基于仿真技术的腰椎间盘突出症“经筋失衡”的研究  

Exploration of the Musculature Imbalance in Lumbar Disc Herniation Patients by Gait Simulation

作　　者：刘慧[1] 沈国权[2] 张喜林[2] 周楠[2] 杨晓伟 黄文杰[4] LIU Hui;SHEN Guo-Quan;ZHANG Xi-Lin;ZHOU Nan;YANG Xiao-Wei;HUANG Wen-Jie(Dept.of Traditional Chinese Medicine,the Affiliated Hospital of Qingdao University,Qingdao 266000 Shandong,China;Dept.of Tuina,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China;Shanghai Jiao Tong University,Shanghai 200420,China)

机构地区：[1]青岛大学附属医院中医科,山东青岛266000 [2]上海中医药大学附属岳阳中西医结合医院推拿科,上海200437 [3]上海中医药大学附属龙华医院,上海200032 [4]上海交通大学,上海200240

出　　处：《广州中医药大学学报》2021年第4期655-662,共8页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:81173358);上海市自然科学基金项目(编号:13ZR1442900);上海市科委创新课题资助项目(编号:14YZ060);山东省中医药科技发展计划项目(编号:2019-0408)。

摘　　要：【目的】基于仿真技术,分析异常步态模式下腰椎间盘突出症(LDH)患者腰及下肢的肌群肌肉力变化,将肌肉按照肌筋膜理论与经筋理论进行匹配,探讨LDH患者“经筋失衡”的特点。【方法】选取2015年8月~2016年10月在上海中医药大学附属岳阳中西医结合医院推拿科接受治疗的20例LDH患者作为LDH组,另选取5例同期体检正常的健康志愿者作为正常组。采集正常组和LDH组的步态分析数据,以驱动AnyBody肌骨模型进行逆向动力学分析,得到腰、骨盆及下肢肌肉力和关节力,并通过比较以分析LDH患者腰及下肢肌肉失衡规律。【结果】LDH组患侧背侧链肌群和胫骨后肌的肌肉力峰值有小于健侧的趋势,而患侧外侧链和前表链大部分肌肉的肌肉力峰值有大于健侧的趋势。【结论】LDH患者两侧肢体存在“经筋失衡”状态,以患侧背侧链肌群和胫骨后肌肌肉力减小、外侧链和前表链肌群肌肉力增大为特征。Objective To analyze the changes of muscle force of waist and lower limb of lumbar disc herniation(LDH)patients under the mode of abnormal gait by using the gait simulation technique,and to explore the characteristics of the musculature imbalance in LDH patients.Methods The study was carried out in 20 LDH patients(served as LDH group)admitted in the Tuina Department of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,which is affiliated to Shanghai University of Traditional Chinese Medicine,from August 2015 to October 2016,and 5 healthy volunteers taking the health examination in the same period served as the normal group.We collected the gait analysis data of the normal subjects and LDH patients,and obtained their ground reaction forces and parameters of body movement in drive AnyBody musuloskeletal model.By inverse kinetic analysis,the muscle force of the loin,pelvis,and lower limbs was calculated.After comparing the peak muscle force value of bilateral body sides of the LDH patients,we explored the regular patterns of muscle dysfunction of LDH patients.Results In the LDH group,the peak muscle force of the superficial back muscle chains and tibialis posterior of the affected side showed a decreasing trend,while the peak muscle force of the lateral muscle chains and most of the superficial front muscle chains of the affected side showed an increasing trend in comparison with those of the healthy side.Conclusion In LDH patients,the musculature imbalance exists in the bilateral sides of the patients,and is characterized by the decreased muscle force of the superficial back muscle chains and tibialis posterior of affected side,and by the increased muscle force of the lateral muscle chains and the superficial front muscle chains of the affected side.

关 键 词：腰椎间盘突出症 经筋失衡 步态 仿真技术 

分 类 号：R681.53[医药卫生—骨科学]