基于筋骨平衡理论探讨急性腰扭伤脊柱调衡机制

Mechanism of Spinal Balance in Acute Lumbar Sprain Based on the Theory of Muscle-bone Balance

中医筋骨平衡理论由来已久,筋骨之间关系密切,相互依存、互为根本,筋骨动态平衡及动静力稳态对于维持人体脊柱关节的正常运动发挥重要作用,而筋骨失衡,即"筋出槽"和"骨错缝"使筋骨正常关系发生错乱,是导致急性腰扭伤发生的重要诱因;筋骨失衡状态下脊柱内环境稳态被打破,肌肉、韧带及小关节囊等组织的柔韧性、灵活性、约束性降低,对急性损伤暴力的耐受力减弱,急性腰扭伤风险不断增高。脊柱筋骨动态平衡理论在筋骨损伤的治疗中逐渐凸显,应用中医脊柱调衡法治疗急性腰扭伤已经得到临床实践。急性腰扭伤早期及时应用中医脊柱调衡法重建脊柱的筋骨力学动态平衡对其疗效和预后至关重要。本文主要从脊柱调衡法治疗急性腰扭伤的理论溯源、病机认识、现代力学机制研究及脊柱调衡治疗等方面展开论述,进一步梳理脊柱调衡法治疗急性腰扭伤的治疗策略,为临床治疗急性腰扭伤提供参考。

The theory of muscles-bones balance of TCM has a long history.The muscles and bones are closely related,interdependent and fundamental to each other.The dynamic balance of muscles and bones and the steady state of dynamic and static forces play an important role in maintaining the normal movement of human spine joints,and the imbalance of muscles and bones,that is,"muscles off-position"and"dislocation of bones"disturbs the normal relationship between muscles and bones,which is the important inducement of acute lumbar sprain.Under the imbalance of muscles and bones,the internal stability of the spine is broken,and the flexibility and restraint of muscles,ligaments,and facet joint capsules are reduced.The tolerance for acute injury violence is weakened,and the risk of acute lumbar sprains is increasing.The theory of spinal muscles and bones dynamic balance has gradually become prominent in the treatment of muscle and bone injuries.The application of TCM spinal balance method in the treatment of acute lumbar sprain has been clinically practiced.In the early stage of acute lumbar sprain,the timely use of TCM spinal balance method to reconstruct the dynamic balance of spine muscles and bones is very important for its efficacy and prognosis.This article mainly discussed the theoretical origin,pathogenesis understanding,modern mechanical mechanism research and spinal balance treatment of acute lumbar sprain,and further sorted out the treatment strategy of spinal balance treatment for acute lumbar sprain,which could provide a reference for clinical treatment of acute lumbar sprain.