超声引导下阿是穴埋线治疗腰臀部肌筋膜疼痛综合征的临床研究  

A clinical study on the treatment of lumbogluteal myofascial pain syndrome with ultrasound-guided Ashi points catgut embedding

作　　者：刘诗若 许磊 王卓妍 王超 王轩 殷继超 LIU Shiruo;XU Lei;WANG Zhuoyan;WANG Chao;WANG Xuan;YIN Jichao(Department of Spine,Xi'an Hospital of Traditional Chinese Medicine,Xi'an 710021,China;Functional Department,Xi'an Hospital of Traditional Chinese Medicine,Xi'an 710021,China;College of Medical Technology,Shaanxi University of Chinese Medicine,Xianyang 712046,China;Administrative Office,Xi'an Health School,Xi'an 710054,China)

机构地区：[1]陕西省西安市中医医院脊柱病区,陕西西安710021 [2]陕西省西安市中医医院功能科,陕西西安710021 [3]陕西中医药大学医学技术学院,陕西咸阳712046 [4]陕西省西安市卫生学校办公室,陕西西安710054

出　　处：《中国中西医结合影像学杂志》2024年第6期666-670,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：陕西省科技厅重点研发计划一般项目(2022SF-173,2022SF-224,2023-YBSF-158);西安市卫健委科研人才项目(2022yb03);陕西省中医药管理局科研能力提升项目(SZY-NLTL-2024-021);陕西中医药大学面上项目(2021FS02)。

摘　　要：目的:采用超声剪切波弹性成像技术(SWE)评价超声引导下埋线阿是穴治疗腰臀部肌筋膜疼痛综合征(MPS)的临床疗效。方法:将120例腰臀部MPS患者随机分为埋线组和针刺组各60例,均用超声对腰臀部阿是穴进行体表定位,并分别于超声引导下行埋线治疗与针刺治疗,针刺组3次/周,埋线组2次/周,治疗2周。比较2组治疗前、末次治疗后及随访1周后阿是穴的杨氏模量值、腰臀部疼痛评分(VAS)及腰部功能评分(JOA)。结果:末次治疗后,2组阿是穴杨氏模量值、VAS评分均低于治疗前(均P<0.05),JOA评分均高于治疗前(均P<0.05);随访1周后,埋线组阿是穴杨氏模量值、VAS评分均低于针刺组(均P<0.05),埋线组JOA评分高于针刺组(P<0.05)。结论:超声引导下阿是穴埋线可降低腰臀部MPS患者腰痛程度、改善腰部功能,效果明显,其机制可能与延长局部刺激时间、降低阿是穴杨氏模量值及恢复局部组织形态有关。Objective:To evaluate the clinical efficacy of ultrasound-guided Ashi points catgut embedding on myofascial pain syndrome(MPS)in the lumbogluteal region by using shear wave elastography.Methods:A total of 120 patients with lumbogluteal MPS were randomly divided into an embedding group and a needling group,with 60 patients in each group.The Ashi points in the lumbogluteal region were located by ultrasound,and the embedding therapy and needling therapy were performed under ultrasound guidance,respectively.The needling group received treatment 3 times a week and the embedding group received treatment 2 times a week for 2 weeks.The Young's modulus of Ashi points,visual analogue scale(VAS)score and Japanese Orthopaedic Association(JOA)score were compared between the two groups before and after the last treatment and at 1 week follow-up.Results:After the last treatment,the Young's modulus of Ashi points and VAS score in both groups were lower than those before treatment(both P<0.05),and the JOA score was higher than that before treatment(P<0.05).At 1 week follow-up,the Young's modulus of Ashi points and VAS score in the embedding group were lower than those in the needling group(both P<0.05),and the JOA score was higher than that in the needling group(P<0.05).Conclusions:Ultrasound-guided embedding at Ashi points can reduce low back pain and improve lumbar function in patients with lumbogluteal MPS,and the effect is significant.The mechanism may be related to prolonging local stimulation time,reducing the Young's modulus of Ashi points,and restoring local tissue morphology.

关 键 词：超声检查 穴位埋线 阿是穴 杨氏模量值 

分 类 号：R246.9[医药卫生—针灸推拿学]