微创埋线后PGLA线体对正常人体三阴交穴刺激效应的时效性观察
|
摘要
目的:探讨聚乙交酯-丙交酯(PGLA)线体对正常人体经穴刺激效应存在的客观性及时效性,为临床使用PGLA线体行微创埋线及其合理间隔周期提供理论依据。方法:应用医学影像学磁共振成像(MRI)技术采集8例正常人体左侧三阴交穴局部埋线前、后多个时间点T2加权成像(T2WI)压脂及T2图(T2-Mapping)8回波系列图像,所得T2-Mapping 8回波序列图像利用相关软件生成T2-Mapping图后测量埋线局部T2值,分析PGLA线体微创埋线前、后三阴交穴局部T2WI压脂像信号强度及T2值随时间变化的特点。结果:1)埋线前T2WI压脂像上未见异常信号,埋线后各时间点T2WI压脂像上均见到局部高信号,其中埋线后8h、埋线后第3天、埋线后第7天局部信号强度之间无明显差异,埋线后第10天局部信号强度较前减弱,埋线后第14天局部信号强度较前明显减弱。2)与埋线前比较,埋线后各时间点T2值均显著升高(P<0.01);埋线后1周内各时间点T2值之间比较:埋线后8h、埋线后第3天、埋线后第7天之间差异无统计学意义(P>0.05);埋线1周后各时间点T2值之间比较:埋线后第10天与埋线后第7天相比T2值有所下降但差异无统计学意义(P>0.05),埋线后第14天(2周)与埋线后第7天(1周)相比T2值明显下降(P<0.01)。结论:PGLA线体对正常人体经穴局部的刺激效应客观存在且具有一定时效性,其有效刺激时间在14d左右,临床使用同规格型号的PGLA线体施行微创埋线时合理的埋植间隔周期应在14d左右。
Objective To observe the time-effect of stimulation of the embedded poly glycolide-co-lactide(PGLA)suture in Sanyinjiao(SP6)area in normal human body,so as to provide an experimental evidence for clinical application of micro-invasion suture-embedding at an appropriate interval.Methods A total of 8 healthy volunteer students(3 boys and 5 girls,ranging in age from 24 to 27 years)were recruited in the present study.A piece of sterilized PGLA suture was implanted into the left SP6 using minimally invasive surgery after strict local skin disinfection.The fat-suppression T2 weighted magnetic resonance images(MRI,displaying local lesion after eliminating interference of fat tissue signals),and T2 mapping 8-echo train images were acquired before and 8 h,3,7,10 and 14 days after PGLA suture embedment by using a MR imaging system.After transformation of the T2-mapping 8-echo train images into T2-mapping images by using a relevant software,the T2 values(meaning the relaxation time of the local muscle)of the left SP6 were measured,followed by analysis of the signal intensity of T2 weighted fat-suppression images and T2 values at different time-points.Results Before the suture embedding,no abnormal signals were found in the signal intensity of T2 weighted fat-suppression images.After PGLA suture embedment,the local signal intensity of T2 WI fatsuppression images was relatively increased at the 8 th h,and on day 3,7,10 and 14 relevant to pre-embedment,but gradually atte-nuated on day 10 and 14.The T2 values were significantly increased at the 5 time-points of post-embedment(all P<0.01),but without significant differences among the 8 thh,the 3 rd and 7 thd(P>0.05),and being markedly lowered on day 14 relevant to day 7(P<0.01)in spite of being still markedly higher than that of pre-embedding(P<0.01).Conclusion The signal intensity of T2 weighted fat-suppression images and T2 values acquired from PGLA-suture-embedded SP6 acupoint area in healthy subjects may keep at least for 2 weeks,suggesting that the stimulating reaction of suture-embedment persists more than 14 days.Hence,when a micro-invasion embedding with PGLA suture performed,the interval of two weeks would be appropriate.
Objective To observe the time-effect of stimulation of the embedded poly glycolide-co-lactide(PGLA)suture in Sanyinjiao(SP6)area in normal human body,so as to provide an experimental evidence for clinical application of micro-invasion suture-embedding at an appropriate interval.Methods A total of 8 healthy volunteer students(3 boys and 5 girls,ranging in age from 24 to 27 years)were recruited in the present study.A piece of sterilized PGLA suture was implanted into the left SP6 using minimally invasive surgery after strict local skin disinfection.The fat-suppression T2 weighted magnetic resonance images(MRI,displaying local lesion after eliminating interference of fat tissue signals),and T2 mapping 8-echo train images were acquired before and 8 h,3,7,10 and 14 days after PGLA suture embedment by using a MR imaging system.After transformation of the T2-mapping 8-echo train images into T2-mapping images by using a relevant software,the T2 values(meaning the relaxation time of the local muscle)of the left SP6 were measured,followed by analysis of the signal intensity of T2 weighted fat-suppression images and T2 values at different time-points.Results Before the suture embedding,no abnormal signals were found in the signal intensity of T2 weighted fat-suppression images.After PGLA suture embedment,the local signal intensity of T2 WI fatsuppression images was relatively increased at the 8 th h,and on day 3,7,10 and 14 relevant to pre-embedment,but gradually atte-nuated on day 10 and 14.The T2 values were significantly increased at the 5 time-points of post-embedment(all P<0.01),but without significant differences among the 8 thh,the 3 rd and 7 thd(P>0.05),and being markedly lowered on day 14 relevant to day 7(P<0.01)in spite of being still markedly higher than that of pre-embedding(P<0.01).Conclusion The signal intensity of T2 weighted fat-suppression images and T2 values acquired from PGLA-suture-embedded SP6 acupoint area in healthy subjects may keep at least for 2 weeks,suggesting that the stimulating reaction of suture-embedment persists more than 14 days.Hence,when a micro-invasion embedding with PGLA suture performed,the interval of two weeks would be appropriate.
