三维侧凸角定量评估手法治疗腰椎间盘突出症的近期效果  

Short-term effect of manipulation therapy for lumbar disc herniation quantitatively evaluated by three-dimensional scoliosis angle

作　　者：顾江鹏 陈许晶 刘一康 郭伟 刘晓民[4] 王飞 冯伟 Gu Jiangpeng;Chen Xujing;Liu Yikang;Guo Wei;Liu Xiaomin;Wang Fei;Feng Wei(Department of Orthopedics of Integrated Traditional Chinese and Western Medicine,Air Force Special Medical Center,Beijing 100142,China;Fifth Clinical Medical College of Anhui Medical University,Hefei 230032,Anhui Province,China;Hebei North University,Zhangjiakou 075000,Hebei Province,China;School of Electronic Information and Control Engineering,Beijing University of Technology,Beijing 100024,China)

机构地区：[1]空军特色医学中心中西医结合正骨科,北京市100142 [2]安徽医科大学第五临床学院,安徽省合肥市230032 [3]河北北方学院,河北省张家口市075000 [4]北京工业大学电子信息与控制工程学院,北京市100024

出　　处：《中国组织工程研究》2025年第21期4552-4559,共8页Chinese Journal of Tissue Engineering Research

基　　金：中央军委后勤保障部卫生局项目(2021ZY005),课题负责人:冯伟;空军军医大学课题(2019ZTA03),课题负责人:冯伟;空军特色医学中心科技助推项目(2022ZTYB32),课题负责人:王飞。

摘　　要：背景:腰椎间盘突出症患者因髓核压迫、力学失衡而出现不同的身体畸形,冯天有教授在此基础上提出“四步腰型”,冯伟教授提出三维侧凸角客观量化“四步腰型”。目的:探讨三维侧凸角在评估新医正骨疗法治疗腰椎间盘突出症患者疗效中的应用价值。方法:纳入149例腰椎间盘突出症患者,其中四步腰型Ⅰ/Ⅱ型96例,Ⅲ/Ⅳ型55例,均进行2周的手法治疗;另纳入10名健康志愿者作为健康对照。利用表面形貌技术测量三维侧凸角,比较四步腰型Ⅰ/Ⅱ型及Ⅲ/Ⅳ型患者三维侧凸角治疗前后的差异,比较患者治疗后与健康受试者的差异,比较Ⅰ/Ⅱ型和Ⅲ/Ⅳ型三维侧凸角治疗变化量的差异,探索三维侧凸角各投影面内在相关性及与常用临床疗效评分的相关性。结果与结论:(1)四步腰型Ⅰ/Ⅱ型与Ⅲ/Ⅳ型患者治疗前后的三维侧凸角差异有显著性意义(P <0.05);(2)Ⅰ/Ⅱ型、Ⅲ/Ⅳ型患者治疗后与健康受试者冠侧凸和横截凸差异有显著性意义(P <0.05),矢侧凸无统计学差异(P> 0.05);(3)三维侧凸角在各个投影面之间两两呈现相关性,与主观量表之间存在相关性;(4)提示三维侧凸角在手法治疗前后脊柱畸形程度定量评估中具有很好的作用,通过定量化的指标能够揭示患者治疗前后病情变化规律;三维侧凸角能反映影响患者生活状态的严重程度,但单一平面参数评估脊柱侧弯有一定局限性。BACKGROUND:Patients with lumbar disc herniation have different physical deformities due to nucleus pulposus compression and mechanical imbalance.On this basis,Professor Feng Tianyou proposed the“four-step waist type.”Professor Feng Wei proposed the objective quantification of three-dimensional scoliosis angle“four-step waist type.”OBJECTIVE:To explore the application value of three-dimensional scoliosis angle in evaluating the efficacy of Feng’s spinal manipulation in the treatment of patients with lumbar disc herniation.METHODS:A total of 149 hospitalized patients with lumbar disc herniation were enrolled sequentially,including 96 cases of type-Ⅰ/Ⅱ and 55 cases of type-Ⅲ/Ⅳ.The patients were treated with manual therapy for 2 weeks,and 10 healthy volunteers were included as healthy controls.The three-dimensional scoliosis angle was measured using surface topography technology.The difference of three scoliosis angles between patients with type-Ⅰ/Ⅱ and type-Ⅲ/Ⅳ was compared before and after treatment.The difference between patients after treatment and healthy subjects was compered.The difference of three-dimensional scoliosis angles between type-Ⅰ/Ⅱ and type-Ⅲ/Ⅳ after treatment was compared.The intrinsic correlation of each projection plane of three-dimensional scoliosis angle and its correlation with commonly used clinical efficacy scores were explored.RESULTS AND CONCLUSION:(1)The three-dimensional scoliosis angle was significantly different in patients with type-Ⅰ/Ⅱ and type-Ⅲ/Ⅳ before and after treatment(P<0.05).(2)There were significant differences in coronal curve angle and transverse curve angle between patients with type-Ⅰ/Ⅱ,type-Ⅲ/Ⅳ and healthy subjects(P<0.05),but there was no significant difference in sagittal curve angle(P>0.05).(3)There was a correlation between the angles of each section of the three-dimensional angle,and there was a correlation between the three-dimensional angle and the subjective scale.(4)It is indicated that the three-dimensional sc

关 键 词：腰椎间盘突出症 脊柱侧弯 腰型 表面形貌 新医正骨 手法治疗 疗效 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R681.5