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| 无痛筋针对慢性非特异性下腰痛的疗效研究 |
| Study on the efficacy of painless Sinew Acupuncture for chronic non-specific lower back pain observed |
| 投稿时间：2024-04-19 修订日期：2024-04-19 |
| 中文关键词: 筋针 慢性非特异性下腰痛 剪切波弹性成像 临床疗效 |
| 英文关键词: Sinew Acupuncture chronic nonspecific lower back pain shear wave elastography (SWE) clinical efficacy |
| 基金项目:浙江省中医药科技计划项目(2022ZA098) |
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| 中文摘要: |
| [目的] 探讨无痛筋针能否缓解慢性非特异性下腰痛(chronic non-specific low back pain, CNSLBP)患者的临床症状,改善肌肉功能,提高活动能力和生活质量。 [方法] 根据纳入和排除标准,收集在浙江康复医疗中心门诊或住院治疗的90例CNSLBP患者的临床资料。将患者分为传统针刺组和筋针组,每组各45例。传统针刺组直刺双侧肾俞、大肠俞、腰阳关和阿是穴治疗；筋针组平刺压痛点筋穴治疗,三周为一个疗程。治疗前、治疗后、治疗一个疗程后、治疗结束一个月后分别进行评估,记录每组患者的疼痛视觉模拟(visual analogue scale,VAS) 评分、Oswestry残疾指数(Oswestry Disability Index, ODI)评分、运用剪切波弹性成像(shear wave elastography,SWE)超声技术测量竖脊肌和多裂肌的杨氏模量与厚度。对两组患者的数据进行对照分析,明确筋针治疗CNSLBP的临床疗效。 [结果]各组患者在性别、年龄、病程、以及治疗前的VAS评分、ODI)评分、竖脊肌和多裂肌的杨氏模量与厚度等方面差异无统计学意义(P>0.05),提示各组患者基线一致,具有可比性。重复测量方差分析结果显示,VAS评分、ODI评分的分组因素、时间因素,以及二者的交互作用均有统计学意义((P< 0.05);进一步两两比较结果显示,治疗一个疗程后、治疗结束一月后,筋针组各评分均明显低于传统针刺组,具有统计学意义(P<0.001)。治疗一个疗程后,各组患者杨式模量均较治疗前降低,具有统计学意义(均P<0.001)。组间比较显示,治疗一个疗程后,筋针组患者竖脊肌、多裂肌杨氏模量低于传统针刺组,差异有统计学意义(P<0.001)。 [结论] SWE能客观有效评估筋针治疗的疗效,筋针能有效缓解CNSLBP患者的临床症状,改善肌肉功能。 |
| 英文摘要: |
| [Objective] To investigate whether painless Sinew Acupuncture can relieve clinical symptoms, and release muscle tension, joint mobility, and function in patients with chronic non-specific low back pain (CNSLBP). [Methods] According to the inclusion and exclusion criteria, 90 patients with CNSLBP treated as outpatients or inpatients at Zhejiang Rehabilitation Medical Center were collected and divided into the traditional acupuncture group, and the tendon acupuncture group, 45 cases in each group. The traditional acupuncture group was treated with the direct stabbing of bilateral Shenshu, Dachangshu, lumbar yangguan, and a-shi points; the Sinew acupuncture group was treated with flat stabbing of pressure pain point tendon points. 3 weeks as 1 course of treatment. Before treatment, after 1 session, after 1 course of treatment, and 1 month after the end of treatment, the visual analog scale (VAS) score, Oswestry Disability Index (ODI) score, Young"s modulus and muscle thickness of [1]erector spinae and multifidus muscles. The data of the two groups of patients were controlled and analyzed to clarify the clinical efficacy of sinew acupuncture in the treatment of CNSLBP. [Results] There were no statistically significant differences between the groups in terms of gender, age, disease duration, and pretreatment VAS score, ODI score, and Young"s modulus and thickness of the erector spinae and multifidus muscles (P>0.05), suggesting that the groups were consistent and comparable at baseline. The results of repeated measures ANOVA showed that the grouping factor, time factor, and the interaction between VAS score and ODI score were statistically significant (P< 0.05); further two-by-two comparisons showed that the differences between the two groups in terms of VAS score and Oswestry score were not statistically significant before treatment (P>0.05), after one course of treatment, One month after the end of treatment, all scores in the Sinew acupuncture group were significantly lower than those in the traditional acupuncture group, and the difference was statistically significant (P<0.001). After one course of treatment, the Young"s modulus of patients in each group was lower than that before treatment, and the difference was statistically significant (all P<0.001). Comparison between groups showed that after 1 course of treatment, the Young"s modulus of the erector spinae and multifidus muscles of the patients in the Sinew acupuncture group was lower than that of the traditional acupuncture group, and the difference was statistically significant (P<0.001). [Conclusion] Sinew acupuncture can effectively alleviate the clinical symptoms of patients with CNSLBP, release muscle tension, and improve the mobility and function. |
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