电针对腰椎间盘突出症患者多裂肌特性的影响

Effect of electroacupuncture on the multifidus muscle in patients with lumbar disc herniation

目的:观察电针对腰椎间盘突出症(LDH)患者腰椎功能障碍和多裂肌特性的影响。方法:将60例LDH患者随机分为观察组和对照组,每组30例。对照组予对症治疗;在对照组治疗基础上,观察组于L_(3)~S_(1)夹脊穴、大肠俞行针刺治疗,同侧L_(3)、L_(5)夹脊穴连接电针,予连续波,频率20Hz,强度以患者耐受为宜,留针20 min,隔日1次,10次为一疗程,共治疗2个疗程。比较两组患者治疗前后改良Oswestry功能障碍指数(ODI)、健康调查简表(SF-36)的生理维度(PCS)及心理维度(MCS)评分,于治疗前后行腰椎MRI测量L_(4)、L_(5)椎体下缘平面的多裂肌横截面积(CSA)、脂肪浸润(FI)、T2值。结果:治疗后,两组患者ODI、PCS、MCS评分较治疗前改善(P<0.05),且观察组患者ODI、PCS评分优于对照组(P<0.05)。治疗后,观察组患者多裂肌FI、T2值较治疗前降低(P<0.05),且低于对照组(P<0.05)。结论:电针可改善LDH患者腰椎功能障碍,减轻多裂肌水肿及脂肪浸润。

Objective To observe the effect of electroacupuncture(EA) on lumbar dysfunction and multifidus muscle characteristics in patients with lumbar disc herniation(LDH). Methods Sixty patients with LDH were randomly divided into an observation group and a control group, 30 cases in each group. The patients in the control group were treated with symptomatic treatment. On the basis of the treatment of the control group, the patients in the observation group were treated with acupuncture at L_(3)-S_(1) Jiaji(Ex-B 2) and Dachangshu(BL 25), and the ipsilateral L_(3) and L_(5) Jiaji point were connected with EA(continuous wave, frequency of 20 Hz, and the intensity was appropriate to the patient’s tolerance). The needles were retained for 20 min, once every other day, and 10 times were taken as a course of treatment. A total of 2 courses of treatment was given. The modified Oswestry disability index(ODI) as well as the physical component summary(PCS) and mental component summary(MCS) of the 36-item short form health survey(SF-36) were compared between the two groups before and after treatment. Lumbar MRI was performed before and after treatment to measure the cross-sectional area(CSA), fatty infiltration(FI) and T2 values of multifidus muscle at the lower edge of L_(4) and L_(5) vertebral bodies. Results After treatment, the ODI, PCS and MCS socres in the two groups were improved compared with those before treatment(P<0.05), and the ODI and PCS socres in the observation group were better than those in the control group(P<0.05). After treatment, the FI and value of T2 in the observation group were lower than those before treatment(P<0.05), and lower than those in the control group(P<0.05). Conclusion EA could improve lumbar dysfunction, relieve edema and fatty infiltration of multifidus muscle in patients with LDH.