银质针治疗腰椎间盘突出症的临床肌电图观察

ELECTROMYOGRAPHY BEFORE AND AFTER SILVER NEEDLE ACUPUNCTURE TREATMENT IN PATIENTS WITH PROTRUSION OF THE LUMBAR INTERVERTEBRAL DISC

本文对12 例腰椎间盘突出症采用银质针针刺疗法治疗前后进行腰部骶棘肌临床肌电图对照检查,以观察该症引起的腰部神经肌肉功能变化与治疗效果的关系。结果提示治疗前全部病例有自发性电活动,经银质针疗法后7 例减少,4 例消失;3 例患者治疗前运动单位平均时限低于正常的80 % ,为肌源性损害表现,治疗后全部恢复正常;6 例患者治疗后一周检查最大用力收缩动作电位出现混合相,单纯混合相、单纯相波形,与治疗后临床出现短暂的下肢肌无力相符,其具体机理有待阐明。作者认为,肌电跟踪检查结果能够反映神经肌肉的功能状态,明确腰椎间盘突出症的恢复程度,具有较大的临床价值。银质针针刺疗法对腰椎管外软组织损害严重的慢性腰突症患者有显著疗效,特别是对肌紧张的长期的松解作用,其机制需进一步研究。

Patients with protrusion of the lumbar intervertebral disc were examined by electromyogram (EMG) before and after silver needle acupuncture treatment. Changes of the patients' neuromuscular function were observed. All patients' spontaneous potential were decreased or vanished after treatment. Three patients with marked decrease of the duration of motor unit potential were found to restore to normal level. Mixed pattern or mixed simple patterns of electromyogram were observed 1 week after treatment in 6 patients, which was in accord with the transient lower limb myasthenia. We thought that the result of EMG follow up study could reflect changes in neuromuscular function, and explicit the recovery of the protrusion of the lumbar intervertebral disc, therefore has considerable clinic value. Silver needle acupuncture treatment has notable effect on patients with chronic extravertebral soft tissue lesion, particularly its long term loosening effect on myospasm. The mechanism of acupuncture treatment needs further study.