腰椎间盘突出症筋骨失衡-炎症浸润特征研究  

Study on the characteristics of muscle-bone imbalance and inflammatory infiltration in lumbardisc herniation

作　　者：曹奔 周鑫 任君 汤程 朱清广[1] 程艳彬[1] 孔令军[1] 房敏[1,2] CAO Ben;ZHOU Xin;REN Jun;TANG Cheng;ZHU Qingguang;CHENG Yanbin;KONG Lingjun;FANG Min(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Shuguang Hospital,Shanghai University ofTraditional Chinese Medicine,Shanghai 201203,China)

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 [2]上海中医药大学附属曙光医院,上海201203

出　　处：《中华中医药杂志》2023年第10期4959-4963,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.82030121);中医药传承与创新“百千万”人才工程(岐黄工程)岐黄学者(2018);上海市“科技创新行动计划”启明星培育项目(No.22YF1449900);国家中医药管理局中医药创新团队及人才支持计划项目(No.ZYYCXTD-C-202008)。

摘　　要：目的:评估腰椎间盘突出症(LDH)患者脊柱屈伸活动度、竖脊肌紧张度与压痛阈失衡程度,并观察血清炎症指标异常表达现象,揭示LDH患者筋骨失衡-炎症浸润特征。方法:2021年1—12月于上海中医药大学附属岳阳中西医结合医院门诊及线上纳入36例LDH患者为试验组,36例无LDH受试者为对照组。应用三维运动捕捉、肌肉状况测定系统评估患者“筋骨功能”(包括脊柱屈伸活动度、竖脊肌紧张度、压痛阈),应用液相悬浮芯片、ELISA法检测受试者血清炎症指标。通过统计分析揭示两组差异性特征指标。结果:试验组脊柱屈曲角度、关节活动度较对照组显著下降(P<0.01);试验组两侧竖脊肌紧张度、压痛阈存在显著失衡现象(P<0.01),且两侧肌紧张、压痛阈差值显著高于对照组(P<0.01);试验组存在显著的炎症浸润现象,外周血干扰素-γ、白介素-6、白介素-8含量显著高于对照组(P<0.05)。患者筋骨失衡程度与炎症浸润水平存在显著的负相关性(P<0.01)。结论:LDH患者存在显著的筋骨失衡现象和炎症浸润特征,且两者之间存在显著的负相关性。Objective:The range of motion(ROM)of lumbar spine,muscle tension(MT)and tenderness threshold(TT)of erector spinae and the expression of serum inflammatory indexes were observed in lumbar disc herniation(LDH),to reveal the characteristics of muscle and bone imbalance-inflammatory infiltration in LDH patients.Methods:A total of 36 patients with LDH as treatment group and 36 healthy participants as control group were recruited from the Tuina Department of Yueyang Hospital in Shanghai and online system from January to December 2021.The musculoskeletal function of the patients(ROM,MT,TT)was evaluated using a three-dimensional motion capture system and muscle condition assessment system,and the serum inflammatory markers were detected using Liquid-phase suspension chip and ELISA.The differences between the two groups were analyzed.Results:The ROM of lumbar spine in the LDH group were significantly lower than those in the non-LDH group(P<0.01).There was a significant imbalance in the MT and TT of the bilateral erector spine in the LDH group(P<0.01),and the difference of bilateral MT and TT in the LDH group was significantly higher than that in the non-LDH group(P<0.01).There was significant infammatory infiltration in LDH group,and the level of interferon-,interleukin-6 and interleukin-8 in peripheral blood in LDH group were significantly higher than non-LDH group(P<0.05).There was a significant negative correlation between the degree of muscle-bone imbalance and the level of inflammatory infiltration(P<0.01).Conclusion:There is a significant muscle-bone imbalance and infammatory infiltration in LDH patients.Besides,there is a significant correlation between them.

关 键 词：腰椎间盘突出症 筋骨失衡 炎症因子 关节活动度 肌紧张 压痛阈 相关性 

分 类 号：R274.9[医药卫生—中西医结合]