脊柱解剖变异对脊柱推拿触诊准确性的影响  

Effect of Spinal Anatomical Variation on the Accuracy of Spinal Tuina and Palpation

作　　者：黄瑞信 吴志伟[1,2] 姚重界 朱清广 孔令军[1,2] 程艳彬[1,2] 房敏[1,2,3] HUANG Ruixin;WU Zhiwei;YAO Chongjie;ZHU Qingguang;KONG Lingjun;CHENG Yanbin;FANG Min(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Research Institute of Tuina,Shanghai Institute of Traditional Chinese Medicine,Shanghai 200437,China;School of Acupuncture-moxibustion and Tuina,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]上海市中医药研究院推拿研究所,上海200437 [3]上海中医药大学针灸推拿学院,上海201203

出　　处：《世界中医药》2024年第22期3576-3582,共7页World Chinese Medicine

基　　金：国家自然科学基金面上项目(82474672)——中医推拿有效干预颈椎病临床评估的肌骨协调耦合机制研究;国家自然科学基金面上项目(81973973)——推拿“以痛为腧”干预膝骨关节炎“肌肉力学—痛觉中枢”调控机制研究。

摘　　要：脊柱推拿是治疗“椎骨错缝”的独特疗法之一,脊柱推拿触诊贯穿脊柱推拿治疗始终。推拿医生触诊脊柱、评估“椎骨错缝”节段并进行针对性的整复手法治疗是推拿临床代表性诊疗方法之一。然而,脊柱解剖变异的存在使得脊柱触诊准确性受到影响,也是推拿临床误诊误治的原因之一。目前,国内外有关脊柱解剖变异对脊柱推拿触诊造成干扰的相关文献十分有限。本文探讨棘突不对称分叉、长短变化、偏歪,横突不对称、融合及移行椎等脊柱解剖变异对脊柱推拿触诊准确性的影响,以期为脊柱解剖变异的推拿触诊方法提供参考及借鉴。Spinal Tuina is one of the unique therapies for the treatment of“subluxation”,while spinal Tuina palpation is in the whole process of spinal Tuina treatment.As one of the representative clinical diagnosis and treatment methods of Tuina,palpation is conducted by Tuina doctors to evaluate the“subluxation”,and to perform targeted repositioning maneuvers.However,the accuracy of spinal palpation is affected by spinal anatomical variation,one of the reasons for misdiagnosis and mistreatment in Tuina.However,there is limited literature about the interference caused by the spinal anatomical variation on spinal Tuina palpation.This paper discusses the influence of spinal anatomical variations including spinous process asymmetry bifurcation,length change,deviation,transverse process asymmetry,fusion,and transitional vertebra on spinal Tuina palpation,to provide references for Tuina palpation methods on spinal anatomical variations.

关 键 词：脊柱 解剖变异 推拿 触诊 椎骨错缝 棘突 横突 移行椎 

分 类 号：R244.1[医药卫生—针灸推拿学]