超声形态学评估银质针对腰椎间盘突出症患者多裂肌形态学的影响  

Effects of silver needle comprehensive therapy on the ultrasonographic morphology of multifidus muscles in patients with lumbar disc herniation:an ultrasound morphologic assessment

作　　者：曹正培 芦胜胜 张家欢 王晓英[1] Cao Zhengpei;Lu Shengsheng;Zhang Jiahuan;Wang Xiaoying(The First People’s Hospital of Jiujiang City,Jiujiang 332000,Jiangxi Province,China)

机构地区：[1]九江市第一人民医院,江西省九江市332000

出　　处：《中国组织工程研究》2025年第11期2261-2267,共7页Chinese Journal of Tissue Engineering Research

基　　金：江西省中医药管理局科技计划项目(2022A119),项目负责人:曹正培。

摘　　要：背景:银质针等针刺治疗腰椎间盘突出症的研究较多,但基于肌筋膜触发点理论的研究尚少。目的:从肌筋膜触发点理论出发探讨银质针综合疗法对腰椎间盘突出症患者多裂肌超声形态学及临床疗效的影响。方法:前瞻性选取2022年1月至2023年4月就诊的159例腰椎间盘突出症患者作为研究对象,按照随机数字表法随机分为常规组(n=53)、传统针灸组(n=53)和银质针组(n=53)。常规西药组给予常规西药治疗,传统针灸组根据经络走向和症状定位采用传统针刺疗法治疗,银质针组采用银质针灸肌筋膜疼痛触发点进行治疗,3组均连续治疗4周。记录所有患者治疗前后筋膜触发点数量、疼痛程度、腰椎功能、多裂肌超声形态学变化、临床疗效、中医症候评分。结果与结论:(1)治疗后3组的腰背部各肌肉筋膜触发点数量减少,且银质针组较传统针灸组和常规西药组明显减少(P<0.05);(2)银质针组的疼痛分级指数评分、目测类比评分、现有疼痛强度评分、Oswestry功能障碍指数和下背痛功能障碍调查问卷评分均低于传统针灸组和常规西药组(P<0.05);(3)银质针组的多裂肌超声形态学各指标均优于传统针灸组和常规西药组(P<0.05);(4)银质针组的中医症候评分低于传统针灸组和常规西药组(P<0.05);(5)3组的临床疗效比较有显著差异(P<0.05)。结果表明:基于肌筋膜触发点理论应用银质针综合疗法能有效减轻腰椎间盘突出症患者疼痛,提高临床疗效,改善腰椎功能障碍和多裂肌形态。BACKGROUND:Many studies have focused on acupuncture,such as silver needles,for the treatment of lumbar disc herniation,but there are few studies based on the myofascial trigger point theory.OBJECTIVE:To observe the effects of silver needle comprehensive therapy on the ultrasound morphology and clinical efficacy of multifidus muscles in patients with lumbar disc herniation based on the theory of myofascial trigger points.METHODS:A total of 159 patients with lumbar disc herniation who were seen from January 2022 to April 2023 were selected as the research subjects and randomly divided into three groups:conventional group(n=53),traditional acupuncture group(n=53),and silver needle group(n=53).The conventional group received routine western medicine treatment;the traditional acupuncture group used traditional acupuncture therapy based on meridian pathways and symptom localization;and the silver needle group used silver needle warm acupuncture at myofascial trigger points for intervention.All three groups received continuous treatment for 4 weeks.The number of myofascial trigger points,pain assessment,lumbar function evaluation,ultrasound morphology changes of multifidus muscles,clinical efficacy,and traditional Chinese medicine symptom score were recorded before and after treatment in the three groups.RESULTS AND CONCLUSION:(1)After treatment,the number of myofascial trigger points in the lumbar muscles decreased in all groups,and the silver needle group showed a significant reduction compared with the traditional acupuncture group and the conventional group(P<0.05).(2)The pain rating index score,visual analogue scale score,present pain intensity score,Oswestry disability index score,and Roland-Morris disability questionnaire score in the silver needle group were lower than those in the traditional acupuncture group and the conventional group(P<0.05).(3)The ultrasound morphology indexes of multifidus muscles in the silver needle group were superior to those in the traditional acupuncture group and the conventional we

关 键 词：肌筋膜触发点 银质针 腰椎间盘突出症 多裂肌 疼痛 临床疗效 

分 类 号：R454[医药卫生—治疗学] R318[医药卫生—临床医学] R274.9