内热针治疗慢性非特异性颈痛患者的疗效及磁共振成像观察

Therapeutic effects of internal heat acupuncture on chronic nonspecific neck pain and MRI examination results

目的探究内热针治疗慢性非特异性颈痛(NCNP)患者的临床疗效及磁共振成像观察。方法86例NCNP患者按照随机数表法分为内热针综合治疗组和单一热磁治疗组,每组43例,选取招募同期30例无颈部疾病的志愿者作为无颈痛对照组,单一热磁治疗组给予热磁治疗,内热针综合治疗组给予内热针和热磁综合治疗,比较2组患者治疗前后C5水平椎旁肌肉核磁共振结果(椎旁肌肉面积与椎体面积比值),疼痛情况(VAS评分),颈椎活动功能(NDI评分),焦虑情况(SAS评分),生活质量情况(SF-36评分)以及不良反应发生情况。结果2组患者治疗前颈半棘肌,多裂肌和回旋肌与椎体面积的比值显著低于无颈痛对照组(P<0.05),治疗后上述指标显著高于治疗前,但仍低于无颈痛对照组(P<0.05),内热针综合治疗组上述指标高于单一热磁治疗组(P<0.05);2组患者治疗后VAS和NDI评分指标显著低于治疗前(P<0.05),内热针综合治疗组上述指标低于单一热磁治疗组(P<0.05);2组患者治疗后SAS评分显著低于治疗前,SF-36评分显著高于治疗前(P<0.05),其中,内热针综合治疗组SAS评分显著低于单一热磁治疗组(P<0.05),SF-36评分显著高于单一热磁治疗组(P<0.05);2组患者皮肤损伤情况发生率差异无统计学意义(P>0.05)。结论 通过内热针的诊治,可以显著舒缓NCNP患者颈痛,增加椎旁肌肉的横截面积,并改善其颈椎功能和焦虑情绪,提高生活质量,且安全可靠。

Objective To investigate the therapeutic effects of internal heat acupuncture on nonspecific chronic neck pain(NCNP) and magnetic resonance imaging(MRI) examination results.Methods A total of 86 patients with NCNP were divided into internal heat needle combination treatment group(n=43) and simple thermomagnetic treatment group(n=43) according to random number table method,at the same time, 30 volunteers without neck diseases were enrolled as control.The patients in simple thermomagnetic treatment group were treated by thermomagnetic therapy only,however,the patients in internal heat needle combination treatment group were treated with internal heat needle combined with thermomagnetic therapy.The paravertebral muscle image results at C5 level(Ratio of paravertebral muscle area to vertebral body area),cervical pain(VAS score),motor function(NDI score),anxiety(SAS score),the life quality(SF-36 score) and the incidence of adverse reactions were observed and compared between the two groups before and after treatment.Results Before treatment,the ratios of cervical semispinous muscle,multifidus muscle and gyrospinal muscle to vertebral body area in the two treatment groups were significantly lower than those in control group(P<0.05).After treatment,the above indexes in the two treatment groups were significantly higher than those before treatment,however,which were significantly lower than those in control group(P<0.05),moreover,which in internal heat needle combination treatment group were significantly higher than those in simple thermomagnetic treatment group(P<0.05). After treatment the scores of VAS and NDI in the two treatment groups were significantly higher than those before treatment,moreover, which in internal heat needle combination treatment group were significantly lower than those in simple thermomagnetic treatment group(P<0.05). After treatment,the SAS scores in the two treatment groups were significantly lower than those before treatment,however, the SF-36 scores were significantly higher than those before treatment(P<0.05). Moreover the SAS scores in internal heat needle combination treatment group were significantly lower than those in simple thermomagnetic treatment group(P<0.05),but the SF-36 scores were significantly higher than those in simple thermomagnetic treatment group(P<0.01).There was no significant difference in the incidence of skin injury between the two treatment groups(P>0.05).Conclusion The internal heat needle therapy for NCNP can significantly relieve cervical pain of patients,increase the cross-sectional area of paravertebral muscles,improve the function of cervical spine,anxiety and life quality of patients, with safety and reliability.