基于整体力学的超声可视化注射联合针刀松解治疗第三腰椎横突综合征效果观察

徐倩岚; 王华燕; 詹晶晶; 吴单; 杜奋飞

doi:10.16766/j.cnki.issn.1674-4152.003851

基于整体力学的超声可视化注射联合针刀松解治疗第三腰椎横突综合征效果观察

doi: 10.16766/j.cnki.issn.1674-4152.003851

东阳市人民医院康复科, 浙江东阳 322100

基金项目:

浙江省医药卫生科技计划项目 2022ZH065

金华市科技计划项目 2022-3-022

详细信息

通讯作者:
杜奋飞，E-mail: dilj42@163.com

中图分类号: R681.57
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- 文章访问数: 35
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- 被引次数: 0
出版历程
- 收稿日期: 2024-06-18
- 网络出版日期: 2025-02-13

The treatment of third lumbar transverse process syndrome by ultrasound visualization injection and acupotomy based on holistic mechanics

Rehabilitation Department of Dongyang People' s Hospital, Dongyang, Zhejiang 322100, China

摘要

摘要: 目的探讨第三腰椎横突综合征(简称“腰3横突综合征”)患者接受基于整体力学的超声可视化注射下针刀松解治疗的效果及其安全性。方法选取2022年12月—2023年12月东阳市人民医院收治的腰3横突综合征患者90例为研究对象，采用随机数表法分3组，每组30例。A组采用基于整体力学的超声可视化注射+针刀松解治疗，B组采用腰3横突尖的超声可视化注射+针刀松解治疗，C组采用常规针刺激痛点治疗。观察比较3组治疗后临床疗效，治疗前、治疗1周、4周后Owestry功能指数、VAS评分，患者依从性及不良反应发生情况。结果 A组总有效率(96.67%，29/30)显著高于C组(73.33%, 22/30，P < 0.05)。治疗前，3组Owestry功能指数、VAS评分比较，差异无统计学意义(P>0.05)，治疗1周、治疗4周后Owestry功能指数、VAS评分均显著低于治疗前，治疗1周、治疗4周后A组Owestry功能指数、VAS评分均显著低于B组和C组(P < 0.05)。A组总依从率(96.67%，29/30)显著高于C组(70.00%，21/30，P < 0.05)。A组手术点肿胀、剧烈疼痛、肌无力、瘀斑、出血等总不良反应发生率(3.33%，1/30)显著低于C组(26.67%，8/30，P < 0.05)。结论基于整体力学的超声可视化注射联合针刀松解治疗腰3横突综合征疗效显著，能有效改善患者功能指数和疼痛评分，提高患者依从性，且不良反应发生率较低。
- 第三腰椎横突综合征 /
- 针刀松解 /
- 基于整体力学的超声可视化注射 /
- Owestry功能指数 /
- VAS评分
Abstract: Objective To observe the effect and safety of acupotomy release under ultrasound visualization injection based on global mechanics in patients with third lumbar transverse process syndrome. Methods A total of 90 patients with third lumbar transverse process syndrome admitted to Dongyang People' s Hospital from December 2022 to December 2023 were selected as the study objects, and divided into three groups according to the random number table method, with 30 cases in each group. Group A was treated with holistic mechanics-based ultrasound visual injection + acupotomy release treatment, group B was treated with ultrasound visual injection + acupotomy release treatment in third lumbar transverse process, and group C was treated with conventional acupuncture stimulation of pain points. The clinical efficacy, Owestry index, VAS score, patient compliance, and adverse reactions of the three groups were observed and compared before treatment, 1 week, and 4 weeks after treatment. Results The total effective rate of group A (96.67%, 29/30) was significantly higher than that of group C (73.33%, 22/30, P < 0.05). It can be seen that the Owestry function index and VAS scores of the three groups have a changing trend over time, and this trend is different in the groups. Before treatment, there were no significant differences in the Owestry index and VAS score among the three groups (P>0.05). After 1 week and 4 weeks of treatment, Owestry index and VAS score were significantly lower than before treatment. After 1 week and 4 weeks of treatment, the Owestry index and VAS scores of group A were significantly lower than those of group B and group C (P < 0.05). The total compliance rate in group A (96.67%, 29/30) was significantly higher than that in group C (70.00%, 21/30, P < 0.05). The total adverse reaction rate of swelling, severe pain, muscle weakness, ecchymosis, and bleeding in group A (3.33%, 1/30) was significantly lower than that in group C (26.67%, 8/30, P < 0.05). Conclusion The treatment of third lumbar transverse process syndrome with holistic mechanics-based ultrasound visualization injection combined with acupotomy is effective, which can effectively improve patients' functional index and pain score, improve patients' compliance, and have a low incidence of adverse reactions.
- Third lumbar transverse process syndrome /
- Acupotomy release /
- Ultrasonic visual injection based on global mechanics /
- Owestry function index /
- VAS score

