摘要
目的:探讨剪切波声弹性成像技术用于测量不同肌张力时足三里穴位的紧张度变化及运用该方法探测针刺前后足三里穴位紧张度的意义。方法:使用法国Supersonic公司的AixPlore型实时定量剪切波弹性成像超声诊断仪,将L4～15线阵探头置于足三里穴位断面,分别在仰卧位、站位及肌肉紧张时连续记录足三里穴位的组织弹性图,然后通过电影回放,使用其定量分析系统Q-BOX,直径为3mm,每隔20帧测量1次杨氏模量值,各15次,共计测量45次足三里穴位的杨氏模量值变化。毫针在高频超声引导下以经穴断面解剖图谱为依据,对照精确定位;启动弹性成像模式(SWE)记录组织弹性图,使用其定量分析系统Q-BOX,直径为3mm时,测量30名受试者在进针前、进针后及脉冲电刺激时足三里穴位的杨氏模量值。结果:剪切波声弹性成像定量分析系统Q-BOX,直径为3mm,卧位时足三里穴位杨氏模量平均值为(14.01±4.38)kPa(1kPa=0.133mmHg),站位时为(87.24±30.33)kPa,肌肉主动收缩时为(87.42±12.12)kPa;Q-BOX直径为3mm时,卧位进针前、进针后及电刺激时穴位杨氏模量平均值分别为(12.61±6.27)kPa、(24.00±11.94)kPa、(111.48±52.81)kPa;进针前与进针后,进针前与电刺激时的杨氏模量比较,差异均有统计学意义(P<0.01)。结论:剪切波声弹性成像技术可用于肌张力的定量分析,不同的肌张力状态对穴位的紧张度测量有明显影响,为多种疾病状态下的肌张力定量分析及客观评估提供了新方法及新思路。剪切波声弹性成像技术用于足三里穴位"得气"的紧张度研究应在卧位全身肌肉放松状态下进行,它为中医针灸穴位"得气"研究提供了一种新手段。
Objective： To explore the significance of using shear-wave elasto-sonograpgy in the measurement of muscular tensity of Zusanli under different muscular tension condition and explore the significance of detecting Zusanli tension before and after acupuncture by shear-wave elasto-sonograpgy. Methods：The muscular tensity of Zusanli was measured and recorded by a real- time quantitive shear-wave elasto-sonograpgy instrument （AixPlorer）which was produced by France Supersonic company. The muscular tension of Zusanli was detected when the subject took different postures（dorsal decubitus, stance and musculartone） with the L4-15 linear array probe applied at Zusanli acupoint section. After that,the muscular tensity of Zusanli of 30 subjects was measured before acupuncture, during acupuncture and during electroacupuncture then results were compared. The spots of point Zusanli were pinpointed by high-frequency ultrasound according to anatomy atlas of meridian acupoints section. Results：The av erage value of Young＇s modulus in the spots of point Zusanli with supine position was （14.01± 4.38）kPa, with stand position was（87.24±30.33）kPa,with active contractive muscle was（87. 42±12.12）kPa when the diameter of sample was 3ram in the Quantity analysis system of Shear-wave elasto-sonograpgy. The average value of Young＇s modulus in the spots of point Zusanli at decubitus posture during the ahead of acupuncture, acupuncture and electroacupuncture was（ 12.61 ± 6.27）kPa, （24.00± 11.94）kPa,（111. 48±52.81）kPa when the diameter of sample was 3mm in the Quantity analysis system of Shear wave elas- tograpgy. The average value of Young＇s modulus in the spots of point Zusanli during acupuncture was significantly higher than that of the group during the ahead of acupuncture, （P〈0.01）when the diameter of sample was 3ram. The average value of Young＇s modulus in the spots of point Zusanii during electroacupuncture was significantly higher than that of the group during acupuncture, （P〈0.01）when the diameter of sample was 3mm. Conclusions：Shear-wave elasto-sonography can be used in quan- titative analysis of muscular tension and the tension of the acupuncture points will be significantly affected by different degree of muscle tension. The muscular tension can be quantitatively detected by Shear-wave elasto-sonography. Using of Shear-wave elasto-sonography can provide a new method and new idea for quantitative analysis and objective assessment for muscular ten sion of a variety of diseases. The non-invasive measurement of muscular tension of Zusanli by Shear-wave elasto-sonograpgyduring acupuncture and electroaeupuncture provides a new way for the study of ＂De Qi＂ in TCM acupuncture and the study should be applied with the supine position in all the muscle relaxation state.
出处
《中国中西医结合影像学杂志》
2013年第2期113-115,F0002,共4页
Chinese Imaging Journal of Integrated Traditional and Western Medicine
基金
上海市教委科研课题(shzy020)
关键词
弹性成像技术
足三里穴位
肌张力
针灸
Elasticity imaging techniques
Zusanli
Muscletonus
Acupuncture
