内热针治疗慢性非特异性腰痛的剪切波超声弹性成像评价

Assessment of shear wave elastography of inner heating dry needle therapy on chronic nonspecific low back pain

目的使用剪切波超声弹性成像技术评价内热针治疗慢性非特异性下腰痛的临床疗效,为内热针疗法的临床应用提供依据。方法选取2016-03-2016-09临床诊断为慢性非特异性下腰痛患者32例(病例组),男21例,女11例,年龄(47.2±11)岁,健康志愿者32例(对照组),男25例,女7例,年龄(45.0±10)岁,使用超声弹性成像技术测量病例组及对照组腰部竖脊肌的杨氏模量值,比较差异。病例组采用内热针疗法进行治疗,分别于治疗前、治疗后1周、治疗后2月测量其竖脊肌杨氏模量值、VAS评分、JOA评分,对其临床疗效进行分析。结果①腰痛组的竖脊肌杨氏模量值(18.4±4.2)kPa显著高于对照组(10.7±1.0)kPa(P<0.05);②腰痛组经内热针治疗1周后:竖脊肌杨氏模量值为(14.3±2.3)kPa、VAS评分为(2.25±0.92)分较治疗前显著降低,JOA评分为(22.53±2.34)分,较治疗前显著升高(P<0.05),病情好转;③腰痛组经内热针治疗2月后:竖脊肌杨氏模量值为(12.9±1.8)kPa、VAS评分为(1.38±0.75)分、JOA评分为(24.90±1.83)分,较治疗后1周病情进一步好转(P<0.05)。结论内热针治疗可以改善慢性非特异性腰痛患者肌肉张力增高的状态,并且明显改善患者症状。

Objective This study aims to explore the clinical effects of inner heating dry needle therapy for the chronic nonspecific low back pain, and provide experimental evidence for inner heating dry needle therapy’s clinical application. Methods From March 2016 to September 2016, 32 patients diagnosed as chronic nonspecific low back pain were in the patient group, including 21 males and 11 females, with an age of (47.2±11) years old. 32 healthy people were in the control group, including 25 males and 7 females, with an age of (45.0±10) years old. With the adoption of shear wave elastography, lumbar erector spinae of patient group and control group are measured, and the results are compared between the two groups. Patient group undergo inner heating dry needle therapy, and the measuring time of the Yang’s modulus、VAS score and JOA score are before therapy、a week after therapy and two months after therapy respectively .The results are applied to the clinical curative effect analysis. Results 1. Patient group’s Yang’s modulus (18.4±4.2kPa)of lumbar erector spinae is apparently higher than that of the control group (10.7±1.0kPa)(P<0.05). 2. After one week of inner heating dry needle therapy , patient group’s Yang’s modulus of lumbar erector spinae is (14.3±2.3kPa), and VAS score is (2.25±0.92), which are significantly reduced than before treatment. JOA score is(22.53±2.34), which is apprently higher than before(P<0.05). The patient group’s condtion is improving. 3. After two-month of the therapy,patient group’s Yang’s modulus of lumbar erector spinae is(12.9±1.8)kPa,and VAS score is(1.38±0.75), and JOA score is (24.90±1.83). The patient group’s condition is more improvement than one week after treatment. Conclusion Inner heating dry needle therapy could reduce the muscle tone of patients with chronic nonspecific low back pain and could improve the symptoms of patients .