剪切波弹性成像技术评价针灸治疗慢性下腰痛临床研究

Clinical study on evaluation of acupuncture and moxibustion for chronic low back pain by shear wave elastography

目的 观察剪切波弹性成像技术评价针灸治疗慢性下腰痛(CLBP)患者的临床疗效。方法 将我院84例CLBP患者随机分为观察组与对照组各42例。对照组予温热低周波治疗仪治疗,观察组患者在核心肌群训练基础上予以针灸疗法。比较两组患者临床疗效及治疗前后两组患者日本骨科协会评分(JOA)、疼痛视觉模拟类比评分法(VAS)、Oswestry功能障碍指数量表(ODI),采用剪切波弹性成像技术测量第二、三、四横突左、右侧以及髂后上棘左、右侧杨氏模量值。结果 治疗后,观察组患者总有效率显著高于对照组(P<0.05);两组患者JOA评分升高,VAS、ODI评分降低,观察组患者JOA评分高于对照组,VAS、ODI评分低于对照组(P<0.05);两组患者第二、三、四横突左、右侧以及髂后上棘左、右侧杨氏模量值降低,观察组患者第二、三、四横突左、右侧以及髂后上棘左、右侧杨氏模量值低于对照组(P<0.05)。结论 针灸治疗CLBP患者临床疗效满意,显著降低疼痛,改善腰部功能障碍,提高核心肌群的功能,采用剪切波弹性成像技术测量第二、三、四横突左、右侧以及髂后上棘左、右侧杨氏模量值以评估疗效,为患者制定治疗方案提供依据。

Objective To evaluate the clinical efficacy of acupuncture and moxibustion in patients with chronic low back pain(CLBP)by shear wave elastography. Methods Eighty-eight patients with CLBP were randomly divided into two groups,42 cases in observation group and 46 cases in control group. Control group received thermothermal low-frequency therapy,while observation group received acupuncture and moxibustion on the basis of control group. The clinical efficacy,the Japanese Orthopaedic Association score(JOA),Visual analogue scale(VAS)score,Oswestry disability index(ODI),and shear wave elastography were used to measure the second,the left and right sides of the third and fourth transverse processes the Young’s modulus values of the left and right sides of the posterior superior iliac spine of the two groups before and after treatment were compared. Results After treatment,the total effective rate in observation group was higher than that in control group(P<0.05),the JOA scores in both groups increased,while the VAS and ODI scores decreased,the JOA scores in observation group were higher than that in control group,and the VAS and ODI scores were lower than those in control group(P<0.05);the left and right sides of the second,third,and fourth transverse processes,and the left and right sides of the posterior superior iliac spine in both groups decreased,which were lower in observation group than those in control group(P<0.05). Conclusion The clinical efficacy of acupuncture and moxibustion in treatment of CLBP is satisfactory,which can significantly reduce pain,improve lumbar dysfunction,and improve the function of core muscle groups. Shear wave elastography was used to measure the left and right sides of the second,third,and fourth transverse processes and the posterior superior iliac spine. The left and right Young’s modulus values were used to evaluate the curative effect and provided a basis for the patient to formulate a treatment plan.