石氏伤科颈椎定位旋转扳法的动力学参数在体测量  

In vivo measurement of kinetic parameters of cervical fixed-position rotary pulling manipulation of Shi's department of traumatology

作　　者：邓真[1] 王辉昊[1] 王宽[1] 沈知彼[1] 陈威烨[1] 詹红生[1] DENG Zhen;WANG Huihao;WANG Kuan;SHEN Zhibi;CHEN Weiye;ZHAN Hongsheng(Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,The Institute of Traumatology and Orthopedics Affiliated to Shanghai Academy of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院,上海市中医药研究院骨伤科研究所,上海201203

出　　处：《中医正骨》2018年第3期17-21,共5页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：国家自然科学基金项目(81473702,81503596,81202707,81001528);上海市科学技术委员会科研计划项目(14401970402,16401970102,15401934100);上海市卫生和计划生育委员会项目(2017ZZ02024,20170242,ZXYXZ201703,ZYKC201602006,ZY3-LCPT-2-1005);上海市市级医院新兴前沿技术联合攻关项目(SHDC12014121);詹红生上海市名老中医学术经验研究工作室建设项目(SHGZS-2017025,SZYMZYGZS4013)

摘　　要：目的:探讨石氏伤科颈椎定位旋转扳法动力学参数的特征及各参数之间的相互关系。方法:招募34名无明显手法治疗禁忌证的健康志愿者,男29名、女5名,年龄(22.30±4.60)岁。由同一位操作者分别对所有受试者进行石氏伤科颈椎定位(C_5棘突)旋转扳法操作,左右两侧各操作1次。手法操作前,分别在受试者C_5棘突两侧和双侧颏结节处粘贴测力片。采用Runinsense运动力学测量系统记录测定的力-时间曲线图,通过分析力-时间曲线图获取预载荷、载荷峰值、扳动力、扳动时间和施术时间等动力学参数。结果:34名受试者全部完成试验,未发生不良事件。左右两侧施术时间比较,差异无统计学意义[(2 362.65±559.28)ms,(2 403.24±645.33)ms,t=3.591,P=0.631]。C_5棘突左侧的预载荷、扳动力均大于右侧[(7.84±4.03)kg,(6.42±3.20)kg,t=3.374,P=0.042;(6.93±3.21)kg,(6.90±2.36)kg,t=3.363,P=0.049];C_5棘突两侧的载荷峰值、扳动时间比较,两侧间差异均无统计学意义[(14.78±4.78)kg,(13.33±4.50)kg,t=3.202,P=0.069;(159.12±34.50)ms,(148.82±33.00)ms,t=3.271,P=0.056]。左侧颏结节处的载荷峰值、扳动力均大于右侧[(7.68±2.90)kg,(6.68±2.82)kg,t=3.025,P=0.034;(4.49±2.10)kg,(3.42±2.03)kg,t=3.403,P=0.017],扳动时间小于右侧[(165.59±33.59)ms,(182.94±55.21)ms,t=3.786,P=0.025];双侧颏结节处的预载荷比较,差异无统计学意义[(3.18±1.29)kg,(3.27±1.30)kg,t=3.423,P=0.067]。C_5棘突左侧的扳动时间比右侧颏结节处的扳动时间短(t=3.356,P=0.042),C_5棘突右侧的扳动时间比左侧颏结节处的扳动时间短(t=3.307,P=0.038)。左侧颈椎定位旋转扳法操作时,C_5棘突左侧的预载荷与载荷峰值呈正相关(r=0.747,P=0.000);载荷峰值与扳动力呈正相关(r=0.551,P=0.003);C_5棘突左侧其他动力学参数相互之间均不存在直线相关关系。右侧颏结节处的预载荷与载荷峰值、扳动力均呈正相关(r=0.756,P=0.001;r=0.413,P=0.023);载荷峰值与To explore the characteristics of kinetic parameters of cervical fixed-position rotary pulling manipulation of Shi's department of traumatology and the relationship between these parameters.Methods:Thirty-four healthy volunteers without obvious contraindications for manipulation were recruited.They consisted of 29 males and 5 females and their ages were 22.30+/-4.60 years.The cervical fixed-position(C5 spinous process)rotary pulling manipulation of Shi's department of traumatology was performed on all subjectsby the same doctor on the left and the right side respectively.Force measuring sensors were fixed on both sides of C5 spinous process and bilateral mental tubercles of subjects before the manipulation.The force-time curve chart was drawn and recorded by using Runinsense kinematic measuring system.The kinetic param eters,including preload,peak load,thrust force,thrust time and operating tim e,were obtained through analyzing the force-time curve chart.Results:The trials were finished in all subjects and no adverse events occurred.There was no statistical difference in operating time between the left side and the right side(2 362.65+/-5 5 9.28 vs 2 403.24+/-6 4 5.33 m s,^=3.5 9 1,P=0.6 3 1).The preload and the thrust force were greater on the left side compared to the right side of C5 spinous process(7.8 4+/-4.03 vs 6.4 2+/-3.20 kg,^=3.3 7 4,P=0.042;6.93+/-3.21 vs 6.90+/-2.36 kg,^=3.3 6 3,P=0.0 4 9).There was no statistical difference in peak load and thrust time between the left side and the right side of C5 spinous process(14.78+/-4.78 vs 13.33+/-4.50 kg,^=3.2 0 2,P=0.0 69;159.12+/-34.50 vs 148.82+/-33.00 m s,t=3.21\,P=0.0 5 6).The peak load and the thrust force were greater and the thrust time was shorter on the left mental tubercle compared to the right mental tubercle(7.68+/-2.90 vs 6.68+/-2.8 2 k g^=3.0 2 5,P=0.0 34;4.49+/-2.10 vs 3.4 2+/-2.0 3 k g^=3.403=0.017;165.59+/-3 3.5 9 vs 182.94+/-55.21 m s,^=3.786=0.0 2 5).There was no statistical difference in preload between the bilateral mental tubercles(3.18

关 键 词：颈椎 手法 整骨 扳法 动力学 

分 类 号：R274[医药卫生—中医骨伤科学]