剪切波弹性成像观察浮针治疗斜方肌肌筋膜疼痛综合征对患肌弹性的影响  

Application of Shear Wave Elastography to Observe the Elastic Effects of Fu's Subcutaneous Needling on Effected Muscles in Trapezius Myofascial Pain Syndrome

作　　者：魏林翔 林朝阳 吴刚 周恒[3,4] 周纯世 李明韩 WEI Linxiang;LIN Zhaoyang;WU Gang;ZHOU Heng;ZHOU Chunshi;LI Minghan(The First Clinical Medical School of Hubei University of Chinese Medicine,Wuhan 430060,China;Wuhan Sports University,Wuhan 430079,China;Hubei Provincial Hospital of Traditional Chinese Medicine,Wuhan 430074,China;Affiliated Hospital of Hubei University of Chinese Medicine,Wuhan 430074,China;College of Acupuncture and Orthopaedics,Hubei University of Chinese Medicine,Wuhan 430060,China)

机构地区：[1]湖北中医药大学第一临床学院,武汉430060 [2]武汉体育学院 [3]湖北省中医院 [4]湖北中医药大学附属医院 [5]湖北中医药大学针灸骨伤学院

出　　处：《中国中医骨伤科杂志》2025年第2期39-44,共6页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：湖北省中医院院级项目(20200423-1)。

摘　　要：目的:应用剪切波弹性成像(SWE)技术观察浮针对斜方肌肌筋膜疼痛综合征(TMPS)患者斜方肌弹性的影响。方法:招募符合纳入标准的患者44例,在患者患侧的斜方肌肌筋膜疼痛触发点(MTrPs)进行浮针运动疗法。治疗前后分别对患者的健侧及患侧斜方肌进行剪切波弹性成像检查,记录双侧斜方肌的弹性模量、弹性速度、肌肉厚度及患者视觉模拟量表(VAS)评分和颈椎功能障碍指数(NDI)评分。结果:治疗前患侧斜方肌弹性模量和弹性速度明显高于健侧,差异有统计学意义(P<0.01);治疗后患侧斜方肌弹性模量和弹性速度较治疗前明显降低,差异有统计学意义(P<0.01);治疗后患者VAS评分和NDI评分较治疗前明显降低,差异有统计学意义(P<0.01);治疗前患侧斜方肌肌肉厚度高于健侧,差异有统计学意义(P<0.05);治疗后患侧斜方肌肌肉厚度较治疗前差异无统计学意义(P>0.05)。相关性分析显示弹性模量与VAS评分和NDI评分正相关(P<0.01),弹性速度与VAS评分和NDI评分正相关(P<0.01)。结论:浮针疗法可明显缓解斜方肌肌筋膜疼痛综合征患者的疼痛和患肌紧张,其疗效与弹性模量和弹性速度降低值存在一定相关性;剪切波弹性成像检测的弹性模量和弹性速度可为肌筋膜疼痛类疾患的诊断和疗效评价提供客观辅助指标。Objective:The effect of Fu's subcutaneous needling on the elasticity of the trapezius muscle in patients with trapezius myofascial pain syndrome(TMPS)is observed using shear wave elastography(SWE).Methods:A total of 44 patients who met the criteria were recruited,and Fu's subcutaneous needling exercise therapy was performed at the myofascial trigger points(MTrPs)of myofascial pain on the affected side of the patient.SWE was examined on the healthy and affected trapezius muscles before and after treatment,and the modulus of elasticity,velocity of elasticity,and muscle thickness of the trapezius muscles were recorded bilaterally,as well as the patients'visual analogue scale(VAS)score and the neck disability index(NDI)score.Results:The elastic modulus and elastic velocity of the trapezius muscle on the affected side were significantly higher than those on the healthy side before treatment,and the difference was statistically significant(P<0.01);the elastic modulus and elastic velocity of the trapezius muscle on the affected side were significantly lower than those before treatment,and the difference was statistically significant(P<0.01);the VAS score and NDI score of the patients were lower than those of the patients before treatment.VAS score and NDI score were significantly lower than before treatment,and the difference was statistically significant(P<0.01);the muscle thickness of the trapezius muscle on the affected side was higher than that on the healthy side before treatment,and the difference was statistically significant(P<0.05);there was no significant difference in the muscle thickness of the trapezius muscle on the affected side after treatment compared with before treatment(P>0.05).Correlation analysis showed that elasticity modulus had a significant positive correlation with the VAS score and NDI score(P<0.01),and the elasticity velocity had a significant positive correlation with the VAS score and NDI score(P<0.01).Conclusion:Fu's subcutaneous needling can effectively relieve pain and tension in the af

关 键 词：斜方肌肌筋膜疼痛综合征 浮针 剪切波弹性成像 斜方肌 弹性模量 弹性速度 

分 类 号：R47[医药卫生—护理学]