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表 1 3组腰3横突综合征患者一般资料比较

Table 1. Comparison of general data among three groups of patients with Third Lumbar Transverse Process Syndrome

组别	例数	性别[例(%)]		年龄(x±s，岁)	病程[M(P₂₅, P₇₅)，月]	发病部位[例(%)]
组别	例数	男性	女性	年龄(x±s，岁)	病程[M(P₂₅, P₇₅)，月]	左侧	右侧	双侧
A组	30	15(50.00)	15(50.00)	46.20±9.83	6(2, 9)	13(43.33)	10(33.33)	7(23.33)
B组	30	16(53.33)	14(46.67)	42.60±11.32	2(1, 8)	14(46.67)	5(16.67)	11(36.67)
C组	30	14(46.67)	16(53.33)	45.60±9.60	5(2, 6)	8(26.67)	10(33.33)	12(40.00)
统计量		0.267^a		1.056^b	2.357^c	5.171^a
P值		0.875		0.352	0.308	0.270
注：^a为χ²值，^b为F值，^c为H值。

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表 2 3组腰3横突综合征患者临床疗效比较[例(%)]

Table 2. Comparison of clinical efficacy among three groups of patients with Third Lumbar Transverse Process Syndrome[cases(%)]

组别	例数	痊愈	显效	有效	无效	总有效
A组	30	9(30.00)	14(46.67)	6(20.00)	1(3.33)	29(96.67)
B组	30	5(16.67)	11(36.67)	10(33.33)	4(13.33)	26(86.67)
C组	30	4(13.33)	10(33.33)	8(26.67)	8(26.67)	22(73.33)^b
统计量		7.845^a				6.653^c
P值		0.020				0.036
注: ^a为H值，^c为χ²值。与A组比较，^bP < 0.017。

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表 3 3组腰3横突综合征患者不同时点Owestry功能指数比较(x±s，分)

Table 3. Comparison of Owestry function index across three groups of patients with Third Lumbar Transverse Process Syndrome at different time points(x±s, points)

组别	例数	治疗前	治疗1周	治疗4周后
A组	30	37.77±6.28	14.67±2.14^abc	3.43±1.07^abc
B组	30	38.27±6.25	22.67±2.20^ac	13.57±3.00^ac
C组	30	38.47±5.88	28.27±3.42^c	20.57±4.47^c
F值		0.103	198.857	221.574
P值		0.902	< 0.001	< 0.001
注：与C组比较，^aP < 0.05；与B组比较，^bP < 0.05，组内与治疗前比较，^cP < 0.05。F_时点=643.049，P_时点 < 0.001；F_组间=125.519，P_组间 < 0.001；F_交互=42.940，P_交互 < 0.001。

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表 4 3组腰3横突综合征患者治疗前后VAS评分比较(x±s，分)

Table 4. Comparison of VAS scores before and after treatment in three groups of patients with Third Lumbar Transverse Process Syndrome(x±s, points)

组别	例数	治疗前	治疗1周	治疗4周
A组	30	8.07±1.34	3.23±1.04^abc	1.10±0.40^abc
B组	30	8.23±1.33	4.80±1.21^ac	2.87±0.68^ac
C组	30	8.23±1.33	6.17±1.26^c	4.00±0.95^c
F值		0.156	46.729	126.221
P值		0.856	< 0.001	< 0.001
注：与C组比较，^aP < 0.05；与B组比较，^bP < 0.05，组内与治疗前比较，^cP < 0.05。F_时点=672.861，P_时点 < 0.001；F_组间=57.950，P_组间 < 0.001；F_交互=30.887，P_交互 < 0.001。

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表 5 3组腰3横突综合征患者干预后依从性比较[例(%)]

Table 5. Comparison of compliance after intervention among three groups of patients with Third Lumbar Transverse Process Syndrome[cases(%)]

组别	例数	完全依从	部分依从	不依从	总依从
A组	30	17(56.67)	12(40.00)	1(3.33)	29(96.67)
B组	30	11(36.67)	14(46.67)	5(16.67)	25(83.33)
C组	30	9(30.00)	12(40.00)	9(30.00)	21(70.00)
注：3组总依从率比较，χ²=7.680，P=0.021。与A组比较，^bP < 0.017。

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表 6 3组腰3横突综合征患者不良反应比较[例(%)]

Table 6. Comparison of adverse reactions in patients with Third Lumbar Transverse Process Syndrome among the three groups[cases(%)]

组别	例数	手术点肿胀	剧烈疼痛	肌无力	瘀斑	出血	合计
A组	30	1(3.33)	0	0	0	0	1(3.33)
B组	30	1(3.33)	0	0	1(3.33)	1(3.33)	3(10.00)
C组	30	2(6.67)	2(6.67)	2(6.67)	1(3.33)	1(3.33)	8(26.67)
注：3组总不良反应发生率比较，χ²=7.500，P=0.024。与A组比较，^bP < 0.017。

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