peng;YUE Gong-lei;DU Guang-zhong(College of Acupuncture-Moxibustion and Tuina,Shandong University of Traditional Chinese Medicine,Jinan 250355;Department of Acupuncture-Moxibustion and Tuina,Qilu Hospital of Shandong University,Jinan 250012;Department of Radiology,Qilu Hospital of Shandong University,Jinan 250012)

机构地区：[1]山东中医药大学针灸推拿学院,济南250355 [2]山东大学齐鲁医院针灸推拿科,济南250012 [3]山东大学齐鲁医院放射科,济南250012

出　　处：《针刺研究》2023年第4期399-403,共5页Acupuncture Research

摘　　要：目的:观察大椎穴浅筋膜厚度与颈椎病的相关性,探讨其腧穴敏化形态结构改变的实质。方法:采用回顾性研究,将344例颈椎磁共振成像(MRI)检查者依照《颈椎病诊治与康复指南》(2017年)诊断标准分为对照组73例与观察组271例,对照组为健康人群,观察组为符合诊断标准的颈椎病患者,包括颈型颈椎病、神经根型颈椎病、脊髓型颈椎病、椎动脉型颈椎病、交感型颈椎病5种类型。根据颈椎MRI图像,测量大椎穴皮肤、浅筋膜层和腱膜韧带层厚度。结果:观察组大椎穴深度为(56.6±8.8)mm、浅筋膜厚度为(22.8±7.6)mm,对照组大椎穴深度为(49.8±7.0)mm、浅筋膜厚度为(16.6±6.6)mm,观察组明显大于对照组(P<0.01)。观察组中脊髓型颈椎病、颈型颈椎病和神经根型颈椎病大椎穴浅筋膜厚度依次为(23.8±8.1)mm、(23.0±7.3)mm和(22.6±6.5)mm,大椎穴深度依次为(58.7±8.8)mm、(56.2±9.1)mm和(55.8±6.4)mm,均较对照组的大椎穴浅筋膜厚度和大椎穴深度明显增加(P<0.01)。观察组中脊髓型颈椎病的大椎穴浅筋膜厚度较交感型颈椎病(17.8±8.1)mm和椎动脉型颈椎病(19.9±5.9)mm明显增厚(P<0.01,P<0.05);与脊髓型颈椎病相比,颈型颈椎病、神经根型颈椎病、交感型颈椎病和椎动脉型颈椎病患者大椎穴穴位深度较薄(P<0.05,P<0.01);与交感型颈椎病相比,颈型颈椎病和神经根型颈椎病患者大椎穴穴位深度明显增厚(P<0.01)。结论:大椎穴浅筋膜厚度与颈椎病有相关性,且与颈椎病分型中脊髓型、颈型和神经根型颈椎病相关。颈椎病状态下大椎穴腧穴敏化的形态结构改变主要为浅筋膜增厚。Objective To observe the correlation between the thickness of superficial fascia at Dazhui(GV14) acupoint and cervical spondylosis,so as to explore the essence of its morphological and structural changes of acupoint sensitivity.Methods A retrospective study was conducted.According to the diagnostic criteria of “Guidelines for Diagnosis,Treatment and Rehabilitation of Cervical Spondylosis”(2017),344 cases of cervical spine magnetic resonance imaging(MRI) examination were included and divided into control group(73 cases) and observation group(271 cases).The control group was healthy population,and the observation group was patients with cervical spondylosis conforming to the diagnostic criteria,including cervical spondylosis of neck type,cervical spondylosis radiculopathy,cervical spondylotic myelopathy,cervical spondylosis of vertebral artery type,and sympathetic cervical spondylosis.According to MRI images of cervical spine,the structure of GV14 acupoint including skin,superficial fascia layer and aponeurosis ligament layer were measured.Results The acupoint depth and the superficial fascia thickness at GV14 in the observation group were(56.6±8.8) mm and(22.8±7.6) mm,the acupoint depth and the superficial fascia thickness at GV14 were(49.8±7.0) mm and(16.6±6.6)mm in the control group,which were significantly greater in the observation group than in the control group(P<0.01).The superficial fascia thickness at GV14 of cervical spondylotic mye-lopathy,cervical spondylosis of neck type and cervical spondylosis radiculopathy in the observation group was(23.8±8.1)mm,(23.0±7.3)mm and(22.6±6.5)mm,the acupoint depth of GV14 was(58.7±8.8)mm,(56.2±9.1)mm and(55.8±6.4)mm,which were significantly thicker than the superficial fascia thickness and the acupoint depth in the control group(P<0.01).In the observation group,the superficial fascia thickness of GV14 of cervical spondylosis myelopathy was significantly thicker than those of sympathetic cervical spondylosis(17.8±8.1) mm and cervical spondylosis of verteb

关 键 词：腧穴敏化 大椎穴 颈椎病 磁共振成像 回顾性研究 

分 类 号：R245.2[医药卫生—针灸推拿学]