推拿干预对腰椎间盘磁共振T2弛豫时间的影响

目的:观察推拿干预对腰椎间盘突出症(LDH)患者椎间盘磁共振T2弛豫时间(T2值)的影响。方法:将29例符合纳入标准的LDH患者随机分为观察组(14例)和对照组(15例)。观察组予2个疗程的腰椎推拿干预治疗,对照组观察期间给予空白治疗,比较治疗前后患者疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)评分,及前纤维环(AAF)、髓核(NP)、后纤维环(PAF)的T2值的变化情况,并对患者进行安全性评价。结果:治疗后,观察组VAS及ODI评分较治疗前均明显降低(均P<0.01),且观察组2项评分显著低于对照组(均P<0.01),对照组治疗前后比较差异无统计学意义;观察组各腰椎间盘NP的T2值较治疗前和对照组均明显上升(均P<0.01),对照组各腰椎间盘NP的T2值较治疗前比较差异无统计学意义;2组各腰椎间盘AAF和PAF的T2值较治疗前比较差异均无统计学意义,观察组各腰椎间盘AAF和PAF的T2值较对照组比较差异均无统计学意义。观察组有2例不良反应,均评估为安全级别2级,对照组未出现不良反应。结论:推拿干预能显著改善LDH患者临床症状,且腰椎间盘磁共振NP的T2值显著上升,AAF和PAF的T2值无显著上升。

Effect of Massage Intervention on T2 Relaxation Time of Lumbar Disc MRI

Objective: To observe the effect of massage intervention on T2 relaxation time (T2 value) of disc magnetic resonance in patients with lumbar disc herniation (LDH). Methods: Twenty-nine patients with LDH were randomly divided into treatment group (n=14) and control group (n=15). The treatment group was given 2 courses of lumbar massage intervention treatment, and the control group was given blank treatment during the observation period. The changes of visual analogue scale (VAS) scores, Oswestry dysfunction index (ODI) scores, and T2 values of nucleus pulposus (NP), anterior annulus fibrosus (AAF) and posterior annulus fibrosus (PAF) were observed before and after treatment, and the differences between the two groups were compared. The safety of the patients was evaluated. Results: After treatment, VAS scores and ODI scores in treatment group were significantly lower than those before treatment (both P<0.01), and those in treatment group were significantly lower than those in control group (both P<0.01), and there was no significant difference in the VAS scores and ODI scores in the control group before and after treatment. The T2 value of NP of each intervertebral disc in treatment group increased significantly as compared with that before treatment and control group (all P<0.01), and there was no significant difference in the T2 value of NP of the control group before and after treatment. The AAF and PAF T2 values in the two groups were not significantly different from those before treatment, and there was no significant difference in the AAF and PAF T2 values between the two groups after treatment. There were 2 cases of adverse reactions in the treatment group, both of which were evaluated as safety level 2, while the control group had no adverse reactions. Conclusion: After massage intervention, the T2 value of NP in lumbar disc increased significantly, while the T2 value of AAF and PAF did not increase significantly.