基于剪切波弹性成像技术评价浮针治疗第三腰椎横突综合征的临床疗效观察

Evaluation of the clinical efficacy of floating needle in the treatment of third lumbar transverse syndrome based on shear wave elastography

目的基于剪切波弹性成像(SWE)技术评价浮针治疗第三腰椎横突综合征(TLTPS)的临床疗效和安全性。方法纳入2022年8月至2023年7月深圳市罗湖区中医院治未病科及住院部确诊的TLTPS患者64例,按随机数字表法将入组患者分为两组,各32例。对照组采用传统针刺+康复锻炼,试验组采用浮针+康复锻炼,治疗前后比较两组日本骨科协会治疗评分(JOA)、视觉模拟评分法(VAS)、SWE弹性模量值、临床有效率和不良反应率。结果与对照组相比,试验组在改善JOA、VAS评分效果更佳(均P<0.05),临床总有效率更高(P<0.05),SWE弹性模量值明显降低(P<0.05),在减轻TPLPS患者疼痛、改善恢复腰椎功能上显著优于对照组,两组不良反应率差异无统计学意义。结论浮针治疗TPLPS能有效降低疼痛程度和恢复腰部功能,明显减缓局部软组织紧张,临床操作安全,疗效显著,值得进一步推广和应用。

Objective To evaluate the clinical efficacy and safety of Fu's subcutaneous needling for the treatment of third lumbar transverse spine syndrome(TLTPS)based on shear wave elastography(SWE)technique.Methods Sixty-four patients with TLTPS diagnosed in the outpatient and inpatient departments of the Department of Therapeutic and Orthopedic Diseases and the Department of Orthopedics of Luohu Hospital of Traditional Chinese Medicine in Shenzhen,China,from August 2022 to July 2023 were included,and the enrolled patients were divided into two groups of 32 cases each according to the method of randomized numerical table.The control group used traditional acupuncture~+rehabilitation exercise,and the experimental group used floating acupuncture~+rehabilitation exercise.The Japanese Orthopaedic Association(JOA),Visual Analogue Scale(VAS),SWE elasticity modulus value,clinical efficiency and adverse reaction rate were compared between the two groups before and after treatment.Results Compared with the control group,the experimental group was more effective in improving the JOA and VAS scores(both P<0.05),had a higher total clinical effective rate(P<0.05),had a significantly lower SWE elasticity modulus value(P<0.05),and was significantly better than the control group in relieving the pain of patients with TPLPS and improving the recovery of lumbar spine function,and there was no statistical significance in the difference of the rate of adverse reactions between the two groups.Conclusion Fu's subcutaneous needling treatment for TPLPS can effectively reduce the degree of pain and restore lumbar function,significantly slow down the local soft tissue tension,safe clinical operation,significant therapeutic effect,and worthy of further promotion and application.