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针灸中的精准靶向：一项针对非特异性下腰痛的超声引导方法的试点及可行性研究方案

Precision targeting in acupuncture: a pilot and feasibility study protocol of ultrasound-guided approach for non-specific low back pain.

作者信息

Liu Zihan, Chang Tianying, Fu Jili, Chi Hui, Wang Xiaodan, Wang Lisha, Cui Wenqi, Cui Yingzi, Cong Zhibin

机构信息

Changchun University of Chinese Medicine, Changchun, Jilin Province, China.

EBM Office, the Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, Jilin Province, China.

出版信息

Pilot Feasibility Stud. 2025 Jul 1;11(1):89. doi: 10.1186/s40814-025-01673-x.

DOI:10.1186/s40814-025-01673-x
PMID:40598418
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12210429/
Abstract

INTRODUCTION: Non-specific low back pain (NLBP) is increasingly prevalent in the world due to changes in lifestyle and work habits. It is found that the symptom is usually associated with damage in the thoracolumbar fascia (TLF) and its surrounding muscles. This paper introduces a pioneering approach for treating NLBP, using the heterogeneous echo zones on ultrasound images as needling targets, presenting a novel treatment protocol. METHODS: An open randomized controlled trial is designed and conducted, in which 48 patients with NLBP will be randomly allocated at a ratio of one to one to an ultrasound-guided acupuncture (UGA) group and a regular acupuncture treatment (RA) group. The trial involves a 3-week treatment along with a follow-up for 3 weeks. Its primary purpose is to evaluate the feasibility and safety of ultrasound-guided acupuncture in the TLF and its adjacent muscles as a treatment method for NLBP. As its secondary objective, the treatment effectiveness will be assessed by observing the changes in the patient's pain level and low back dysfunction before and after treatment. The ultrasound-related parameters and adverse events will also be collected. DISCUSSION: It is a novel therapeutic approach to treat NLBP with ultrasound-guided acupuncture performed in the TLF and its adjacent muscles, which is characterized by integrating acupuncture with ultrasound. This study is a single-site, open, randomized controlled study designed and conducted to evaluate the effectiveness of the method. If this strategy turns out to be safe and feasible, future in-depth and extensive research will be planned. TRIAL REGISTRATION: International Traditional Medicine Clinical Trial Registry, ITMCTR2025000046. Registered on January 9, 2025. http://itmctr.ccebtcm.org.cn/.

摘要

引言：由于生活方式和工作习惯的改变，非特异性下腰痛（NLBP）在全球范围内日益普遍。研究发现，该症状通常与胸腰筋膜（TLF）及其周围肌肉的损伤有关。本文介绍了一种开创性的治疗NLBP的方法，即将超声图像上的异质回声区作为针刺靶点，提出了一种新颖的治疗方案。 方法：设计并进行了一项开放性随机对照试验，48例NLBP患者将按1:1的比例随机分配到超声引导下针刺（UGA）组和常规针刺治疗（RA）组。试验包括为期3周的治疗以及3周的随访。其主要目的是评估在TLF及其相邻肌肉中进行超声引导下针刺作为NLBP治疗方法的可行性和安全性。作为次要目标，将通过观察患者治疗前后疼痛程度和腰部功能障碍的变化来评估治疗效果。还将收集超声相关参数和不良事件。 讨论：在TLF及其相邻肌肉中进行超声引导下针刺治疗NLBP是一种新颖的治疗方法，其特点是将针刺与超声相结合。本研究是一项单中心、开放性、随机对照研究，旨在评估该方法的有效性。如果该策略被证明是安全可行的，将计划在未来进行深入和广泛的研究。 试验注册：国际传统医学临床试验注册中心，ITMCTR2025000046。于2025年1月9日注册。http://itmctr.ccebtcm.org.cn/

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本文引用的文献

[1]
[Scoping review of acupuncture-moxibustion treatment for non-specific low back pain].

Zhongguo Zhong Yao Za Zhi. 2023-12

[2]
Global, regional, and national burden of low back pain, 1990-2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021.

Lancet Rheumatol. 2023-5-22

[3]
Ultrasound Imaging of Thoracolumbar Fascia Thickness: Chronic Non-Specific Lower Back Pain versus Healthy Subjects; A Sign of a "Frozen Back"?

Diagnostics (Basel). 2023-4-16

[4]
Nonspecific Low Back Pain.

N Engl J Med. 2022-5-5

[5]
Hyaluronan homeostasis and its role in pain and muscle stiffness.

PM R. 2022-12

[6]
Exercise therapy for chronic low back pain.

Cochrane Database Syst Rev. 2021-9-28

[7]
Efficacy, acceptability, and safety of muscle relaxants for adults with non-specific low back pain: systematic review and meta-analysis.

BMJ. 2021-7-7

[8]
Hyaluronan and the Fascial Frontier.

Int J Mol Sci. 2021-6-25

[9]
Therapeutic ultrasound for chronic low back pain.

Cochrane Database Syst Rev. 2020-7-5

[10]
The Influence of Cognitive Behavioral Therapy on Pain, Quality of Life, and Depression in Patients Receiving Physical Therapy for Chronic Low Back Pain: A Systematic Review.

PM R. 2019-2

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