脊柱手法结合石氏伤科功法改善腰椎曲度的影像学评价研究  

Imaging Evaluation Study of Spinal Manipulation Combined with Shi's Traumatology Exercises to Improve Curvature of Lumbar Spine

作　　者：张开勇[1,2,3,4] 刘鹏 徐斯伟[4] 张必萌[4] 庄园[5] 詹红生 ZHANG Kaiyong;LIU Peng;XU Siwei;ZHANG Bimeng;ZHUANG Yuan;ZHAN Hongsheng(Shi's Traumatology Medical Center,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Institute of Orthopaedics and Traumatology,Shanghai Institute of traditional Chinese Medicine,Shanghai 201204,China;Zhan Hongsheng Shanghai Famous Traditional Chinese Medicine Academic Experience Research Studio,Shanghai 201401,China;Shanghai General Hospital,Shanghai 200940,China;Philips(China)Investment Co.,Ltd,Shanghai 200070,China)

机构地区：[1]上海中医药大学附属曙光医院石氏伤科医学中心,上海201203 [2]上海市中医药研究院骨伤科研究所,上海201204 [3]詹红生上海市名中医学术经验研究工作室,上海201401 [4]上海市第一人民医院,上海200940 [5]飞利浦(中国)投资有限公司,上海200070

出　　处：《辽宁中医杂志》2023年第6期96-99,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：上海市慢性筋骨病临床医学研究中心(20MC1920600);上海市临床重点专科“中医骨伤科学”(shslczdzk03901);全国中医学术流派传承工作室第二论建设项目“石氏伤科”;上海中医药大学高峰造尖行动计划高峰高原创新中医骨伤团队;上海市进一步加快中医药事业发展三年行动计划(2018—2020年);海派中医流派传承工程[ZY(2018-2020)-CCCX-1010];国家自然科学基金项目(81973871);上海市科学技术委员会重点项目(16401970102);促进市级医院临床技能与临床创新三年行动计划(2020—2022年)重大临床研究项目(SHDC2020CR1051B);上海市中西医临床协作试点项目[ZXYXZ-201703,ZY(2018-2020)-FWTX-1007];上海市高水平大学建设项目(中医药标准化引领战略)。

摘　　要：目的观察脊柱手法结合石氏伤科功法对腰突症患者腰椎曲度的影像学变化。方法对30例腰椎间盘突出症患者行脊柱手法结合石氏伤科功法治疗,应用多层螺旋CT观察治疗前后腰椎曲度的变化。结果脊柱手法结合石氏伤科功法治疗腰椎间盘突出症总有效率83.3%(25/30);治疗前后患者的腰椎生理曲度分别为(2.94±0.53)mm和(3.98±0.68)mm,经统计学观察两者差异有统计学意义;治疗前后患者的腰椎总前凸角为(55.85±7.88)°和(65.49±7.31)°,经统计学观察两者差异具有统计学意义。治疗前后患者骶骨倾斜角为(40.12±5.94)°和(40.17±5.89)°,经统计学观察两者差异无统计学意义。治疗前后患者的各节段椎间孔前后径为(18.62±1.06)mm,治疗后为(18.66±1.26)mm,经统计学观察两者差异具有统计学意义。治疗前后患者的各节段椎间孔上下径为(12.19±0.95)mm和(12.54±0.76)mm,经统计学观察两者差异无统计学意义。结论脊柱手法结合石氏伤科功法可以改善腰椎曲度、腰椎总前凸角、椎间孔前后径,从而达到治疗目的。多层螺旋CT腰椎扫描重建对腰椎间盘突出症的疗效评价具有重要参考价值。Objective To observe the imaging changes of Shi's traumatology spine manipulation combined with exercises on lumbar spine curvature in patients with lumbar protrusion.Methods Thirty patients with lumbar disc herniation were treated with Shi's trauma spine manipulation combined with exercises.Multi-slice spiral CT was used to observe the changes in the curvature of the lumbar spine before and after treatment.Results The total effective rate of Shi's traumatology spine manipulation combined with exercises was 83.3%(25/30)in the treatment of lumbar disc herniation.The physiological curvature of the lumbar spine in patients before and after treatment was(2.94±0.53)mm and(3.98±0.68)mm,respectively.The difference between the two was statistically significant after statistical observation.The total lumbar lordosis angle of the patients before and after treatment was(55.85±7.88)°and(65.49±7.31)°,which were statistically observed.The difference between the two was statistically significant.The inclination angle of the sacrum of the patients before and after treatment was(40.12±5.94)°and(40.17±5.89)°,and there was no statistically significant difference between the two after statistical observation.The anteroposterior diameter of the intervertebral foramina of each segment of the patient before and after treatment was(18.62±1.06)mm,and after treatment it was(18.66±1.26)mm.The difference between the two was statistically significant.The upper and lower diameters of the intervertebral foramina of the patients before and after treatment were(12.19±0.95)mm and(12.54±0.76)mm,and the difference was not statistically significant after statistical observation.Conclusion Shi's traumatology spine manipulation combined with exercises can improve the curvature of the lumbar spine,the total lumbar lordosis angle and the anteroposterior diameter of the intervertebral foramen,so as to achieve the purpose of treatment.Multi-slice spiral CT scan and reconstruction of the lumbar spine has important reference value for the eval

关 键 词：脊柱手法 石氏伤科 功法 腰椎曲度 影像学观察 

分 类 号：R274.2[医药卫生—中医骨伤科学]