电针对不同多裂肌脂肪浸润率腰椎间盘突出症疗效的影响

Effect of electroacupuncture on lumbar disc herniation with different multifidus fatty infiltration rates

目的:观察电针治疗不同多裂肌脂肪浸润率腰椎间盘突出症(LDH)患者的疗效。方法:108例LDH患者,治疗前均行MRI检查,测量多裂肌的脂肪浸润率(FI),根据结果分为A组(FI<10%)、B组(10%≤FI≤20%)、C组(FI>20%),每组36例。均采用电针治疗,穴取患侧L_(3)~S_(1)夹脊穴及大肠俞等,患侧L3、L_(5)夹脊穴行电针(连续波,频率20 Hz),留针20 min,隔日1次,共治疗10次。观察各组治疗前后Oswestry功能障碍指数(ODI)评分,健康调查简表(SF-36)的生理维度(PCS)、心理维度(MCS)评分。结果:与治疗前比较,3组治疗后ODI评分降低(P<0.05),PCS、MCS评分增加(P<0.05)。治疗后,A组ODI评分低于B组、C组(P<0.05),B组低于C组(P<0.05);A组PCS评分高于B组、C组(P<0.05),B组高于C组(P<0.05)。结论:电针可改善LDH患者疼痛、生理及心理健康,多裂肌脂肪浸润率可能是影响电针疗效的因素之一。

Objective To observe the therapeutic effect of electroacupuncture on lumbar disc herniation(LDH)with different multifidus fatty infiltration rates.Methods A total of 108 eligible LDH patients received MRI test before treatment and the multifidus fatty infiltration rate(FI)was measured.According to the results,they were divided to group A(FI<10%),group B(10%≤FI≤20%)and group C(FI>20%),36 cases in each one.EA was provided in all of the groups.The selected acupoints were Jiaji(EX-B 2)from L_(3) to S_(1) and Dachangshu(BL 25),etc.on the affected side.EA was applied to Jiaji(EX-B 2)at L_(3) and L_(5) on the affected side(continuous wave,20 Hz in frequency),retained for 20 min.The treatment was given once every two days,for 10 times totally.Before and after treatment,the score of Oswestry disability index(ODI)and the scores of physical component summary(PCS)and mental component summary(MCS)of medical outcomes survey short form-36(SF-36)scale were observed in each group separately.Results Compared with before treatment,ODI score was reduced(P<0.05)and the scores of PCS and MCS were increased(P<0.05)after treatment in the three groups.After treatment,ODI score in the group A was lower than that in either the group B or the group C(P<0.05)and the score in the group B was lower than that in the group C(P<0.05).PCS score in the group A was higher than that in either the group B or the group C(P<0.05)and the score in the group B was higher than the group C(P<0.05).Conclusion Electroacupuncture relieves pain and improves physical and psychological health of LDH patients.Multifidus fatty infiltration rate is probably one of the factors to influence the therapeutic effect of electroacupuncture.