中国组织工程研究

中国组织工程研究 ›› 2025, Vol. 29 ›› Issue (11): 2261-2267.doi: 10.12307/2025.357

• 肌肉肌腱韧带组织构建 tissue construction of the muscle, tendon and ligament • 上一篇    下一篇

超声形态学评估银质针对腰椎间盘突出症患者多裂肌形态学的影响

曹正培，芦胜胜，张家欢，王晓英   

  1. 九江市第一人民医院，江西省九江市  332000

  • 收稿日期:2024-01-09 接受日期:2024-03-22 出版日期:2025-04-18 发布日期:2024-08-10
  • 通讯作者: 芦胜胜，硕士，主治医师，九江市第一人民医院，江西省九江市 332000
  • 作者简介:曹正培，男，1987年生，汉族，在读硕士，主治医师，主要从事各类颈肩腰腿疼痛疾病及腰椎间盘突出症方面的研究。
  • 基金资助:
    江西省中医药管理局科技计划项目(2022A119)，项目负责人：曹正培

Effects of silver needle comprehensive therapy on the ultrasonographic morphology of multifidus muscles in patients with lumbar disc herniation: an ultrasound morphologic assessment 

Cao Zhengpei, Lu Shengsheng, Zhang Jiahuan, Wang Xiaoying   

  1. The First People’s Hospital of Jiujiang City, Jiujiang 332000, Jiangxi Province, China
  • Received:2024-01-09 Accepted:2024-03-22 Online:2025-04-18 Published:2024-08-10
  • Contact: Lu Shengsheng, Master, Attending physician, The First People’s Hospital of Jiujiang City, Jiujiang 332000, Jiangxi Province, China
  • About author:Cao Zhengpei, Master candidate, Attending physician, The First People’s Hospital of Jiujiang City, Jiujiang 332000, Jiangxi Province, China
  • Supported by:
    Science and Technology Program of Jiangxi Provincial Administration of Traditional Chinese Medicine, No. 2022A119 (to CZP)

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摘要：

文题释义：
肌筋膜触发点：位于肌肉组织内、可以感知到的紧绷区域中的小结节，这些结节非常容易被触发，极其敏感，是触痛的重要点。
多裂肌：属于椎旁肌中最靠近椎骨的肌肉，参与调节腰椎稳定和运动的角色，多裂肌等肌肉和韧带及腰椎共同参与腰椎稳定性的维持。

背景：银质针等针刺治疗腰椎间盘突出症的研究较多，但基于肌筋膜触发点理论的研究尚少。
目的：从肌筋膜触发点理论出发探讨银质针综合疗法对腰椎间盘突出症患者多裂肌超声形态学及临床疗效的影响。
方法：前瞻性选取2022年1月至2023年4月就诊的159例腰椎间盘突出症患者作为研究对象，按照随机数字表法随机分为常规组(n=53)、传统针灸组(n=53)和银质针组(n=53)。常规西药组给予常规西药治疗，传统针灸组根据经络走向和症状定位采用传统针刺疗法治疗，银质针组采用银质针灸肌筋膜疼痛触发点进行治疗，3组均连续治疗4周。记录所有患者治疗前后筋膜触发点数量、疼痛程度、腰椎功能、多裂肌超声形态学变化、临床疗效、中医症候评分。
结果与结论：①治疗后3组的腰背部各肌肉筋膜触发点数量减少，且银质针组较传统针灸组和常规西药组明显减少(P < 0.05)；②银质针组的疼痛分级指数评分、目测类比评分、现有疼痛强度评分、Oswestry功能障碍指数和下背痛功能障碍调查问卷评分均低于传统针灸组和常规西药组(P < 0.05)；③银质针组的多裂肌超声形态学各指标均优于传统针灸组和常规西药组(P < 0.05)；④银质针组的中医症候评分低于传统针灸组和常规西药组(P < 0.05)；⑤3组的临床疗效比较有显著差异(P < 0.05)。结果表明：基于肌筋膜触发点理论应用银质针综合疗法能有效减轻腰椎间盘突出症患者疼痛，提高临床疗效，改善腰椎功能障碍和多裂肌形态。
https://orcid.org/0009-0006-8653-6835(曹正培)

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

关键词: ">肌筋膜触发点, 银质针, 腰椎间盘突出症, 多裂肌, 疼痛, 临床疗效

Abstract: BACKGROUND: Many studies have focused on acupuncture, such as silver needles, for the treatment of lumbar disc herniation, but there are few studies based on the myofascial trigger point theory.
OBJECTIVE: To observe the effects of silver needle comprehensive therapy on the ultrasound morphology and clinical efficacy of multifidus muscles in patients with lumbar disc herniation based on the theory of myofascial trigger points. 
METHODS: A total of 159 patients with lumbar disc herniation who were seen from January 2022 to April 2023 were selected as the research subjects and randomly divided into three groups: conventional group (n=53), traditional acupuncture group (n=53), and silver needle group (n=53). The conventional group received routine western medicine treatment; the traditional acupuncture group used traditional acupuncture therapy based on meridian pathways and symptom localization; and the silver needle group used silver needle warm acupuncture at myofascial trigger points for intervention. All three groups received continuous treatment for 4 weeks. The number of myofascial trigger points, pain assessment, lumbar function evaluation, ultrasound morphology changes of multifidus muscles, clinical efficacy, and traditional Chinese medicine symptom score were recorded before and after treatment in the three groups.

RESULTS AND CONCLUSION: (1) After treatment, the number of myofascial trigger points in the lumbar muscles decreased in all groups, and the silver needle group showed a significant reduction compared with the traditional acupuncture group and the conventional group (P < 0.05). (2) The pain rating index score, visual analogue scale score, present pain intensity score, Oswestry disability index score, and Roland-Morris disability questionnaire score in the silver needle group were lower than those in the traditional acupuncture group and the conventional group (P < 0.05). (3) The ultrasound morphology indexes of multifidus muscles in the silver needle group were superior to those in the traditional acupuncture group and the conventional western medicine group (P < 0.05). (4) Traditional Chinese medicine symptom scores in the silver needle group were lower than those in the traditional acupuncture group and the conventional western medicine group (P < 0.05). (5) There were significant differences in clinical efficacy among the three groups (P < 0.05). To conclude, applying silver needle comprehensive therapy based on the theory of myofascial trigger points can effectively reduce pain, improve clinical efficacy, and enhance lumbar spine dysfunction and multifidus muscle morphology in patients with lumbar disc herniation.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: ">myofascial trigger points, silver needle, lumbar disc herniation, multifidus muscle, pain, clinical efficacy

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