表面肌电图用于腰椎间盘突出症疗效评定的研究

目的　采用表面肌电图检测技术对腰椎间盘突出症疗效评定的作用进行初步探讨。方法　腰椎间盘突出症 3 7例 ,其中男性 2 1例 ,女性 16例 ,年龄 2 0～ 61岁 ,平均 3 9.46± 11.5岁 ,接受腰骶部透热治疗、腰牵、推拿及经络导平等综合物理治疗。在入院时及住院治疗一月后 ,受试者分别接受腰背肌等长收缩测试 ,取俯卧位 ,下半身固定 ,嘱受试者用力保持上半身与下半身在同一水平面 ,此测试持续至受试者不能耐受为止 (以上半身开始向下偏离水平面为标准 ) ,同时用芬兰ME3 0 0 0P型表面肌电图仪记录肌电图 ,测试患侧与健侧骶棘肌和多裂肌等腰脊旁肌的表面肌电图中位频率的斜率 (MFslope ,MFs) ,平均肌电图波幅。结果　治疗后 ,2 9例症状缓解 ,患侧MFs的衰减降低 ,与治疗前比较差异显著 (P <0 .0 5 ) ,健侧MFs的衰减无显著改变 ;治疗后 ,平均EMG波幅健侧无显著改变 ,患侧波幅有增高趋势 ,但差异无显著性。 8例症状未缓解患者 ,健、患侧差异显著 ,治疗前后MFs及平均EMG波幅差异无显著。本组 13例病人 ,治疗后作CT检查 ,无 1例显示腰椎间盘回纳。结论　表面肌电图可用作腰椎间盘突出症临床疗效评定的客观指标之一 ,具有较好的临床应用价值。

Application of surface EMG in evaluation of effectiveness of clinical interventions for lumbar intervertebral disc prolapse

Objective To explore the applicability of s urface EMG in the assessment of clinical effectiveness of interventions for lumb ar intervertebral disc prolapse. Methods Thirty- sev en subjects with lumbar intervertebral disc prolapse underwent a series of compr ehensive physical therapy interventions for one month in hospital. Surface EMG ( ME 3000 P) was used to record the potentials during the activities of lumbar par aspinal muscles during isometric contraction. Parameters including the median fr equency slopes (MFs) and amplitude of the action patentials were used as the ind ices of the therapeutic effects in these patients. Results Symptom relief was achieved in 29 patients at the end of the treatment. Su rface EMG demonstrated that attenuation of MFs was significantly reduced in the affected side as compared to that before the treatment ( P <0.05). The amplitu de of the potentials was increased, but the difference was not significant as co mpared to that before the treatment ( P >0.05). In 8 patients whose clinical s ymptoms were not improved after the treatment, no significant difference was rev ealed between the EMG parameters obtained before and after the treatment. CT sca n showed no significant changes as compared with that taken before the hospitali zed treatment. Conclusion Surface EMG may be used as an objective tool for evaluation of therapeutic effect during the rehabilitation of patient with prolapsed intervertebral lumbar disc.