剪切波速度评价肌筋膜疼痛综合征患者疗效的价值初探

Evaluation the curative effect by shear wave velocity for patients with myofascial pain syndrome

目的应用剪切波速度(SWV)评价肌筋膜疼痛综合征(MPS)患者的治疗效果,探讨其临床应用价值。方法选取80例MPS患者(MPS组)和80例同期健康志愿者(对照组),采用视觉模拟评分(VAS)、疼痛评定指数(PRI)和现时疼痛强度(PPI)评估患者疼痛程度;使用声辐射力脉冲弹性成像观察斜方肌组织弹性,并记录SWV值。所有MPS患者均接受6个疗程的常规治疗,将疗效达到显效及痊愈的患者根据自愿原则进行分组,继续以SWV值作为疗效观察指标并进行治疗者为继续治疗组,未继续治疗者为停止治疗组,两组患者随访1年,比较治疗后复发率的差异。结果MPS组患者平均SWV值(4.35±1.56)m/s,对照组平均SWV值(1.53±0.56)m/s,差异有统计学意义(t=15.218,P=0.000)。治疗过程中MPS患者VAS评分和SWV值均呈下降趋势,差异均有统计学意义(F=3.649、2.631,P=0.000、0.018)。MPS患者治疗后显效及痊愈者63例,显效率78.8%;治疗后MPS患者的VAS评分、PRI、PPI均显著低于治疗前,差异均有统计学意义(均P<0.05)。MPS组治疗后平均SWV值(2.63±1.09)m/s,显著低于治疗前(4.35±1.56)m/s,差异有统计学意义(t=8.084,P=0.000)。继续治疗组30例患者的复发率显著低于停止治疗组33例患者(6.7%vs.40.0%),差异有统计学意义(χ^2=8.760,P=0.003)。结论SWV值能客观反映MPS患者的斜方肌组织硬度,可作为MPS患者疗效评价的较好指标,具有重要临床应用价值。

Objective To explore the application value of shear wave velocity(SWV)in evaluating the therapeutic effect of patients with myofascial pain syndrome(MPS).Methods Eighty patients with MPS(MPS group)and 80 healthy volunteers(control group)were enrolled.The visual analogue scale(VAS),pain rating index(PRI)and present pain intensity(PPI)were used to assess the pain degree.Acoustic radiation force impulse(ARFI)was used to observe the trapezius muscle tissue elasticity,and the SWV values were recorded.All patients with MPS received 6 courses of conventional treatment.Patients with marked effect and above were grouped according to voluntary principles.Patients who continued to receive treatment were defined as the continuing treatment group,and those who did not receive treatment were defined as the cessation treatment group.The two groups were followed up for 1 year to compare the difference in recurrence rate after treatment.Results The mean SWV of MPS group was(4.35±1.56)m/s,and that of the control group was(1.53±0.56)m/s,the difference was statistically significant(t=15.218,P=0.000).The VAS value and SWV value of MPS patients showed a downward trend during the treatment,and the differences were statistically significant(F=3.649,2.631,P=0.000,0.018).In the MPS patients,63 cases were markedly effective and above,the effective rate was 78.8%.The VAS value,PRI value and PPI value of MPS patients after treatment were significantly lower than those before treatment,and the differences were statistically significant(all P<0.05).The mean SWV value[(2.63±1.09)m/s]in the MPS group after treatment was significantly lower than that before treatment[(4.35±1.56)m/s],and the difference was statistically significant(t=8.084,P=0.000).The recurrence rate in the continuing treatment group was significantly lower than that in the cessation treatment group(6.7%vs.40.0%),and the difference was statistically significant(χ^2=8.760,P=0.003).Conclusion SWV value can objectively reveal the hardness of the trapezius muscle in MPS patients.Taking SWV value as a judgment indicator of curative effect can better evaluate the therapeutic effect of MPS patients,and has important clinical application value.