| 董桂芳,杨倩玫,伍晓鸣,孙景环,牟 霜.肌骨超声联合剪切波弹性成像对针刺阿是穴治疗梨状肌综合征疗效的评估价值[J].,2022,(4):731-736 |
| 肌骨超声联合剪切波弹性成像对针刺阿是穴治疗梨状肌综合征疗效的评估价值 |
| Evaluation Value of Musculoskeletal Ultrasound Combined with Shear Wave Elastograph in the Treatment of Piriformis Syndrome by Acupuncture at Ashi Point |
| 投稿时间：2021-06-05 修订日期：2021-06-28 |
| DOI：10.13241/j.cnki.pmb.2022.04.028 |
| 中文关键词: 肌骨超声 剪切波弹性成像 针刺 阿是穴 梨状肌综合征 疗效 |
| 英文关键词: MSKUS SWE Acupuncture Ashi point Piriformis syndrome Curative effect |
| 基金项目:重庆市2018年科卫联合中医药科技项目（ZY201802105）；2018年重庆市科研机构绩效激励引导专项项目（cstc2018jxj1130012） |
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| 中文摘要: |
| 摘要 目的：探讨肌骨超声（MSKUS）联合剪切波弹性成像技术（SWE）在评估针刺阿是穴治疗梨状肌综合征（PS）疗效中的应用价值。方法：选取临床诊断单侧急性起病的PS患者40例，以患侧为治疗组，健侧为空白对照组，患侧采用阿是穴针刺，辅以梨综五针法行针刺治疗。健侧及患侧治疗前、治疗1疗程、治疗2疗程后均运用二维MSKUS及SWE技术获取梨状肌厚度、梨状肌出口处坐骨神经厚径、梨状肌弹性模量值及弹性评分，同时于上述各个时点记录患侧视觉模拟评分（VAS）及临床症状积分，对上述超声影像学指标、VAS评分、临床症状积分进行分析比较，并计算治疗有效率。结果：针刺治疗前，患侧梨状肌厚度、梨状肌出口处坐骨神经厚径、梨状肌杨氏模量值及梨状肌弹性评分与健侧相比，差异均具有统计学意义（P＜0.05）。患侧治疗2个疗程后，梨状肌出口处坐骨神经厚径、梨状肌杨氏模量值与健侧相比，差异有统计学意义（P＜0.05）。患侧于治疗前、治疗1疗程、治疗2疗程后，上述超声影像学指标均好转，且呈逐渐下降趋势，且各时间节点两两相比较，差异均具有统计学意义（P＜0.05）。针刺治疗过程中，PS患者的疼痛症状不断改善，临床症状积分与VAS评分呈不断下降趋势，整体比较差异有统计学意义（P＜0.05），且于任意时点两两比较，差异均具有统计学意义（P＜0.05）。治疗2个疗程后，PS患者治疗总有效率达92.50%。结论：针刺阿是穴治疗对急性期PS患者的临床疗效显著，MSKUS联合SWE技术能够为针刺阿是穴治疗的疗效评价提供科学客观的超声定量依据，具有良好的应用价值及临床意义。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the application value of musculoskeletal ultrasound(MSKUS) combined with shear wave elastography(SWE) in evaluating the efficacy of acupuncture at ashi point on piriformis syndrome (PS). Methods: 40 PS patients with unilateral acute onset were selected, the affected side was the treatment group, and the healthy side was the blank control group. The affected side was treated with acupuncture at ashi point, supplemented by acupuncture treatment with li five needles method. The piriformis thickness, sciatic nerve thickness at the exit of the piriformis muscle, piriformis elastic modulus and piriformis elasticity score were obtained by two-dimensional MSKUS and SWE technology between healthy side and affected side before treatment, after 1 course of treatment and after 2 courses of treatment. Meanwhile, the visual analogue scale (VAS) and clinical symptom score of the affected side were recorded at the above time points. The ultrasound imaging indexes, VAS score and clinical symptom score were analyzed and compared, and the effective rate was calculated. Results: Before acupuncture treatment, there were statistically significant differences in piriformis muscle thickness, sciatic nerve thickness at the exit of the piriformis muscle, piriformis Young's modulus and piriformis elasticity score between the affected side and the healthy side (P<0.05). After 2 courses of treatment, the sciatic nerve thickness at the exit of the piriformis muscle and piriformis Young's modulus in the affected side were significantly different compared with healthy side (P<0.05). Before treatment, after 1 course of treatment and 2 courses of treatment, the above ultrasound imaging indexes of the affected side were improved, and showed a gradual downward trend, and two-by-two comparison in different time points, the difference were statistically significant (P＜0.05). During the acupuncture treatment, the pain symptoms of PS patients continued to improve, the clinical symptom score and VAS score showed a continuous downward trend, and the overall comparison difference was statistically significant (P<0.05), and two-by-two comparison at any time point, the difference were statistically significant (P＜0.05). After 2 courses of treatment, the total effective rate of treatment for PS patients was 92.50%. Conclusion: Acupuncture at Ashi point has a significant clinical effect on acute PS. MSKUS combined with SWE can provide a scientific and objective ultrasound quantitative basis for the evaluation of acupuncture curative effect, and has good application value and clinical significance. |
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