不同时长法对腰肌劳损患者腰背部肌电信号的影响  

Effects of rolling manipulation with different durations on lumbodorsal electromyographic signals in patients with humbar muscle strain

作　　者：董文阳 孙武权[2] 朱清广[2] 张帅攀 单一鸣[2] 刘元红 陈金田 DONG Wenyang;SUN Wuquan;ZHU Qingguang;ZHANG Shuaipan;SHAN Yiming;LIU Yuanhong;CHEN Jintian(Longhua Hospital Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China;Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;School of AcupunctureMoxibustion and Tuina,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Shanghai Tongren Hospital,Shanghai200336,China)

机构地区：[1]上海中医药大学附属龙华医院,上海200032 [2]上海中医药大学附属岳阳中西医结合医院,上海200437 [3]上海中医药大学针灸推拿学院,上海201203 [4]上海同仁医院,上海200336

出　　处：《中医正骨》2023年第6期49-52,58,共5页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：国家自然科学基金项目(81874512)。

摘　　要：目的:观察不同时长■法对腰肌劳损患者腰背部肌电信号的影响。方法:将75例符合要求的腰肌劳损患者随机分为3组,每组25例。3组患者均于腰背部足太阳膀胱经循行处(两侧竖脊肌和腰方肌)行■法治疗,■法时长分别为5 min(短时间组)、10 min(中等时间组)、15 min(长时间组)。■法的前摆垂向力为50~70 N、回摆垂向力为20~40 N,■法频率为138次·min^(-1)。每周治疗3次,连续治疗2周。分别于治疗前及末次治疗后采用表面肌电仪采集两侧竖脊肌和腰方肌的表面肌电信号,比较3组患者的两侧竖脊肌和腰方肌表面肌电信号频率。结果:3组患者均有4例退出,其中短时间组4例均为不愿继续参加试验,中等时间组1例为不按要求治疗、3例为不愿继续参加试验,长时间组2例为不按要求治疗、2例为不愿继续参加试验。治疗前和末次治疗后,3组患者左侧竖脊肌、右侧竖脊肌、左侧腰方肌、右侧腰方肌的表面肌电信号频率比较,组间差异均无统计学意义[治疗前:H=2.611,P=0.271;H=3.417,P=0.181;H=1.934,P=0.380;H=2.440,P=0.295;末次治疗后:H=5.805,P=0.055;H=3.159,P=0.206;H=3.530,P=0.171;H=2.511,P=0.285];3组患者左侧竖脊肌、右侧竖脊肌表面肌电信号频率治疗前后的差异均无统计学意义(左侧竖脊肌:Z=0.243,P=0.808;Z=-1.234,P=0.217;Z=-0.295,P=0.768;右侧竖脊肌:Z=0.678,P=0.498;Z=1.443,P=0.149;Z=-0.280,P=0.779);短时间组和长时间组患者左侧腰方肌、右侧腰方肌表面肌电信号频率治疗前后的差异无统计学意义(左侧腰方肌:Z=0.000,P=1.000;Z=-0.653,P=0.513;右侧腰方肌:Z=0.608,P=0.543;Z=-0.591,P=0.555),中等时间组患者末次治疗后左侧腰方肌、右侧腰方肌的表面肌电信号频率较治疗前增高[左侧腰方肌:(77.2,23.6)Hz,(86.7,31.1)Hz,Z=-2.240,P=0.025;右侧腰方肌:(81.3,29.9)Hz,(81.3,32.5)Hz,Z=-2.833,P=0.005]。结论:在前摆垂向力为50~70 N、回摆垂向力为20~40 N、频率为138次·min^(-1)的条件Objective:To observe the effects of rolling manipulation with different durations on lumbodorsal electromyographic(EMG)signals in patients with lumbar muscle strain(LMS).Methods:Seventyfive patients with LMS were enrolled in the study and were randomly divided into 3 groups,25 cases in each group.The patients were treated with rolling manipulation 138 times in a minute along the lumbodorsal bladder meridian of FootTaiyang,that was to say bilateral erector spinae muscle(ESM)and quadratus lumborum muscle(QLM),for 5 minutes(short time group),10 minutes(medium time group)and 15 minutes(long time group)respectively.The frontswing vertical force and backswing vertical force of the manipulation were 50-70 N and 20-40 N respectively.All patients in the 3 groups were treated three times a week for consecutive 2 weeks.The surface EMG signals of bilateral ESM and QLM were collected by using surface electromyography before the treatment and after the last treatment respectively,and the surface EMG signal frequencies were compared among the 3 groups.Results:Four patients in short time group,3 cases in medium time group and 2 cases in long time group dropped out of the trial for unwilling to continue the trial,while 1 patient in medium time group and 2 cases in long time group dropped out for failing to be treated as required.There was no statistical difference in surface EMG signal frequencies of left ESM,right ESM,left QLM and right QLM among the 3 groups before the treatment and after the last treatment (respectivelypretreatment:H=2.611,P=0.271;H=3.417,P=0.181;H=1.934,P=0.380;H=2.440,P=0.295;after the last treatment:H=5.805,P=0.055;H=3.159,P=0.206;H=3.530,P=0.171;H=2.511,P=0.285).Furthermore,the differences in surface EMG signal frequencies of left ESM and right ESM between pretreatment and posttreatment were not statistically significant in the 3 groups(left ESM:Z=0.243,P=0.808;Z=-1.234,P=0.217;Z=-0.295,P=0.768;right ESM:Z=0.678,P=0.498;Z=1.443,P=0.149;Z=-0.280,P=0.779),and the differences in surface EMG signal frequencies

关 键 词：腰肌 扭伤和劳损 滚法推拿疗法 肌电描记术 临床试验 

分 类 号：R244.1[医药卫生—针灸推拿学]