推拿(扌衮)法操作动力学参数的优化试验

Optimized dynamics parameters of rolling manipulation in Chinese Tuina

目的:采用正交试验方法,对推拿扌磙法行气活血效应的动力学参数进行优化。方法:试验于2005-12/2006-04在上海中医药大学附属岳阳中西医结合医院B超室进行。对扌磙法动力学参数——力量(3,4,5kg)、频率(90,120,150次/min)、时间(7.5,10,12.5min)进行三因素三水平的正交试验。选取54名健康男性志愿者作为试验对象,按照L27(313)正交表规定的试验顺序,分别用不同动力学参数扌磙法于受试者左下肢腓肠肌处进行推拿,扌磙法推拿前后分别用彩色超声多普勒诊断系统测量腘动脉血流量,并计算扌磙法前后腘动脉血流量的增益率,以腘动脉血流量的增益率为观察指标,进行统计分析。结果:54名受试者全部进入结果分析。①扌磙法操作的动力学参数力量、频率、时间中,只有频率的主效应有显著性差异(F=7.399,P<0.01),但两因素间的交互效应均存在显著性差异(F=3.615,3.541,3.423,P<0.05),三因素间的交互效应也存在显著性差异(F=5.501,P<0.01)。②综合主效应和交互效应分析认为扌磙法操作的动力学参数以施加力量4kg、频率120次/min、时间10min组合模式提高腘动脉血流量增益率的效果最显著,腘动脉血流量增益率为(127.51±12.81)%。结论:最佳扌磙法行气活血效应的动力学参数组合模式为施加力量4kg、频率120次/min、时间10min;同时试验也提示,推拿手法操作并非力量越大、操作时间越长,疗效就越好。

AIM： To optimize the dynamics parameters in activating vital energy and blood circulation effects of rolling manipulation in Chinese Tuina with the recycle orthogonal test. METHODS： The experiment was conducted in the B Ultrasound Room of Yueyang Hospital of Integrated Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine from December 2005 to April 2006. The orthogonal test was done in 3 factors and 3 levels including pressure （3, 4, 5 kg）, frequency （90, 120, 150 times per minute） and continuous time （7.5, 10, 12.5 minutes）. Totally 54 healthy male volunteers were regarded as subjects and given rolling manipulation on left gastrocnemius muscle in prone position according to L27 （3^13）. Volume flow in popliteal artery was measured by Color Ultrasound Doppler System before and after rolling manipulation to calculate the increase rate of volume flow. The statistics analysis was conducted with the increase rate of volume flow in popliteal artery as the ohservation index. RESULTS： All the 54 subjects entered the result analysis. Among the dynamics parameters, there were only significant differences in the frequency effect （F=7.399, P 〈 0.01）, but there were significant differences in interaction effects between any two parameters （F=3.615, 3.541, 3.423, P 〈 0.05）,so was the three parameters （F=5.501, P 〈 0.01）. The comprehensive main effect and interaction effects showed that dynamics model with 4 kg in pressure, 120 times per minute in frequency, and 10 minutes in continuous time was the hest in improving the increase rate of volume flow （127.51±12.81）%. CONCLUSION： The optimal dynamics model of rolling manipulation is of 4 kg in pressure, 120 times per minute in frequency, and 10 minutes in continuous time. Meanwhile, the findings do not indicate that the more the pressure and the longer the continuous time, the better the curative effect.