腰三针治疗腰椎间盘突出症患者的磁共振成像(1)
摘要 目的：觀察腰三针对腰椎间盘突出症的治疗效果，并研究磁共振成像(MRI)在评价疗效过程中的价值。方法：选取2016年1月至2017年1月湖北省中医院收治的腰椎间盘突出症患者60例，随机分为对照组和观察组，每组30例。对照组患者针刺华佗夹脊穴、环跳(患侧)、秩边(患侧)、阿是穴，30 min/次，1次/d，5次/周；观察组在对照组基础上加用腰三针，治疗频次同对照组，2组均以10次为1个疗程，均为2个疗程，观察2组治疗前后简易McGill疼痛评分、功能障碍指数(ODI)、日本骨伤协会(JOA)下腰痛评分指标变化，同时利用ImageJ软件测量腰椎MRI T2加权像中L3～5椎体水平上竖脊肌和腰大肌的横截面积大小。结果：治疗后，2组简易McGill疼痛评分、ODI评分均较治疗前显著下降，观察组下降趋势较对照组明显(P<0.05)。治疗后2组JOA评分均较治疗前显著增加，其中观察组优于对照组(P<0.05)。治疗后2组竖脊肌和腰大肌的横截面积均较治疗前增加，观察组增加幅度大于对照组(P<0.05)。McGill疼痛评分、ODI与腰大肌、竖脊肌同水平椎体面积比值呈负相关关系，JOA下腰痛评分与腰大肌、竖脊肌同水平椎体面积比值呈正相关关系。结论：腰三针可明显增加腰椎间盘突出症竖脊肌和腰大肌横截面积，有效缓解腰椎间盘突出症临床症状而改善患者功能。
关键词 腰椎间盘突出症；腰三针；竖脊肌；腰大肌；横截面积；疗效；McGill；功能障碍指数；JOA下腰痛评分
Abstract Objective：To observe the therapeutic effects of three special acupoints at waist on lumbar intervertebral disc protrusion，and to study the value in the process of MRI in evaluating the curative effect.Methods：A total of 60 cases of patients with lumbar intervertebral disc protrusion admitted in our hospital during January 2016 to January 2017 were included in the study，and randomly divided into the control group and the observation group，with 30 cases in each group.The patients of the control group were acupunctured Jiaji (EX-B2) and Huantiao (GB 30) (affected side)，Zhibian (BL 54) (affected side)，ashi acupoint，30 min/times，1 time/day，5 times per week； the observation group was treated combined with three special acupoints at waist on the basis treatment of the control group.The treatment frequency was the same with the control group.Both the two groups of patients had 10 times as a course of treatment，two course of treatment.The changes of simple McGill pain score，Oswestry disability index (ODI)，low back pain score (JOA) indicators of two groups before and after the treatment were observed.At the same time，ImageJ software was used to measure lumbar MRI T2 weighted images of erector spinae and psoas major cross-sectional area in the L3～5 vertebral level.Results：1) After treatment，the simple McGill pain scores and ODI scores in the two groups was with significant reduction，and the decline in observation group was more significantly than the control group (P<0.05).2) In the two groups after treatment，JOA scores were significantly increased，and the observation group was superior to that of the control group (P<0.05).3) After treatment，the cross-sectional area of erector spinae and psoas major in the two groups increased，and the observation group with greater increase amplitude (P<0.05).4) McGill pain scores and ODI were negatively related with psoas major，erector spinae at vertebral area.JOA was positively related to psoas major and erector spinae at vertebral area.Conclusion：Three special acupoints at waist can obviously increase the cross-sectional area of erector spinae and psoas major in the lumbar intervertebral disc protrusion，effectively relieve the clinical symptoms of patients with lumbar disc prolapse and improve the function of the patients., 百拇医药(胡君 刘宇 李志超 黄伟 刘耕心)
关键词 腰椎间盘突出症；腰三针；竖脊肌；腰大肌；横截面积；疗效；McGill；功能障碍指数；JOA下腰痛评分
Abstract Objective：To observe the therapeutic effects of three special acupoints at waist on lumbar intervertebral disc protrusion，and to study the value in the process of MRI in evaluating the curative effect.Methods：A total of 60 cases of patients with lumbar intervertebral disc protrusion admitted in our hospital during January 2016 to January 2017 were included in the study，and randomly divided into the control group and the observation group，with 30 cases in each group.The patients of the control group were acupunctured Jiaji (EX-B2) and Huantiao (GB 30) (affected side)，Zhibian (BL 54) (affected side)，ashi acupoint，30 min/times，1 time/day，5 times per week； the observation group was treated combined with three special acupoints at waist on the basis treatment of the control group.The treatment frequency was the same with the control group.Both the two groups of patients had 10 times as a course of treatment，two course of treatment.The changes of simple McGill pain score，Oswestry disability index (ODI)，low back pain score (JOA) indicators of two groups before and after the treatment were observed.At the same time，ImageJ software was used to measure lumbar MRI T2 weighted images of erector spinae and psoas major cross-sectional area in the L3～5 vertebral level.Results：1) After treatment，the simple McGill pain scores and ODI scores in the two groups was with significant reduction，and the decline in observation group was more significantly than the control group (P<0.05).2) In the two groups after treatment，JOA scores were significantly increased，and the observation group was superior to that of the control group (P<0.05).3) After treatment，the cross-sectional area of erector spinae and psoas major in the two groups increased，and the observation group with greater increase amplitude (P<0.05).4) McGill pain scores and ODI were negatively related with psoas major，erector spinae at vertebral area.JOA was positively related to psoas major and erector spinae at vertebral area.Conclusion：Three special acupoints at waist can obviously increase the cross-sectional area of erector spinae and psoas major in the lumbar intervertebral disc protrusion，effectively relieve the clinical symptoms of patients with lumbar disc prolapse and improve the function of the patients., 百拇医药(胡君 刘宇 李志超 黄伟 刘耕心)
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