摘要: |
目的 运用超声剪切波弹性成像(SWE)技术评估肩胛间区肌筋膜疼痛综合征针灸治疗疗效及应用价值。
方法 前瞻性收集2021-2022年间我院收治的肩胛间区肌筋膜疼痛综合征患者48例,其中空白对照组9例,随机纳入局部对症治疗组15例,颈部肩胛背神经治疗组24例。空白对照组未进行任何治疗,两个治疗组分别针对肩胛间区疼痛区域及颈部肩胛背神经走行区行针灸治疗,每周 3次,连续治疗2周。分析VAS评分及疼痛缓解率,采用SWE技术在治疗前后进行菱形肌前方内外侧筋膜弹性参数(Emean和SWV)测量,比较治疗前后各组间统计学差异。
结果 治疗后局部对症治疗组,颈部肩胛背神经治疗组VAS 评分均较治疗前明显下降,总有效率为92.3%(36/39),其中痊愈8例,显效22例,有效6例,无效3例,局部对症治疗组有效率为80%(12/15),颈部肩胛背神经治疗组有效率为100%,差异比较有统计学意义(P<0.05)。空白对照组观察过程中菱形肌前方筋膜弹性参数呈增高趋势,内侧筋膜Emean从19.17(15.54,24.14)KPa上升至21.28(18.62,24.46)KPa,外侧筋膜从19.90(15.86,23.67)KPa上升至24.40(16.78,30.32)KPa。局部对症治疗组,颈部肩胛背神经治疗组菱形肌前方内外侧筋膜弹性参数均呈下降趋势,但差异无明显统计学意义 (P >0 05)。
结论
超声剪切波弹性成像技术可以量化评估针灸治疗肩胛间区肌筋膜疼痛综合征的疗效,本研究为肩胛间区肌筋膜疼痛综合征的病因分析提供了理论依据。 |
关键词: 肌筋膜疼痛综合征 针灸 超声剪切波弹性成像 |
DOI: |
投稿时间:2023-05-10修订日期:2023-05-31 |
基金项目:基于肌骨超声探讨肝脾论治针刺对项背MPS激痛点的作用机制研究 |
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Evaluation of the therapeutic effect of acupuncture and moxibustion on interscapular myofascial pain syndrome by ultrasonic shear wave elastography and analysis of the pain mechanism |
Wu Lan ying,Liu yong,Miao rui heng,Zhou wei jun,Xu ping,Yang min |
(Beijing Shijitan Hospital Capital Medical University) |
Abstract: |
Evaluation of the therapeutic effect of acupuncture and moxibustion on interscapular myofascial pain syndrome by ultrasonic shear wave elastography (SWE)and analysis of the pain mechanism
Abtract objective To explore the evaluation value of SWE in the treatment of interscapular myofascial pain syndrome. Methods 48 patients with interscapular myofascial pain syndrome admitted to our hospital from 2021 to 2022 were prospectively collected. There were 9 cases in the blank control group , 15 cases were randomly included in the local symptomatic treatment group, 24 cases in the dorsal scapular nerve treatment group, and no treatment was given in the blank control group. The two treatment groups were treated with acupuncture and moxibustion at the interscapular pain area on the affected side and the dorsal scapular nerve running area on the neck, three times a week, for two consecutive weeks. Analyze VAS score and pain relief rate, measure the elastic parameters (Emean and Vmean ) of the fascia of the rhomboid muscle using shear wave SWE technology and compare the differences in elastic parameters between the groups before and after treatment.Result After treatment, the VAS scores of the local symptomatic treatment group and the cervical dorsal scapular nerve treatment group decreased significantly compared to before treatment. The total effective rate of the treatment group was 92.3% (36/39), of which 8 cases were cured, 22 cases were significantly improved, 6 cases were effective, and 3 cases were ineffective. The effective rate of the local symptomatic treatment group was 80% (12/15), and the effective rate of the dorsal scapular nerve treatment group was 100%, with a statistically significant difference (P<0.05). During the observation process,the level of elastic parameters in the blank control group showed an increasing trend, with the Emean of the medial fascia increasing from 19.17(15.54,24.14)KPa to 21.28(18.62,24.46)KPa,and the lateral fascia increasing from 19.90(15.86,23.67)KPa to 24.40(16.78,30.32)KPa. The local symptomatic treatment group and the neck dorsal scapular nerve compression treatment group showed a downward trend in the elastic parameters of the inner and outer fascia of the rhombic muscle, but the difference was not statistically significant (P>0.05). Conclusion Ultrasound shear wave elastic imaging technology can quantitatively evaluate the therapeutic effect of acupuncture and moxibustion in the treatment of interscapular myofascial pain syndrome, and provide a theoretical basis for the etiology analysis of interscapular myofascial pain syndrome. |
Key words: Myofascial pain syndrome Acupuncture and moxibustion Ultrasonic shear wave elastography |