颈椎定点旋转手法在体生物力学量化及影响因素分析  

Quantification of in vivo biomechanics and analysis of influencing factors in cervical spine fixed-point rotation manipulation

作　　者：梁基耀 周红海[2,3,4] 韦贵康 苏少亭[1] 陈龙豪 何心愉 刘粮酺 Liang Jiyao;Zhou Honghai;Wei Guikang;Su Shaoting;Chen Longhao;He Xinyu;Liu Liangpu(Graduate School of Guangxi University of Chinese Medicine,Nanning 530001,Guangxi Zhuang Autonomous Region,China;Orthopedic College,Guangxi University of Chinese Medicine,Nanning 530001,Guangxi Zhuang Autonomous Region,China;Guangxi Key Laboratory of Biomechanics and Injury Repair in Traditional Chinese Medicine Orthopedics and Traumatology,Nanning 530001,Guangxi Zhuang Autonomous Region,China;Research Center for the Inheritance and Development of Academic Thought and Clinical Diagnosis and Treatment of Wei Guikang Master of Traditional Chinese Medicine,Nanning 530001,Guangxi Zhuang Autonomous Region,China;Third Clinical Medical College Affiliated to Zhejiang Chinese Medical University,Hangzhou 310000,Zhejiang Province,China)

机构地区：[1]广西中医药大学研究生院,广西壮族自治区南宁市530001 [2]广西中医药大学骨伤学院,广西壮族自治区南宁市530001 [3]广西中医骨伤科生物力学与损伤修复重点实验室,广西壮族自治区南宁市530001 [4]国医大师韦贵康学术思想与临床诊疗传承发展研究中心,广西壮族自治区南宁市530001 [5]浙江中医药大学附属第三临床医学院,浙江省杭州市310000

出　　处：《中国组织工程研究》2025年第3期486-492,共7页Chinese Journal of Tissue Engineering Research

基　　金：广西自然科学基金项目(2023GXNSFAA026297),项目负责人:周红海;广西中医药大学自治区级硕士研究生科研创新项目(YCSW2023375),项目负责人:梁基耀;广西卫生厅医疗卫生重点课题(ZD200857),项目负责人:周红海;广西教育厅课题(200420),项目负责人:周红海。

摘　　要：背景:颈椎定点旋转手法属于技术要求较高的力学操作,但目前其生物力学还缺少相关量化数据;且颈椎定点旋转手法的影响因素研究包括了众多参数并且存在差异性,需要进一步对其影响因素进行分析,以完善其相关数据。目的:量化颈椎定点旋转手法在体生物力学参数,探讨各生物力学参数之间的相关性,及研究对象个体特征差异对手法力学参数的影响。方法:选取35例颈椎病患者为测试对象,均为广西中医药大学第一附属医院仁爱分院骨伤科门诊就诊者。术者佩戴穿戴式力学测量手套采集手法力学参数,包括拇指预加载力、拇指最大推力、掌心预加载力、掌心旋扳力和掌心旋扳最大作用力。并采集患者个人特征参数,包括年龄、身高、体质量和颈围。对手法操作过程中的关键力学参数进行特征分析及不同个体特征进行量化,对力学指标参数进行Spearman相关性分析;分析不同个体特征参数对生物力学可能存在的影响。结果与结论:(1)双侧力学参数相比,左侧操作与右侧操作无显著差异性(P>0.05)。(2)拇指预加载力均值为(7.21±1.19)N、拇指最大推力均值为(28.40±4.48)N、掌心预加载力均值为(5.67±2.49)N、掌心旋扳力均值为(10.90±5.11)N、掌心旋扳最大作用力均值为(16.00±7.27)N。(3)掌心预加载力和掌心旋扳力存在显著正相关(Rs=0.812,P<0.01);掌心预加载力和掌心旋扳最大作用力存在显著正相关(Rs=0.773,P<0.01);掌心旋扳力和掌心旋扳最大作用力存在显著正相关(Rs=0.939,P<0.01)。(4)患者体质量与拇指预加载力、掌心预加载力、掌心旋扳力及掌心旋扳最大作用力之间存在显著正相关(P<0.05)。(5)结果证实,颈椎定点旋转手法治疗颈椎病操作中生物力学有一定的标准量值。该手法左右侧操作无显著差异性,具有较好的一致性和可重复性。掌心预加载力、掌心旋扳力及掌心旋扳最大作用�BACKGROUND:Fixed-point rotation manipulation of cervical spine is a mechanical operation with high technical requirements,but the biomechanics of fixedpoint manipulation of cervical spine still lacks relevant quantitative data.Moreover,the research on the influencing factors of cervical fixed-point rotation manipulation includes many parameters and there are differences,so it is necessary to further analyze its influencing factors to improve its related data.OBJECTIVE:To quantify the biomechanical parameters of cervical spine fixed-point rotation manipulation,explore the correlation between different biomechanical parameters,and the influence of individual characteristics of the subjects on the biomechanical parameters of cervical spine fixed-point rotation manipulation.METHODS:Totally 35 cases of cervical spondylosis were Outpatients from Orthopedic Department of Renai Branch of the First Affiliated Hospital of Guangxi University of Chinese Medicine and selected as the subjects investigated.Wearable mechanical measuring gloves were used to collect biomechanical parameters of cervical spine fixed-point rotation manipulation,including:thumb preload,thumb maximum thrust,palm preload,palm wrench force,and palm wrench maximum force.Personal characteristic parameters were collected,including age,height,weight,and neck circumference.The key biomechanical parameters in the process of cervical spine fixed-point rotation manipulation were analyzed and different individual characteristics were quantified.The results of biomechanical parameters were analyzed using Spearman correlation analysis.The possible effects of different individual characteristic parameters on biomechanics were analyzed.RESULTS AND CONCLUSION:(1)Compared with bilateral mechanical parameters,there was no significant difference between left manipulation and right manipulation(P>0.05).(2)The average of thumb preload force was(7.21±1.19)N;the average of thumb maximum thrust was(28.40±4.48)N;the average of palm preload was(5.67±2.49)N;the average of pal

关 键 词：颈椎定点旋转手法 生物力学 影响因素分析 量化研究 颈椎病 正骨手法 保守治疗 个体特征 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R608