引文
[1]王念宏,张子英.微创埋线安全性浅析[J].中国针灸,2016,36(2):184-186.
[2]霍金,赵冏琪,袁永,等.穴位埋线疗法作用机制的研究现状[J].中国针灸,2017,37(11):1251-1254.
[3]梁欣,聂红昉,侯珣瑞,等.运用磁共振T2图动态观察正常人体足三里穴微创埋线后线体对局部的刺激效应[J].针刺研究,2016,41(4):356-360.
[4]梁欣,聂红昉,侯珣瑞.微创埋线后线体对正常人体经穴刺激效应的时效观察[J].中国针灸,2016,36(6):607-611.
[5]孙文善,郯志清.新型生物医学材料及其在微创埋线中的应用价值[J].上海针灸杂志,2010,29(2):131-132.
[6]郭长青,刘乃刚,胡波.针灸穴位图解[M].2版,北京:人民卫生出版社,2013:75-76.
[7]宋玲玲,梁碧玲,沈君,等.MR T2图评价膝关节软骨的初步探讨[J].中华放射学杂志,2008,42(3):231-235.
[8]孙文善.微创埋线临床操作规范[J].上海针灸杂志,2012,31(1):69.
[9]任树森.中医穴位埋线疗法[M].北京:中国中医药出版社,2011:5.
[10]韦宝伟,刘布鸣.聚乳酸乙醇酸的生物降解和安全性研究进展[J].现代药物与临床,2012,27(4):422-428.
[11]刘慧敏.聚乙丙交酯新型埋线材料与羊肠线的临床应用比较[J].中国组织工程研究,2012,16(38):7185-7192.
[12]唐青青,蔡红.不同材质微创埋线治疗单纯性肥胖症临床观察[J].江苏中医药,2013,45(6):45-46.
[13]王莲莲,李景溪,施展.可吸收缝线材料的可降解与临床应用[J].中国组织工程研究,2015,19(16):2619-2623.
[14]黄振国,闫燃,张雪哲,等.MRI在多发性肌炎、皮肌炎诊疗中的应用[J].磁共振成像,2012,3(4):260-264.
[15]杨正汉,冯逢,王霄英.磁共振成像技术指南[M].北京:人民军医出版社,2007:223-224.
[16]杨敏星,闫然,黄振国,等.T2-mapping在特发性炎性肌病中的应用[J].临床放射学杂志,2014,33(4):559-563.
[2]霍金,赵冏琪,袁永,等.穴位埋线疗法作用机制的研究现状[J].中国针灸,2017,37(11):1251-1254.
[3]梁欣,聂红昉,侯珣瑞,等.运用磁共振T2图动态观察正常人体足三里穴微创埋线后线体对局部的刺激效应[J].针刺研究,2016,41(4):356-360.
[4]梁欣,聂红昉,侯珣瑞.微创埋线后线体对正常人体经穴刺激效应的时效观察[J].中国针灸,2016,36(6):607-611.
[5]孙文善,郯志清.新型生物医学材料及其在微创埋线中的应用价值[J].上海针灸杂志,2010,29(2):131-132.
[6]郭长青,刘乃刚,胡波.针灸穴位图解[M].2版,北京:人民卫生出版社,2013:75-76.
[7]宋玲玲,梁碧玲,沈君,等.MR T2图评价膝关节软骨的初步探讨[J].中华放射学杂志,2008,42(3):231-235.
[8]孙文善.微创埋线临床操作规范[J].上海针灸杂志,2012,31(1):69.
[9]任树森.中医穴位埋线疗法[M].北京:中国中医药出版社,2011:5.
[10]韦宝伟,刘布鸣.聚乳酸乙醇酸的生物降解和安全性研究进展[J].现代药物与临床,2012,27(4):422-428.
[11]刘慧敏.聚乙丙交酯新型埋线材料与羊肠线的临床应用比较[J].中国组织工程研究,2012,16(38):7185-7192.
[12]唐青青,蔡红.不同材质微创埋线治疗单纯性肥胖症临床观察[J].江苏中医药,2013,45(6):45-46.
[13]王莲莲,李景溪,施展.可吸收缝线材料的可降解与临床应用[J].中国组织工程研究,2015,19(16):2619-2623.
[14]黄振国,闫燃,张雪哲,等.MRI在多发性肌炎、皮肌炎诊疗中的应用[J].磁共振成像,2012,3(4):260-264.
[15]杨正汉,冯逢,王霄英.磁共振成像技术指南[M].北京:人民军医出版社,2007:223-224.
[16]杨敏星,闫然,黄振国,等.T2-mapping在特发性炎性肌病中的应用[J].临床放射学杂志,2014,33(4):559-563.