剪切波弹性成像在针灸治疗肩胛间区肌筋膜疼痛综合征中的应用价值  

Application value of shear wave elastography in the treatment of myofascial pain syndrome in the interscapular region by acupuncture and moxibustion

作　　者：吴兰英 刘勇 苗瑞恒 周玮珺 徐平 杨敏 WU Lanying;LIU Yong;MIAO Ruiheng;ZHOU Weijun;XU Ping;YANG Min(Department of Ultrasound,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院超声科,北京市100038

出　　处：《临床超声医学杂志》2023年第8期609-612,共4页Journal of Clinical Ultrasound in Medicine

基　　金：校局级科研课题项目(PZ2019007)。

摘　　要：目的 探讨剪切波弹性成像(SWE)在针灸治疗肩胛间区肌筋膜疼痛综合征(MPS)中的应用价值。方法 前瞻性收集于我院接受针灸治疗的肩胛间区MPS患者39例,其中针对肩胛间区疼痛区域行针灸治疗15例(局部对症治疗组),针对颈部肩胛背神经走行区行针灸治疗24例(颈部肩胛背神经治疗组),均每周治疗3次,连续治疗2周,应用视觉模拟(VAS)评分评估其临床疗效,并计算总有效率;应用SWE测量治疗前后菱形肌内、外侧筋膜杨氏模量平均值(Emean),比较两组治疗前、后Emean及总有效率。结果 局部对症治疗组和颈部肩胛背神经治疗组治疗后VAS评分均较治疗前明显下降,总有效率为92.3%(36/39),其中痊愈8例,显效22例,有效6例,无效3例,局部对症治疗组总有效率为80.0%(12/15),颈部肩胛背神经治疗组总有效率为100%(24/24),两组总有效率比较差异有统计学意义(P<0.05)。治疗前,局部对症治疗组菱形肌内、外侧筋膜Emean分别为21.09(18.31,32.33)kPa、28.82(18.42,36.49)kPa,颈部肩胛背神经治疗组菱形肌内、外侧筋膜Emean分别为23.46(18.16,29.89)kPa、27.33(16.05,40.42)kPa;两组治疗前菱形肌内、外侧筋膜Emean比较差异均无统计学意义。治疗后,局部对症治疗组菱形肌内、外侧筋膜Emean分别为16.57(14.53,22.32)kPa、19.47(10.92,23.14)kPa,颈部肩胛背神经治疗组菱形肌内、外侧筋膜Emean分别为18.90(12.79,23.93)kPa、20.49(11.78,25.87)kPa;两组治疗后菱形肌内、外侧筋膜Emean均较治疗前降低,差异均有统计学意义(均P<0.05);两组治疗后菱形肌内、外侧筋膜Emean比较差异均无统计学意义。结论 SWE可以定量评估针灸治疗肩胛间区MPS疗效,为肩胛间区MPS的病因分析提供影像学依据。ObjectiveTo explore the application value of shear wave elastography(SWE) in the treatment of myofascial pain syndrome(MPS)in the interscapular region by acupuncture and moxibustion.MethodsA total of 39 patients with MPS in the interscapular region treated in our hospital were prospectively collected.Among them,15 patients were randomly included in the local symptomatic treatment group(acupuncture and moxibustion treatment for the interscapular region pain area),while 24 patients were in the cervical dorsal scapular nerve treatment group(acupuncture and moxibustion treatment for the cervical dorsal scapular nerve walking area),and acupuncture and moxibustion treatment was performed three times a week for two consecutive weeks.The visual analogue scale(VAS)score was used to evaluate the clinical effect,and total effective rate was calculated.The mean of Young's modulus(Emean)of the medial and lateral fasciae of the rhomboid muscles before and after treatment were measured by SWE.The Emean and total effective rate before and after treatment between the two groups were compared.ResultsCompared with before treatment,the VAS score in the local symptomatic treatment group and the cervical dorsal scapular nerve treatment group were significantly decreased after treatment,the total effective rate was 92.3%(36/39),including 8 cases of cured,22 cases of significantly effective,6 cases of effective,and 3 cases of ineffective.Moreover,total effective rate were 80.0%(12/15)and 100%(24/24)in the local symptomatic treatment group and cervical dorsal scapular nerve treatment group,there was significant difference(P<0.05).Before treatment,the Emean of the medial and lateral fasciae of the rhomboid muscles were 21.09(18.31,32.33)kPa and 28.82(18.42,36.49)kPa in the local symptomatic treatment group,and23.46(18.16,29.89)kPa and 27.33(16.05,40.42)kPa in the cervical dorsal scapular nerve treatment group,respectively.There were no significant differences between the two groups in the comparison of Emean in the medial and lateral fasc

关 键 词：剪切波弹性成像 肌筋膜疼痛综合征 针灸治疗 

分 类 号：R445.1[医药卫生—影像医学与核医学]