磁共振联合T2-mapping对电针治疗腰椎间盘突出症中短期疗效评价的价值分析  

Value analysis of short-and medium-term efficacy evaluation of magnetic resonance combined with T2-mapping for electroacupuncture in the treatment of lumbar disc herniation

作　　者：朱薇萍 吕莹 徐婷 戴德纯[1] 屠建春[1] ZHU Weiping;LÜYing;XU Ting;DAI Dechun;TU Jianchun(Kunshan Hospital of Traditional Chinese Medicine,Kunshan 215300,China)

机构地区：[1]昆山市中医医院,昆山215300

出　　处：《上海针灸杂志》2025年第3期290-295,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：江苏省重点研发计划项目(BE2021675);江苏省中医药科技发展项目(MS2022086)。

摘　　要：目的通过磁共振(magnetic resonance,MR)常规序列联合T2-mapping观察电针治疗腰椎间盘突出症(lumbar disc herniation,LDH)后有效及无效患者,探讨其在电针治疗LDH中短期疗效评价中的价值。方法随机选择经电针治疗后判定为有效和无效的LDH患者各32例,分别设为A组和B组。两组治疗前后分别记录腰椎日本骨科协会(Japanese Orthopaedic Association,JOA)评估治疗分数、Oswestry功能障碍指数(Oswestry disability index,ODI)评分,进行腰椎MR扫描并测量突出椎间盘髓核T2值和突出部分面积。两组均对治疗后JOA改善率及治疗前T2值、突出面积进行相关性分析,并比较治疗后及随访时T2值和突出面积。结果A组治疗前、治疗后及随访时突出椎间盘髓核T2值均明显高于B组(P<0.05);A组治疗1个疗程后突出部分面积明显小于B组(P<0.05)。A组治疗后JOA评分改善率与治疗前突出椎间盘髓核T2值具有中度相关关系(P<0.05),与突出部分面积未见有线性相关关系(P>0.05)。结论通过MR常规序列联合T2-mapping观察突出椎间盘髓核T2值,在电针治疗LDH中短期疗效评价中存在一定的临床价值,其或可为成为LDH保守治疗方案选择的辅助指标之一。Objective To observe the effective and ineffective patients after electroacupuncture treatment of lumbar disc herniation(LDH)by magnetic resonance(MR)routine sequence combined with T2-mapping,and to explore its value in the evaluation of short-and medium-term efficacy of electroacupuncture treatment of LDH.Method Thirty-two LDH patients were randomly selected to be effective and ineffective after electroacupuncture treatment,and they were divided into the group A and group B respectively.The lumbar spine Japanese Orthopaedic Association(JOA)treatment score and Oswestry disability index(ODI)score were recorded before and after treatment,and lumbar MR scans were performed to measure the T2 value of the nucleus pulposus of the herniated disc and the area of the herniated portion of the disc.The correlation between JOA improvement rate after treatment and T2 value or herniated area before treatment was analyzed in both groups,and the T2 value and herniated area after treatment and at the follow-up visit were compared.Result The T2 value of the nucleus pulposus of the herniated disc in group A was significantly higher than that in group B before treatment,after treatment and at the follow-up visit(P<0.05);the herniated area of group A was significantly smaller than that of group B after treatment(P<0.05).In group A,the improvement rate of JOA score after treatment had a moderate correlation with the T2 value of the nucleus pulposus of the herniated disc before treatment(P<0.05),and no linear correlation with the area of the herniated portion was observed(P>0.05).Conclusion The T2 value of the nucleus pulposus of the herniated disc observed by MR routine sequence combined with T2-mapping has certain clinical value in the evaluation of the short-and medium-term efficacy of electroacupuncture in the treatment of LDH,and may become one of the auxiliary indexes for the selection of the conservative treatment program for LDH.

关 键 词：针刺疗法 腰椎间盘突出症 电针 T2-mapping T2值 

分 类 号：R246.3[医药卫生—针灸推拿学]