基于MR体素内不相干运动弥散加权成像评价中医药治疗腰椎退行性病变的研究  

Evaluation of Treatment of Lumbar Degenerative Diseases by Traditional Chinese Medicine Based on MR Voxel Incoherent Motion Diffusion Weighted Imaging

作　　者：陈馨[1] 莫云海[2] 周礼平[1] CHEN Xin;MO Yunhai;ZHOU Liping(Sichuan Integrated Traditional Chinese and Western Medicine Hospital,Chengdu 610041,Sichuan,China;Chengdu Seventh People's Hospital,Chengdu 610041,Sichuan,China)

机构地区：[1]四川省中西医结合医院,四川成都610041 [2]成都市第七人民医院,四川成都610041

出　　处：《中华中医药学刊》2025年第2期58-61,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家中医药管理局“十二五”中医药重点学科建设项目(国中医药办人教函[2012]48号);四川省中医药管理局项目(2020LC0174)。

摘　　要：目的分析基于磁共振(Magnetic Resonance,MR)体素内不相干运动弥散加权成像(IVIM-DWI)评价中医药治疗腰椎退行性病变的效果。方法纳入2021年6月—2023年6月四川省中西医结合医院收治的腰椎退行性病变患者84例为研究对象,随机数字表法分为两组,42例对照组采用常规方式治疗,42例观察组采用独活寄生汤联合中医手法治疗,对比两组治疗效果、腰椎功能变化情况、疼痛评分、直腿抬高角度、IVIM-DWID定量参数等。结果观察组治疗总有效率为95.24%(40/42),比对照组(73.81%,31/42)高,且治疗后观察组JOA评分、直腿抬高角度高于对照组,功能障碍指数评分(ODI)、视觉模拟评分法(VAS)评分低于对照组(P<0.05);治疗后观察组表观弥散系数(ADC)、慢速弥散系数(D)值高于对照组,组间比较差异显著(P<0.05)。结论中医药治疗腰椎退行性病变效果明确,能有效减轻患者下腰痛或下肢放射痛等症状,改善腰椎活动度,促进腰椎功能的恢复,通过IVIM-DWI能有效评估患者腰椎退行性病变程度,为治疗提供参考依据。Objective To evaluate the effect of traditional Chinese medicine on lumbar degenerative diseases based on magnetic resonance(MR)voxel incoherent motion diffusion weighted imaging(IVIEM-DWI).Methods A total of 84 patients with lumbar degenerative diseases treated in the hospital from June 2021 to June 2023 were included in the study.They were divided into two groups by random number table method.Forty-two cases in the control group were treated by conventional methods,and the other 42 cases in the observation group were treated by Duhuo Jisheng Decoction(独活寄生汤)combined with traditional Chinese medicine.The therapeutic effect,changes in lumbar function,pain score,straight leg elevation angle and IVIEM-DWID quantitative parameters were compared between the two groups.Results The total effective rate of the observation group was 95.24%(40/42),which was higher than that of the control group(73.81%,31/42).After treatment,Japanese Orthopaedic Association(JOA)score and straight leg elevation angle of the observation group were higher than those of the control group,and Oswestry Disability Index(ODI)and visual analogue scale(VAS)scores were lower than those of the control group(P<0.05).After treatment,the values of apparent diffusion coefficient(ADC)and slow diffusion coefficient(D)in the observation group were higher than those in the control group,and there were significant differences between groups(P<0.05).Conclusion Traditional Chinese medicine has a clear effect on the treatment of lumbar degenerative diseases,which can effectively reduce the symptoms of patients with low back pain or lower extremity radiative pain,improve lumbar motion and promote the recovery of lumbar function.IVIEM-DWID can effectively evaluate the degree of lumbar degenerative diseases and provide reference for treatment.

关 键 词：中医药治疗 腰椎退行性病 MR体素内不相干运动弥散加权成像 腰椎功能 

分 类 号：R274.981.5[医药卫生—中西医结合]