不同临床入路银质针治疗臀中肌综合征的临床疗效比较
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作者Author单位AddressE-Mail
廖玉明 LIAO Yu-ming 上海中冶医院康复医学科, 上海 200941 Department of Rehabilitation Medicine, Zhongye Hospital of Shanghai, Shanghai 200941, China 26813912@qq.com 
冯俊芳 FENG Jun-fang 上海中冶医院康复医学科, 上海 200941 Department of Rehabilitation Medicine, Zhongye Hospital of Shanghai, Shanghai 200941, China  
徐伟健 XU Wei-jian 上海中冶医院康复医学科, 上海 200941 Department of Rehabilitation Medicine, Zhongye Hospital of Shanghai, Shanghai 200941, China  
期刊信息:《中国骨伤》2020年,第33卷,第6期,第536-539页
DOI:10.12200/j.issn.1003-0034.2020.06.009
基金项目:
中文摘要:

目的:探讨腰骶椎入路银质针治疗臀中肌综合征的临床疗效。

方法:选取2017年9月至2019年9月银质针治疗的臀中肌综合征患者87例,所选病例除有腰臀部疼痛不适症状外,均经CT或MRI检查证实臀中肌存在炎性渗出等病理性影像学改变。87例臀中肌综合征患者分成两组,腰骶椎入路组42例,男19例,女23例,年龄(50.70±12.45)岁,病程(1.63±1.27)年;臀部入路组45例,男20例,女25例,年龄(52.80±12.18)岁,病程(1.78±1.22)年。腰骶椎入路组在脊椎L1-S2双侧关节突关节和L3横突进针治疗,臀部入路组在臀中肌髂骨翼起点及股骨大转子止点进针治疗。治疗前及4周后测定两组臀中肌综合征患者VAS评分、软组织压痛阈值、患侧髋外展肌肌力,4周时同时评定临床疗效。

结果:4周后,VAS评分腰骶椎入路组为(1.26±0.70)分,臀部入路组为(1.18±0.74)分,组间比较差异无统计学意义(P>0.05)。软组织压痛阈值和患侧髋外展肌肌力,腰骶椎入路组分别为(5.51±0.70)kg和(10.34±2.19)kg,臀部入路组为(4.78±1.05)kg和(9.33±1.42)kg,腰骶椎入路组提升更为显著(P<0.05)。腰骶椎入路组优16例,良20例,可5例,差1例;臀部入路组优13例,良17例,可12例,差3例;两组临床疗效比较差异有统计学意义(P<0.05)。

结论:臀中肌综合征银质针治疗,腰骶椎入路和臀部入路均能有效缓解疼痛,在软组织压痛阈值和髋外展肌肌力改善比较上腰骶椎入路更为突出,整体临床疗效也更为显著。
【关键词】臀中肌综合征  针刺疗法  腰痛  治疗结果
 
Comparative study of different clinical approaches for gluteal muscle syndrome with silver needle
ABSTRACT  

Objective: To explore the clinical efficacy of silver needle lumbar and sacral spine approach in treating gluteal muscle syndrome.

Methods: Eighty-seven patients with gluteal muscle syndrome treated with silver needles in the Department of Rehabilitation Medicine of our hospital from September 2017 to September 2019 were selected. Except for symptoms of waist and hip pain and discomfort,all selected patients were examined by CT or MRI to confirm pathological imaging changes such as inflammatory exudation of the gluteal muscle. The 87 patients with gluteal muscle syndrome were divided into 2 groups according to the digital table method,and 42 patients in the lumbosacral approach group,including 19 males and 23 females,aged (50.70±12.45) years old,and disease duration of(1.63±1.27) years;45 cases in the buttock approach group,including 20 males and 25 females,aged (52.80±12.18) years old,with a course of disease of(1.78±1.22) years. The lumbosacral approach group was treated with spinal L1 to S2 bilateral articular process joints and L3 transverse process acupuncture needles,and the buttock approach group was treated with the gluteus medulla wing starting point and femoral trochanter stop. The VAS scores,soft tissue tenderness thresholds,and hip abductor muscle strength of the affected group were measured before and 4 weeks after treatment in the two groups. The clinical efficacy was also evaluated 4 weeks after treatment.

Results: After 4 weeks,the VAS score of the lumbosacral approach group was 1.26±0.70,and the buttock approach group was 1.18±0.74,which were significantly lower than those before treatment,but there was no statistical difference between the groups(P>0.05). The soft tissue tenderness threshold and ipsilateral hip abductor muscle strength were(5.51±0.70) kg and(10.34±2.19) kg in the lumbosacral approach group,and(4.78±1.05) kg,(9.33±1.42) kg in the buttock approach group. The results in the lumbosacral approach group was better than those in the buttock approach group(P<0.05). The clinical efficacy of the lumbosacral approach group:16 cases got an excellent result,20 good,5 fair and 1 poor;in the buttock approach group,13 excellent,17 good,12 fair and 3 poor. The clinical efficacy between the two groups had statistical difference(P<0.05).

Conclusion: In the treatment of gluteus medius syndrome with silver needle,lumbosacral approach and buttock approach can effectively relieve the pain. Compared with the improvement of soft tissue tenderness threshold and hip abductor muscle strength,the upper lumbosacral approach is more prominent,and the overall clinical effect is more significant
KEY WORDS  Gluteal muscle syndrome  Acupuncture therapy  Low back pain  Treatment outcome
 
引用本文,请按以下格式著录参考文献:
中文格式:廖玉明,冯俊芳,徐伟健.不同临床入路银质针治疗臀中肌综合征的临床疗效比较[J].中国骨伤,2020,33(6):536~539
英文格式:LIAO Yu-ming,FENG Jun-fang,XU Wei-jian.Comparative study of different clinical approaches for gluteal muscle syndrome with silver needle[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(6):536~539
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