基于下肢肌肉激活模式及经筋理论的膝骨关节炎临床研究进展  

Clinical Research Progress of Knee Osteoarthritis Based on Activation Model of Lower Limb Muscles and Theory of Meridians

作　　者：邢华 龚利[1] 邵盛[1] 储宇舟[1] 陈浩 何鹏飞[1] 沈佳韵 XING Hua;GONG Li;SHAO Sheng;CHU Yuzhou;CHEN Hao;HE Pengfei;SHEN Jiayun(Yueyang Integrative Medlicine Hospital Affliated to Shanghai University of Tradlitional Chinese Medlicine,Shanghai China 200437)

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200437

出　　处：《中医学报》2020年第8期1676-1680,共5页Acta Chinese Medicine

基　　金：国家自然科学基金面上项目(81373763);上海市科学技术委员会资助项目(15401970700);上海中医药大学研究生创新能力项目(Y2019079);上海市虹口区“国医强优”三年行动计划建设项目(HGY-MZY-2018-09)。

摘　　要：肌肉激活模式不同于单纯肌力、肌张力的测量,能较好反映一个步态周期中膝关节周围肌肉激活的模式,体现出一个动态活动的过程。单块肌肉的激活模式变化会引起肌肉对、肌群的模式改变,从而影响关节功能和骨性结构。膝骨关节炎患者膝关节周围肌肉激动的具体模式尚无定论,有待进一步流行病学研究。此外肌肉激活模式的变化与神经系统有关,肌肉兴奋与脊髓前角中的阿尔法运动神经元有关,两者之间的关联性需要进一步挖掘,从肌动学分析膝骨关节炎不能单一地从肌肉骨骼系统探索,其内在必然是多系统的联合效应,包括循环系统、神经系统等对于病变作出的代偿机制。目前临床上对于膝骨关节炎患者肌肉激活模式的研究较少,膝骨关节炎的治疗不能局限于结构,应更加注重功能改善,而肌肉激活模式正是体现关节活动功能的动态指标。因此在制定临床治疗方案时,将其纳入考量范围,纠正肌肉激活模式,改善主动肌和拮抗肌的活动模式,以取得更好的临床疗效。Muscle activation mode is different from the measurement of simple muscle strength and muscle tension.It can better reflect the activation mode of the muscles around the knee joint in a gait cycle,reflecting a dynamic activity process.Changes in the activation pattern of a single muscle will cause changes in the pattern of muscle pairs and muscle groups,thereby affecting joint function and bone structure.The specific pattern of muscle excitement around the knee joint in patients with knee osteoarthritis is inconclusive,and further epidemiological studies are needed.In addition,the changes in muscle activation mode are related to the nervous system.Muscle excitement is related to the alpha motor neurons in the anterior horn of the spinal cord.The correlation between the two needs to be further explored.From the analysis of kinematics,knee osteoarthritis cannot be isolated from the muscle.The exploration of the skeletal system is inherently a combined effect of multiple systems,including the circulatory system,nervous system and other compensation mechanisms for the disease.At present,there are few clinical studies on the muscle activation pattern of patients with knee osteoarthritis.The treatment of knee osteoarthritis cannot be limited to the structure,and more attention should be paid to functional improvement.The muscle activation pattern is a dynamic indicator that reflects the function of joint activity.Therefore,when formulating a clinical treatment plan,it should be taken into consideration,correct muscle activation,improve the active pattern of active muscles and antagonistic muscles,in order to achieve better clinical efficacy.

关 键 词：膝骨关节炎 下肢肌肉激活模式 经筋理论 

分 类 号：R259.843[医药卫生—中西医结合]