颈椎治疗过程中骨与椎体的生物力学变化  

Biomechanical changes associated with vertebral body in the process of cervical spondylosis treatment

作　　者：姜淑云[1] 严隽陶[1] 房敏[1] 左亚忠[2] 龚利[1] 孙武权[1] 

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海市200437 [2]上海交通大学医学院附属第一人民医院,上海市200080

出　　处：《中国组织工程研究与临床康复》2009年第11期2029-2032,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：国家自然基金项目(30472247);国家科技部九七三计划项目(2007CB512700);上海市科委项目(024119022)~~

摘　　要：目的:观察颈椎病患者与正常人、颈椎病患者治疗前后影像学和颈周肌群力学指标变化情况,探讨颈椎稳定性在颈椎病发病中的作用,对颈椎病患者非手术疗法的效果以及颈椎病患者的康复结果进行评定。方法:实验于2005-09/2008-11在上海中医药大学附属岳阳中西医结合医院和国家中医药管理局推拿生物力学三级实验室完成。将63例颈椎病患者随机分为推拿组和牵引组,30名正常人做对照组。选取年龄性别与对照组相匹配的颈椎病患者30例,比较两者不稳节段发生率、不稳发生节段部位,以及颈肌力学指标,并观察颈椎病患者采用推拿和牵引治疗2周后的颈椎椎体位移以及颈周肌肌力。结果:①与正常人相比颈椎节段出现不稳病例数及节段数均显著升高。②推拿组患者治疗后颈椎不稳病例数和不稳节段数均显著减少。③颈椎病患者颈伸肌和颈屈肌在60(°)/s等速运动状态下峰值力矩(PT)、F/E显著低于正常人群。④推拿手法治疗后颈椎病患者的峰值力矩、主动肌/拮抗肌比值都有显著的改善。结论:①颈椎稳定性和颈椎周围肌群尤其是颈伸肌肌力变化是颈椎病发生和发展的重要因素。②改善颈椎周围肌群尤其是颈伸肌的肌力是颈椎病手法等非手术治疗方法发生作用的关键环节。OBJECTIVE： To investigate the role of cervical muscles in cervical spondylosis according to the changes of radiology findings and strength cervical extension muscles between cervical spondylosis patients and normal people, in addition, to evaluate the effect of patients with cervical spondylosis treated with nonoperative therapy and rehabilitation. METHODS： The experiment was performed at the Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine and Massage Laboratory of State Administration of Traditional Chinese Medicine from December 2005 to November 2008. Sixty-three patients with cervical spondylosis were randomly divided into massage and traction groups, other 30 normal people were served as the control group. The differences of incidence rate of unstable segments position of unstable segments was compared between patients and normal people, more over, the vertebra displacement and strength of cervical extension muscles after 2 weeks in the massage and traction group was observed. RESULTS： （1）Compared with normal population, the number of cervical segments instability and the cases in several segments were significantly increased.（2）After treatment, the number of cervical segments instability and the cases in several segments were significantly reduced in the massage group. （3）Compared with the normal population, Patients with cervical spondylosis, neck extensor and flexor peak torque （PT）, active muscle/antagonist muscle ratio （F/E） was significantly reduced at 60 ° /s kinetic exercise. （4）After treatment, PT and the active muscle/antagonist muscle ratio was significantly improved in the massage group. CONCLUSION： The characteristics of cervical extension muscles contributed to the prevalence of cervical spondylosis. Cervical muscles play an important role in treating cervical spondylosis without operation.

关 键 词：颈椎节段 稳定性 肌力 颈椎病 推拿 

分 类 号：R681.531[医药卫生—骨科学]