推拿手法结合盆底生物反馈治疗骶髂关节错位临床研究  

Clinical study on the combined therapy of Tuina manipulation and pelvic floor biofeedback for sacroiliac joint dysfunction

作　　者：钟灼琴[1] 廖林 李智荣 许晓英 缪雪钦 张坤木 ZHONG Zhuoqin;LIAO Lin;LI Zhirong;XU Xiaoying;MIAO Xueqin;ZHANG Kunmu(Fujian Provincial Hospital,Fuzhou 350003;The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine;Research Base of Traditional Chinese Medicine Patterns,Fujian University of Traditional Chinese Medicine)

机构地区：[1]福建省立医院,福州350003 [2]福建中医药大学附属第二人民医院 [3]福建中医药大学中医证研究基地

出　　处：《现代中医临床》2025年第2期31-36,共6页Modern Chinese Clinical Medicine

基　　金：国家自然科学基金项目(No.81904316);福建省科技厅引导性项目(No.2024Y0017);福建省卫生健康中青年骨干人才培养项目(No.2023GGA073);福建中医药大学校管课题临床专项项目(No.XB2023022)。

摘　　要：目的 在中医整体观念的指导下,优化临床骶髂关节错位的中医外治方案,降低骶髂关节错位复发率。方法 将纳入的70例受试者随机分为对照组和治疗组,每组各35例。对照组采用规划教材中的常规推拿治疗;治疗组在对照组的基础上加上盆底生物反馈治疗。2组均2 d治疗1次,共10次为1疗程,连续治疗2个疗程。分别于治疗前后进行组内和组间DIERS脊柱4D姿态及运动分析系统+步态跑台系统、改良Oswestry腰部功能障碍指数问卷表、盆底肌肌电位测定和临床疗效评价观察指标比较分析。结果 治疗后2组患者胸椎后凸角、腰椎前凸角、骨盆倾斜距离均较前减小,差异具有统计学意义(P<0.05);且治疗后治疗组相比较对照组步频减小,跨步时间延长,左单支撑相较前增加,右步幅较前增大,步态不对称系数较前减小,差异具有统计学意义(P<0.05);2组ODI评分均有所下降,且治疗组ODI评分低于对照组,差异具有统计学意义(P<0.05);对照组盆底肌Ⅰ型肌肌电位较前无明显改变,治疗组盆底肌Ⅰ型肌肌电位高于治疗前,且高于对照组,差异具有统计学意义(P<0.05)。对照组总有效率71.4%,治疗组总有效率88.60%,治疗组总有效率高于对照组,差异具有统计学意义(P<0.05)。结论 常规推拿手法结合现代盆底生物反馈治疗能够对产后骶髂关节错位起到更好的治疗作用。Objective Under the guidance of the holistic concept of Traditional Chinese Medicine(TCM), this study aims to optimize the TCM external treatment of sacroiliac joint dislocation(SJD) and reduce the recurrence rate.Methods Seventy subjects were randomized into the control group and the experimental group, with 35 in each. The control group was treated with conventional Tuina massage in the standard textbook, while the treatment group received the same tuina therapy combined with pelvic floor biofeedback therapy. Both groups were treated once every 2 days, with a total of 10 sessions per treatment course, and two courses of treatment completed. Pre-and post-treatment assessments included within-group and between-group comparisons using the DIERS Spine 4D Posture and Motion Analysis System + Gait Treadmill System, Modified Oswestry Disability Index(ODI) Questionnaire, Pelvic Floor Muscle Electromyography, and Clinical Efficacy Evaluation.Results After treatment, the thoracic kyphosis, lumbar lordosis and pelvic tilt distance of the two groups were significantly lower than those before treatment(P < 0.05). Additionally, the treatment group exhibited significant improvements in gait: a decrease in step frequency, an increase in step time, greater left single-leg support, larger right stride length, and reduced gait asymmetry compared to the control group(P < 0.05). Both groups showed a decrease in ODI scores, and the ODI score of the treatment group was lower than that of the control group(P < 0.05). The control group had no significant change in the pelvic floor muscle typeⅠmuscle EMG, while the treatment group had a significantly higher pelvic floor muscle typeⅠmuscle EMG than the control group before treatment(P < 0.05). The total effective rate of the control group was 71.4%, and the total effective rate of the treatment group was 88.60%. The total effective rate of the treatment group was higher than that of the control group(P < 0.05).Conclusion Conventional manipulation combined with pelvic floor biofeedbac

关 键 词：整体观念 骶髂关节错位 中医外治 优化研究 

分 类 号：R274.9[医药卫生—中西医结合]