肌骨超声引导针刀经筋层松解术治疗髂胫束综合征患者的效果分析

金伟; 汪海东; 韩红生; 陈东煜; 詹红生; 朱富祥

doi:10.16766/j.cnki.issn.1674-4152.003730

肌骨超声引导针刀经筋层松解术治疗髂胫束综合征患者的效果分析

doi: 10.16766/j.cnki.issn.1674-4152.003730

1.
嘉兴市中医医院中医骨伤科，浙江嘉兴 314001
2.
嘉兴市中医医院超声影像科，浙江嘉兴 314001
3.
上海中医药大学附属曙光医院中医骨伤科，上海 200021
4.
嘉兴市中医医院中医内科，浙江嘉兴 314001

基金项目:

浙江省中医药科技计划项目 2022ZB348

详细信息

通讯作者:
金伟，E-mail: 401240382@qq.com

中图分类号: R681.8 R246.9
计量
- 文章访问数: 21
- HTML全文浏览量: 11
- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2024-02-02
- 网络出版日期: 2024-12-28

Efficacy of musculoskeletal ultrasound-guided acupotomy with tendon release in patients with iliotibial bundle syndrome

1.
Traditional Chinese Medicine Orthopedics, Jiaxing Traditional Chinese Medicine Hospital, Jiaxing, Zhejiang 314001, China

摘要

摘要: 目的探讨肌骨超声引导针刀经筋层松解术治疗对髂胫束综合征患者疼痛、下肢功能、焦虑情绪、术后并发症及恢复情况的影响，分析治疗效果。方法纳入2022年1月—2023年5月在嘉兴市中医医院中医骨伤科就诊的90例髂胫束综合征患者，采用随机数字表法分为超声组、松解术组和对照组，各30例，超声组采用肌骨超声引导针刀经筋层松解术，松解术组采用无定位无引导单纯针刀经筋层松解术，对照组采用局部痛点封闭治疗。观察3组临床疗效，并统计不同治疗方式对患者视觉模拟量表(VAS)、下肢功能量表(LEFS)、焦虑自评量表(SAS)评分的影响，比较手术并发症及复发情况。结果超声组、松解术组、对照组总有效率各为96.67%、83.33%、66.67%，组间比较有统计学意义(χ²=9.274，P=0.010)，超声组总有效率高于对照组(P < 0.05)；治疗2周、4周、6周后，3组VAS、SAS评分较治疗前均下降，且超声组低于松解术组、对照组，松解术组低于对照组(P < 0.05)；治疗2周、4周、6周后，3组LEFS评分较治疗前均上升，且超声组高于松解术组、对照组，松解术组高于对照组(P < 0.05)；3组均未发现并发症；超声组、松解术组、对照组复发率各为6.67%、26.67%、36.67%，组间比较差异有统计学意义(χ²=7.826，P=0.020)，超声组复发率低于对照组(P < 0.05)。结论肌骨超声引导针刀经筋层松解术治疗髂胫束综合征患者可能有较好的疗效，有助于帮助患者缓解疼痛，改善下肢功能及焦虑情绪，安全性良好。
- 肌骨超声 /
- 针刀经筋层松解术 /
- 髂胫束综合征 /
- VAS评分
Abstract: Objective To explore the effects of musculoskeletal ultrasound-guided acupotomy via tendon release on pain, lower limb function, anxiety, postoperative complications, and recovery in patients with iliotibial band syndrome, and to analyze the therapeutic effectiveness. Methods A total of 90 patients with iliotibial band syndrome, treated at the Orthopedics and Traumatology Department of Jiaxing Hospital of Traditional Chinese Medicine from January 2022 to May 2023, were randomly divided into the ultrasound group, the release operation group, and the control group, with 30 cases in each group. The ultrasound group was treated with musculoskeletal ultrasound-guided needle-knife transtendon release, while the release operation group was treated with unoriented and unguided needle-knife transtendon release. The control group was treated with local pain point blocking. The clinical efficacy of the three groups was observed, and the effects on visual analogue scale (VAS), lower extremity functional scale (LEFS), and self-rating anxiety scale (SAS) scores were statistically analyzed. Complications and recurrence of surgery were compared among there groups. Results The total effective rate of the ultrasound group, the release group, and the control group was 96.67%, 83.33%, and 66.67%, respectively, with statistically significant differences (χ²=9.274, P=0.010). The total effective rate of the ultrasound group was higher than that of the control group (P < 0.05). After 2, 4, and 6 weeks of treatment, VAS and SAS scores in all 3 groups were decreased compared with the baseline, the ultrasound group showing the lowest scores, followed by the release group, and the control group (P < 0.05). After 2, 4, and 6 weeks of treatment, LEFS scores increased over the same time points, with the ultrasound group showing the highest improvement, followed by the release group, and the control group (P < 0.05). No complications were found in 3 groups. The recurrence rates of the ultrasound group, the release group, and the control group were 6.67%, 26.67%, and 36.67%, respectively, with statistically significant differences between groups (χ²=7.826, P=0.020). The recurrence rate of the ultrasound group was lower than that of the control group (P < 0.05). Conclusion Musculoskeletal ultrasound-guided acupotomy via tendon release demonstrates excellent efficacy in the treatment of patients with iliotibial band syndrome, helping to relieve pain, improve lower limb function, and alleviate anxiety, with a high safety profile.
- Musculoskeletal ultrasound /
- Needle-knife release through tendon /
- Iliotibial band syndrome /
- VAS score

