基于肌骨超声观察经筋排针刺法治疗慢性非特异性腰背痛的临床疗效  

Observation the clinical efficacy of sinew row acupuncture in the treatment of chronic non-specific low back pain based on musculoskeletal ultrasound

作　　者：周立晨[1,2] 黄勇 张宁霞[1] 李美莺[1] 胡诚 张彬彬[1] 徐秋信 胡凡 张芳芳 刘桂珍[1] ZHOU Lichen;HUANG Yong;ZHANG Ningxia;LI Meiying;HU Cheng;ZHANG Binbin;XU Qiuxin;HU Fan;ZHANG Fangfang;LIU Guizhen(Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200062,China;Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属普陀医院,上海200062 [2]上海中医药大学,上海201203

出　　处：《上海针灸杂志》2024年第6期663-668,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：上海市普陀区中医临床重点专科建设项目(ptzyzk2110)。

摘　　要：目的基于肌骨超声观察经筋排针刺法治疗慢性非特异性腰背痛的临床疗效。方法将136例慢性非特异性腰背痛患者随机分为常规针刺组和经筋排刺组,每组68例。常规针刺组行常规针刺治疗,经筋排刺组行经筋排刺法治疗。观察两组治疗前后日本骨科协会评分(Japanese Orthopaedic Association scores,JOA)、Oswestry功能障碍指数(Oswestrydisability index,ODI)评分、疼痛视觉模拟量表(visualanalog scale,VAS)评分以及肌骨超声静息状态和最大等长收缩状态多裂肌厚度的变化。比较两组临床疗效。结果治疗后,两组JOA、ODI和VAS评分以及最大等长收缩状态多裂肌厚度均较治疗前改善(P<0.05),经筋排针刺组静息状态多裂肌厚度优于治疗前(P<0.05)。相关性分析显示,治疗后最大等长收缩状态多裂肌厚度与治疗后JOA评分呈正相关(P<0.05),与VAS评分呈负相关(P<0.05);治疗后静息状态多裂肌厚度与随访时JOA评分呈正相关(P<0.05)。经筋排刺组总有效率优于常规针刺组(P<0.05)。结论经筋排针刺治疗慢性非特异性腰背痛疗效优于常规针刺,可有效缓解疼痛。肌骨超声多裂肌厚度可以作为慢性非特异性腰背痛疗效评价的依据。Objective To observe the clinical effect of sinew row acupuncture on chronic non-specific low back pain based on musculoskeletal ultrasound.Method A total of 136 patients with chronic non-specific low back pain were randomly divided into a conventional acupuncture group and a sinew row acupuncture group,with 68 cases in each group.The patients in the routine acupuncture group were treated with routine acupuncture,and the patients in the sinew row acupuncture group were treated with sinew row acupuncture.The Japanese Orthopaedic Association scores(JOA),Oswestry disability index(ODI)score,visual analog scale(VAS)score,and the thickness of the multifidus muscle in resting state and maximum isometric contraction state measured by musculoskeletal ultrasound before and after treatment were observed in the two groups.The clinical efficacy was compared between the two groups.Result Compared before treatment,the JOA,ODI,VAS scores and the thickness of multifidus muscle in the maximum isometric contraction state were improved after treatment in the two groups(P<0.05),and the thickness of multifidus muscle in the resting state was superior to that before treatment in the sinew row acupuncture group(P<0.05).Correlation analysis showed that the thickness of multifidus muscle in the maximum isometric contraction state after treatment was positively correlated with the JOA score after treatment(P<0.05),and negatively correlated with the VAS score after treatment(P<0.05).The thickness of multifidus muscle at resting state after treatment was positively correlated with JOA score at follow-up(P<0.05).The total effective rate in the sinew row acupuncture group was better than that in the conventional acupuncture group(P<0.05).Conclusion Row acupuncture at sinew is superior to conventional acupuncture in the treatment of chronic non-specific low back pain,which can effectively relieve pain.The thickness of multifidus muscle by musculoskeletal ultrasound can be used as a basis for the evaluation of the efficacy of chronic non-specifi

关 键 词：针刺疗法 经筋排针刺 腰背痛 肌骨超声 镇痛 

分 类 号：R246.2[医药卫生—针灸推拿学]