单侧腰椎间盘突出症患者椎旁肌功能特征

doi:10.3969/j.issn.1006-9771.2023.09.014

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (9): 1098-1103.doi: 10.3969/j.issn.1006-9771.2023.09.014

单侧腰椎间盘突出症患者椎旁肌功能特征

沈星星¹, 陈伟健¹, 李聪聪¹, 李俊毅¹, 王帅¹, 叶子璇¹, 向瑞安¹, 许学猛²()

1.广州中医药大学第五临床医学院，广东广州市 510405
2.广东省第二中医院，广东广州市 510095

收稿日期:2023-04-24 修回日期:2023-06-30 出版日期:2023-09-25 发布日期:2023-10-26
通讯作者: 许学猛 E-mail:xuxuemeng@163.com
作者简介:沈星星(1998-)，男，汉族，江西南昌市人，硕士研究生，主要研究方向：中医药防治退行性骨关节病。
基金资助:
1.广东省自然科学基金项目(2021A1515011545);2.广东省科技计划项目(2021B1111610007);广东省科技计划项目(2018B020207009);3.广州市科技计划项目(202206010048)

Characteristics of paravertebral muscles in patients with unilateral lumbar disc herniation

SHEN Xingxing¹, CHEN Weijian¹, LI Congcong¹, LI Junyi¹, WANG Shuai¹, YE Zixuan¹, XIANG Ruian¹, XU Xuemeng²()

1. The Fifth Clinical Medical School, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510405, China
2. Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, Guangdong 510095, China

Received:2023-04-24 Revised:2023-06-30 Published:2023-09-25 Online:2023-10-26
Contact: XU Xuemeng E-mail:xuxuemeng@163.com
Supported by:
Guangdong Natural Science Foundation(2021A1515011545);Guangdong R & D Plan(2021B1111610007);Guangdong R & D Plan(2018B020207009);Guangzhou R & D Plan(202206010048)

摘要/Abstract

摘要：

目的探讨单侧腰椎间盘突出症患者椎旁肌群的功能失衡特征。

方法 2022年1月至2023年1月，选择广东省第二中医院就诊的单侧腰椎间盘突出症患者30例(观察组)和一般资料匹配的健康人30例(对照组)，采用MyotonPRO测量多裂肌和竖脊肌的肌张力、肌肉硬度；同时采集观察组的疼痛视觉模拟量表(VAS)评分、日本骨科学会评分(JOA)和患病时间。

结果观察组双侧多裂肌和竖脊肌的平均肌张力和肌肉硬度均显著大于对照组(|t| > 5.407, P < 0.001)。观察组患侧竖脊肌和多裂肌的张力和硬度显著高于健侧(|t| > 11.219, P < 0.001)。观察组患侧多裂肌和竖脊肌肌张力与VAS评分呈显著正相关(r > 0.942, P < 0.001)，与JOA评分呈显著负相关(|r| > 0.886, P < 0.001)。

结论单侧腰椎间盘突出症患者患侧多裂肌和竖脊肌肌张力和肌肉硬度升高，双侧不对称。

关键词: 腰椎间盘突出症, 多裂肌, 竖脊肌, 肌张力, 肌肉硬度

Abstract:

Objective To explore the imbalance of paravertebral muscle group for patients with unilateral lumbar disc herniation.

Methods From January, 2022 to January, 2023, 30 patients with unilateral lumbar disc herniation (observation group) and 30 healthy people matching in general data (control group) were measured the tension and stiffness of multifidus and erector spinae with MyotonPRO, while the observation group was assessed with Visual Analogue Scale (VAS) for pain and Japanese Orthopaedic Association (JOA) score, and the time of disease was also recorded.

Results The mean of bilateral tension and hardness of multifidus and erector spinae was more in the observation group than in the control group (|t| > 5.407, P < 0.001), and the tension and hardness of multifidus and erector spinae of the affected side were more than those of the unaffected side in the observation group (|t| > 11.219, P < 0.001). The tension and hardness of multifidus and erector spinae of the affected side were positively correlated with VAS score (r > 0.942, P < 0.001), and negatively correlated with JOA score (|r| > 0.886, P < 0.001).

Conclusion The tension and hardness of multifidus and erector spinae of the affected side increase after unilateral lumbar disc herniation, resulting in asymmetry.

Key words: lumbar disc herniation, multifidus, erector spinae, muscle tension, muscle hardness

中图分类号:

R681.5

沈星星, 陈伟健, 李聪聪, 李俊毅, 王帅, 叶子璇, 向瑞安, 许学猛. 单侧腰椎间盘突出症患者椎旁肌功能特征[J]. 《中国康复理论与实践》, 2023, 29(9): 1098-1103.

SHEN Xingxing, CHEN Weijian, LI Congcong, LI Junyi, WANG Shuai, YE Zixuan, XIANG Ruian, XU Xuemeng. Characteristics of paravertebral muscles in patients with unilateral lumbar disc herniation[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1098-1103.

图/表 4

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组别	n	性别(男/女)/n	年龄/岁	身高/cm	体质量/kg	体质量指数/(kg·m^-2)
对照组	30	16/14	38.80±10.87	166.23±0.81	65.35±12.5	23.49±3.20
观察组	30	14/16	38.97±11.11	164.63±0.73	64.38±6.36	23.84±2.62
χ²/t值		0.267	-0.059	0.800	0.377	-0.453
P值		0.606	0.953	0.427	0.707	0.653

组别	n	竖脊肌肌张力/Hz	竖脊肌硬度/(N·m^-1)	多裂肌肌张力/Hz	多裂肌硬度/(N·m^-1)
对照组	30	14.05±1.17	267.05±43.98	13.55±1.32	255.03±52.09
观察组	30	15.68±1.36	326.03±42.39	14.82±1.27	299.83±36.64
t值		-7.058	-7.851	-5.407	-5.449
P值		< 0.001	< 0.001	< 0.001	< 0.001

组别	侧别	n	竖脊肌肌张力/Hz	竖脊肌硬度/(N·m^-1)	多裂肌肌张力/Hz	多裂肌硬度/(N·m^-1)
对照组	左侧	30	13.96±1.10	265.97±43.53	13.48±1.29	253.80±51.26
	右侧	30	14.13±1.24	268.13±45.15	13.61±1.37	256.27±53.76
观察组	健侧	30	15.14±1.21	314.93±41.29	14.34±1.12	289.47±34.84
	患侧	30	16.22±1.30	337.13±41.17	15.31±1.24	310.20±35.98
t₁值			-1.562	-0.934	-1.265	-1.067
P₁值			0.129	0.358	0.216	0.295
t₂值			-12.899	-11.219	-11.372	-12.256
P₂值			< 0.001	< 0.001	< 0.001	< 0.001

临床指标	测量值	统计量	竖脊肌肌张力	多裂肌肌张力	竖脊肌硬度	多裂肌硬度
VAS评分	3.00 (2.00, 5.00)	r值	0.956	0.942	0.954	0.943
VAS评分	3.00 (2.00, 5.00)	P值	< 0.001	< 0.001	< 0.001	< 0.001
JOA评分	17.20±5.17	r值	-0.914	-0.886	-0.886	-0.912
JOA评分	17.20±5.17	P值	< 0.001	< 0.001	< 0.001	< 0.001
病程/月	12.00 (4.00, 120.00)	r值	0.199	0.207	0.238	0.269
病程/月	12.00 (4.00, 120.00)	P值	0.292	0.272	0.206	0.151

单侧腰椎间盘突出症患者椎旁肌功能特征

Characteristics of paravertebral muscles in patients with unilateral lumbar disc herniation

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