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表 1 3组髂胫束综合征患者一般资料比较

Table 1. Comparison of general data of patients with iliotibial band syndrome in the three groups

组别	例数	性别(例)		年龄(x±s，岁)	侧别(例)		病程(x±s，周)
组别	例数	男性	女性	年龄(x±s，岁)	左	右	病程(x±s，周)
超声组	30	18	12	42.03±6.25	15	15	7.80±2.83
松解术组	30	18	12	41.30±6.02	13	17	7.60±2.53
对照组	30	20	10	43.10±6.11	12	18	7.00±2.51
统计量		0.378^a		0.654^b	0.630^a		0.754^b
P值		0.828		0.522	0.730		0.474
注：^a为χ²值，^b为F值。

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表 2 3组髂胫束综合征患者临床疗效比较[例(%)]

Table 2. Comparison of clinical efficacy in patients with iliotibial band syndrome in the three groups[cases (%)]

组别	例数	治愈	有效	无效	总有效
超声组	30	21(70.00)	8(26.67)	1(3.33)	29(96.67)
松解术组	30	18(60.00)	7(23.33)	5(16.67)	25(83.33)
对照组	30	12(40.00)	8(26.67)	10(30.33)	20(66.67)
统计量		8.109^a			9.274^b
P值		0.017			0.010
注：^a为Z值，^b为χ²值。

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表 3 3组髂胫束综合征患者治疗前后VAS评分比较(x±s，分)

Table 3. Comparison of VAS scores before and after treatment in patients with iliotibial band syndrome in the three groups(x±s, points)

组别	例数	治疗前	治疗2周	治疗4周	治疗6周
超声组	30	6.83±2.15	2.67±1.06^a	2.10±1.12^a	1.90±0.88^ad
松解术组	30	7.13±2.37	3.67±1.45^ab	3.17±1.12^ab	2.97±1.61^ab
对照组	30	6.97±2.30	4.97±1.45^abc	4.40±1.19^abc	4.00±1.70^abcd
F值		0.131	22.497	30.314	15.841
P值		0.878	< 0.001	< 0.001	< 0.001
注：F_时间=206.710，P_时间 < 0.001；F_组间=15.038，P_组间 < 0.001；F_交互=5.706，P_交互 < 0.001。与同组治疗前比较，^aP < 0.05；与超声组比较，^bP < 0.05；与松解术组比较，^cP < 0.05；与同组治疗2周比较，^dP < 0.05。

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表 4 3组髂胫束综合征患者治疗前后LEFS评分比较(x±s，分)

Table 4. Comparison of LEFS scores before and after treatment in the three groups of patients with iliotibial band syndrome(x±s, points)

组别	例数	治疗前	治疗2周	治疗4周	治疗6周
超声组	30	52.17±4.34	70.17±2.61^a	73.57±1.99^ad	75.90±1.95^ade
松解术组	30	51.17±3.95	64.23±2.50^ab	68.77±1.79^abd	71.60±1.81^abde
对照组	30	52.63±4.14	58.10±2.71^abc	62.83±1.93^abcd	65.47±1.72^abcde
F值		0.980	160.436	238.089	246.283
P值		0.379	< 0.001	< 0.001	< 0.001
注：F_时间=770.465，P_时间 < 0.001；F_组间=325.720，P_组间 < 0.001；F_交互=31.753，P_交互 < 0.001。与同组治疗前比较，^aP < 0.05；与超声组比较，^bP < 0.05；与松解术组比较，^cP < 0.05；与同组治疗2周比较，^dP < 0.05；与同组治疗4周比较，^eP < 0.05。

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表 5 3组髂胫束综合征患者治疗前后SAS评分比较(x±s，分)

Table 5. Comparison of SAS scores before and after treatment in the three groups of patients with iliotibial band syndrome(x±s, points)

组别	例数	治疗前	治疗2周	治疗4周	治疗6周
超声组	30	62.27±5.14	50.20±5.05^a	40.60±5.12^ad	35.23±5.09^ade
松解术组	30	62.97±5.22	53.53±4.60^ab	45.20±4.89^abd	40.30±5.23^abde
对照组	30	62.50±5.07	56.83±5.50^abc	52.27±5.13^abcd	48.47±5.53^abcde
F值		0.144	14.207	40.677	47.861
P值		0.866	< 0.001	< 0.001	< 0.001
注：F_时间=299.350，P_时间 < 0.001；F_组间=69.515，P_组间 < 0.001；F_交互=10.307，P_交互 < 0.001。与同组治疗前比较，^aP < 0.05；与超声组比较，^bP < 0.05；与松解术组比较，^cP < 0.05；与同组治疗2周比较，^dP < 0.05；与同组治疗4周比较，^eP < 0.05。

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