影响两种不同力学加载模式的腰椎调整手法操作的相关因素分析  

Analysis of related factors affecting the two different mechanical loading modes lumbar adjustment manipulation

作　　者：刘士逸 吕强 周楠[1] 常乾震 陈鸿 罗龙飞 LIU Shiyi;LYU Qiang;ZHOU Nan;CHANG Qianzhen;CHEN Hong;LUO Longfei(Yueyang Hospital of Integrated Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Shuguang Hospital,Shanghai University of Traditional 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》2024年第10期5583-5587,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.81574096,No.82074571)。

摘　　要：目的:探讨影响两种不同力学加载模式的腰椎调整手法操作的完成性和准确性的相关因素。方法:选取2018年1月至2019年12月来自上海中医药大学附属岳阳中西医结合医院推拿科门诊和住院部的腰椎退行性骨关节炎患者150例为研究对象,分析性别、年龄、身体质量指数(BMI)、腹横肌硬度、maxpression加载力、竖脊肌硬度差值、视学模拟评分(VAS)、频率这些因素对两种手法操作的完成性和准确性的影响。结果:患者的腹横肌硬度是影响两种不同力学加载模式的腰椎调整手法操作完成性和准确性的共同因素(P<0.05),此外,传统腰椎斜扳法操作完成性和准确性还与BMI、加载力、竖脊肌硬度差值、VAS评分、频率相关(P<0.05)。结论:腰椎调整手法的操作应该在患者处于自然呼吸和放松的状态下进行,从而减少不良事件发生的可能。Objective:To explore the related factors affecting the completion and accuracy of lumbar spine adjustment manipulations under two different mechanical loading modes.Methods:One hundred and fifty patients with lumbar degenerative osteoarthritis from outpatient and inpatient departments of Tuina Department in Yueyang Hospital of Integrated Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine from January 2018 to December 2019,were selected as the research objects.The effects of gender,age,body mass index(BMI),transverse abdominis muscle stiffness,maxpression force,erector spinae muscle stiffness difference,Visual analogue scale(VAS)score,and frequency on the completion and accuracy of the two manipulations were analyzed.Results:The patient’s transversus abdominis muscle stiffness was the common influencing factor for the completion and accuracy of lumbar adjustment manipulation under two different mechanical loading modes(P<0.05).In addition,the traditional lumbar lateral position adjustment manipulation was also related to BMI,maxpression force,the difference of erector spinae muscle stiffness,VAS score and frequency(P<0.05).Conclusion:Lumbar adjustment manipulation should be performed when the patient is in a state of natural breathing and relaxation to reduce the likelihood of adverse events.

关 键 词：腰椎调整手法 振荡 推拿 完成性 准确性 相关因素 

分 类 号：R244.1[医药卫生—针灸推拿学]