经筋刺法及理筋手法对颈椎病手术后上肢屈肌痉挛患者肌电F波的影响

Effect of acupuncture and massage at tendon on F-wave of electromyogram in the patient of flexor spasm of the upper limb after operation of cervical spondylosis

目的探讨经筋刺法配合理筋手法治疗颈椎病术后上肢屈肌痉挛状态的作用机理。方法将56例患者随机分为治疗组(30例)和对照组(26例)。治疗组采用经筋刺法和理筋手法治疗;对照组采用传统针刺和药物治疗。观察两组患者治疗前后肌电F波波幅、时限及阈值的变化。结果颈椎病术后上肢屈肌痉挛状态病人治疗前肌电F波均表现为波幅高、时限长、阈值低,两组患者之间比较无统计学差异(P>0.05);治疗后,治疗组在治疗前后比较波幅下降(P<0.01)、时限缩短(P<0.001),而对照组无显著性变化(P>0.05),且治疗组F波波幅明显低于对照组(P<0.05)。两组患者治疗后阈值均有提高(P<0.001),但治疗组较对照组患者升高明显(P<0.05)。结论经筋刺法及理筋手法通过降低脊髓前角细胞的兴奋性,降低肌电F波波幅及时限,提高阈值,减弱牵张反射,以缓解痉挛。

Objective To explore the mechanism of acupuncture and massage at the tendon in treatment of the upper limb flexor spasm after cervical operation. Methods Fifty-six cases were randomly divided into a treatment group （n = 30） treated with acupuncture and massage at the tendons, and a control group treated with traditional acupuncture and medication. Changes of F-wave, time limit and threshold value in electromyogram before and after treatment were investigated in the both groups. Results Before treatment, the F-wave in the patient of the upper limb spasm post-cervical operation was characterized by high amplitude, long time limit and low threshold value, with no significant difference between the two groups （P〈0.05） after treatment, the amplitude lowered （P〈 0.01）, the time limit shortened （P〈0. 001） in the treatment group and no significant changes were found in the control group （P〈0. 05）, but the amplitude of F-wave in the treatment group was significantly lower than that in the control group （P〈0.05）. The threshold value significantly increased in the two groups, with the treatment group more signficantly increased than the control group （P〈0. 05）. Conclusion Acupuncture and massage at tendons can relieve the spasm through lowing the excitement in the cells of the anterior horn of the spinal cord, decreasing the amplitude and time limit of the F-wave, increasing the threshold value and reducing traction reflection.