摘要
目的 探讨常规超声成像与实时超声弹性成像(RTE)对慢性足底筋膜炎(PF)患者针刺疗法治疗前后超声参数变化,评估针刺疗法对慢性PF临床疗效与作用.方法 选取慢性PF患者 78 例(95 只足),分为针刺组(26 例,33 只足)、安慰针组(26 例,32 只足)及等待治疗组(26 例,30 只足).针刺组使用针灸针治疗;安慰针组采用平头针治疗;等待治疗组不予特殊治疗.分别记录三组的人口学特征、临床特征及灰阶超声(厚度、回声、是否有钙化、筋膜内ROI中最高频率亮度水平和平均亮度水平)及彩色超声特征(筋膜血流)和超声实时组织弹性成像特征(计算观测部位与周围软组织的弹性应变比),评估灰阶成像与实时超声弹性成像对慢性PF治疗前后的疗效评估及诊断价值.结果 针刺组治疗前后在筋膜厚度、弹性应变比、筋膜内ROI中灰阶最高频率亮度水平和平均亮度水平均差异有统计学意义(P<0.05),安慰针组治疗前后仅在筋膜厚度、弹性应变比差异有统计学意义(P<0.05),而等待治疗组各参数在治疗前后差异均无统计学意义(P>0.05).结论 常规超声成像及实时超声弹性成像能够清晰、量化显示慢性PF患者治疗前后各参数变化,对临床评估慢性PF治疗后效果提供依据.
Abstract
Objective This article aims to explore the changes in ultrasound parameters before and after acupuncture therapy in patients with chronic plantar fasciitis using conventional ultrasound imaging and real-time ultrasound tissue elastography,and to evaluate the clinical efficacy and role of acupuncture therapy in patients with chronic plantar fasciitis.Methods 78 patients(95 feet)with chronic plantar fasciitis admitted were collected and divided into an acupuncture group(26 cases,33 feet),a comfort needle group(26 cases,32 feet),and a waiting group for treatment group(26 cases,30 feet).The acupuncture group was treated with acupuncture;The comfort needle group was treated with flat headed needles;No special treatment will be given during the study period in the waiting treatment group.We recorded the demographic characteristics,clinical features,and gray-scale ultrasound(thickness,echo,presence of calcification,highest frequency brightness level and average brightness level in fascia ROI),color ultrasound features(plantar fascia blood flow),and real-time ultrasound tissue elastic imaging features(cal-culating the elastic strain ratio between the observation site and surrounding soft tissue)of three groups,respectively.Then,we evaluated the efficacy and diagnostic value of conventional ultrasound imaging and real-time ultrasound tissue elastography be-fore and after treatment for chronic plantar fasciitis.Results There were statistically significant differences in the highest fre-quency brightness level and average brightness level of the fascia thickness,elastic strain ratio,and intra fascia ROI in the acu-puncture group before and after treatment.The comfort needle group only had statistically significant differences in fascia thick-ness and elastic strain ratio before and after treatment,while the waiting group had no statistically significant differences in all parameters before and after treatment.Conclusion Conventional ultrasound imaging and real-time ultrasound elastography can clearly and quantitatively display the changes in various parameters of patients with chronic plantar fasciitis before and after treat-ment,providing a basis for clinical evaluation of the efficacy of chronic plantar fasciitis after treatment.
基金项目
中国中医科学院科技创新工程课题(CI2021A03315)
NETL
NSTL
万方数据