基于DTI-MRI的筋结点针刺法治疗神经根型颈椎病临床疗效  

Clinical Efficacy of DTI-MRI-based Fascial Node Acupuncture on Treating Cervical Spondylotic Radiculopathy

作　　者：倪东贺 苏晓婉 李增新[1] 修超[1] 吴秋潼 刘帅 NI Donghe;SU Xiaowan;LI Zengxin;XIU Chao;WU Qiutong;LIU Shuai(Affiliated Hospital of Beihua University,Jilin 132011,China;Jilin Combined Traditional Chinese and Western Medicine Hospital,Jilin Province,Jilin 132001,China)

机构地区：[1]北华大学附属医院,吉林吉林132011 [2]吉林省吉林中西医结合医院,吉林吉林132001

出　　处：《北华大学学报(自然科学版)》2025年第3期361-365,共5页Journal of Beihua University(Natural Science)

基　　金：吉林省中医药管理局项目(2024155)。

摘　　要：目的探讨基于弥散张量成像(DTI)的筋结点针刺法治疗神经根型颈椎病(CSR)的临床疗效。方法应用随机数字表法将60例CSR患者分为对照组(n=30)、试验组(n=30)。对照组采用推拿手法进行治疗,试验组应用筋结点针刺法进行治疗,两组患者均治疗4周。治疗后,对比两组患者的临床疗效、神经功能(JOA量表)、颈部功能障碍指数(NDI量表)。治疗前、后两组患者均行常规磁共振成像(MRI)及DTI检查,基于DTI扫描所得二维原始数据经后处理重建弥散张量纤维束成像(DTT)评估脊髓神经受压情况。结果对照组有2例患者因失访被剔除,最后共有58例患者完成本次试验。治疗前,试验组和对照组DTT分级比较差异无统计学意义(P>0.05),治疗后,试验组DTT分级高于对照组(P<0.05);与治疗前比较,治疗后两组患者JOA评分均提高,NDI评分降低(均P<0.05),试验组JOA评分明显高于对照组,NDI评分明显低于对照组(均P<0.05);治疗前,两组患者DTI-MRI多参数比较差异无统计学意义(P>0.05),治疗后,与对照组比较,试验组VD、ADC显著降低(P<0.05),而AD和FA升高(P<0.05);与对照组比较,治疗后,试验组DTT 0级神经纤维束的比例低,3级神经纤维束的比例高(P<0.05)。结论DTI-MRI多参数(FA、ADC、VD、AD)变化可评价CSR受累神经根治疗的效果,DTT能直观显示CSR患者受压神经根治疗前、后形态变化,可直观定量反映筋结点针刺法治疗效果优于常规推拿。Objective To explore the clinical efficacy of fascial node acupuncture based on diffusion tensor imaging(DTI)in the treatment of cervical spondylotic radiculopathy(CSR).Methods The random number table method was used to divide 60 CSR patients into control group(n=30)and experimental group(n=30).Control group was treated with massage,and experimental group was treated with fascial node acupuncture.Patients in both groups were treated for 4 weeks.After treatment,the clinical efficacy,neurological function(JOA scale),and neckdisability index(NDI scale)of patients in both groups were compared.Before and after treatment,patients in both groups underwent conventional magnetic resonance imaging(MRI)and DTI examinations.Based on the two-dimensional raw data obtained from DTI scans,diffusion tensor tractography(DTT)was reconstructed to evaluate spinal nerve compression.Results Two patients in control group were excluded due to loss of follow-up,and finally a total of 58 patients completed this trial.Before treatment,there was no statistically significant difference in DTT grading between experimental group and control group(P>0.05).After treatment,the DTT grading of experimental group was higher than that of control group(P<0.05).Compared with before treatment,the JOA scores of patients in both groups after treatment were increased,and the NDI scores decreased(both P<0.05).The JOA scores of experimental group were significantly higher than those of control group,and the NDI scores were significantly lower than those of control group(both P<0.05).Before treatment,there was no statistically significant difference in the DTI-MRI multi-parameter values of patients in both groups(P>0.05).After treatment,compared with control group,the VD and ADC of experimental group were significantly decreased(P<0.05),while AD and FA were increased(P<0.05).Compared with control group,after treatment,the experimental group had a low percentage of DTT grade 0 nerve fiber tracts and a high percentage of grade 3 nerve fiber tracts(P<0.05).Conclu

关 键 词：弥散张量成像 筋结点 针刺治疗 神经根型颈椎病 

分 类 号：R245.3[医药卫生—针灸推拿学]