腰椎间盘突出症疗效与影像学区域定位的相关性

Correlativity of the therapeutic effect of acupuncture on prolapse of lumbar intervertebral disc with the area location of image

目的:探讨腰椎间盘突出症针刺牵引治疗效果与影像学区域定位的关系。方法:根据胡有谷的影像学区域定位法将突出的椎间盘在椎管内所处的位置从矢状位、额状位及水平位进行三维定位诊断。对130例腰椎间盘突出症患者针刺治疗效果与影像学区域定位法进行分类对比分析。结果:有效组98例,矢状位定位于Ⅰ层面突出为73例(占74.49%),水平位分区位于1、2区突出为82例(占83.68%),额状位分域突出位于a区域突出为52例(占53.06%);而无效组32例,突出区域分别为Ⅰ层面10例(占31.25%),1、2区12例(占37.50%),a区域3例(占9.38%)。两组进行区域定位比较差异有显著性意义。结论:区域定位可较客观显示腰椎间盘突出的大小、方向、位置、性质,并可较准确推测受累神经根的病理变化,Ⅰ层面、1～2区、a区域突出针刺牵引治疗效果较好。

Objective To probe into the correlativity of the therapeutic effect of acupuncture combined with traction on prolapse of lumbar intervertebral disc with the three-dimensional location. Methods According to the three dimensional location developed by HU You-gu, the position of the prolapse of lumbar intervertebral disc in the spinal canal was located from the sagittal plain, frontal plain and horizontal plain. One hundred and thirty patients with prolapse of lumbar intervertebral disc and completion of clinical data were treated with acupuncture, and the therapeutic effects were analyzed with three-dimensional location. Results Among 98 cases in the effective group, 73 cases had the prolapse at the I plane in sagittal location, accounting for 74.49%, 82 cases had the prolapse at the 1, 2 zone in horizontal location, accounting for 83.68 %, 52 cases had the prolapse at the a area in frontal location, accounting for 53.06% ; among the 32 cases in the ineffective group, 10 cases had the prolapse at the Ⅰ plane, accounting for 31.25%, 12 cases in the 1, 2 zone, accounting for 37.50%, 3 cases in the a area, accounting for 9. 38%. There was a statistically significant difference between the two groups in the location. Conclusion The three-dimensional location can objectively show the size, direction, position, and the characteristics of the protruded discs, and correctly infer the pathological changes of the affected nerve root. Acupuncture combined with tract has a better effect on  plane, 1-2 zone, and a area.