远针近推疗法对老年性肾虚型骨质疏松症患者腰椎生物力学的影响

Impacts on biomechanics of senile osteoporosis of kidney deficiency pattern treated with acupuncture and Tuina therapy

目的:探讨远针近推疗法防治老年性肾虚型骨质疏松症患者的作用机制。方法:将64例患者随机分为针推组(34例)和碳酸钙组(30例)。针推组采用远针近推疗法,即针刺患者双侧下肢委中、太溪穴,同时在患者腰部进行推拿治疗,共治疗30次;碳酸钙组口服碳酸钙D3片,连续服用12周。分别观察和比较两组治疗前后腰椎生物力学指标腰椎曲度、腰椎前凸指数、骶骨倾斜角、腰骶角、L5椎体指数、L3椎体指数的变化。结果:针推组治疗后腰椎前凸指数和骶骨倾斜角均增大,差异有统计学意义(P<0.05,P<0.01),且针推组腰椎前凸指数改善优于碳酸钙组[(19.59±19.16)mm vs(14.47±13.28)mm,P<0.05];治疗后碳酸钙组L5椎体指数较治疗前改善(P<0.05),其腰椎形态学改变产生的原因尚待研究分析。结论:远针近推疗法可以通过良性应力刺激调节腰椎生物力学结构,重建腰椎力学平衡,对于防治骨质疏松症有积极意义。

Objective To explore the mechanism on senile osteoporosis of kidney deficiency pattern in the prevention and treatment with acupuncture and Tuina therapy.Methods Sixty-four cases were randomized into an acupuncture and Tuina therapy group（group A,34 cases） and a calcium carbonate group（group B,30 cases）.In group A,the patients were treated with acupuncture at the distal acupoints and Tuina therapy in the local area.Acupuncture was applied to bilateral Weizhong（BL 40） and Taixi（KI 3）.Tuina therapy was given in the lumbar region.Totally 30 treatments were required.In group B,the Calcium Carbonate D3 were prescribed for oral administration,continuously for 12 weeks.The changes in lumbar curvature,lumbar lordosis index,sacral inclination angle,lumbosacral angle,L5 vertebral index and L3 vertebral index of lumbar biomechanical indices were observed and compared before and after treatment in two groups.Results In group A,the lumbar lordosis index and sacral inclination angle were increased after treatment,indicating the statistical significant differences before and after treatment（P〈0.05,P〈0.01）.The improvement of lumbar lordosis index in group A was superior to that in group B [（19.59±19.16）mm vs（14.47±13.28）mm,P〈0.05].After treatment,in group B,L5 vertebral index was improved as compared with that before treatment（P〈0.05）.It was required to have a study on the reasons of its lumbar morphological change.Conclusion The acupuncture and Tuina therapy regulate the lumbar biomechanical structure through the positive stress stimulation and reconstruct the mechanical equilibrium of the lumbar vertebra.It plays the active significance in the prevention and treatment of osteoporosis.