基于AnyBody仿真技术探讨[扌衮]法治疗膝骨关节炎的效果

Discussing the efficacy of rolling tuina in treating knee osteoarthritis based on AnyBody simulation technology

目的比较膝骨关节炎(KOA)患者接受[扌衮]法治疗前后下肢主要肌群肌肉力的变化及其效果。方法选取2018年1月—6月在上海中医药大学附属岳阳中西医结合医院推拿科就诊的15例KOA患者,对其进行[扌衮]法治疗。采用AnyBody仿真技术对下肢主要肌群肌肉力进行分析,比较肌肉失衡程度的变化。结果经过[扌衮]法治疗后,15例KOA患者都取得治疗效果,下肢前、后侧与外侧肌群肌肉失衡程度有减小趋势,其中股直肌、股二头肌长头、腓骨长肌肌肉失衡程度明显小于治疗前,差异均有统计学意义(均P<0.05);内侧肌群治疗后肌肉失衡程度有增大趋势,其中缝匠肌肌肉失衡程度高于治疗前,但大收肌肌内失衡程度小于治疗前,差异均有统计学意义(均P<0.05)。结论[扌衮]法治疗可以改善KOA患者下肢肌群失衡状态,其起效机制可能与提高KOA患者下肢的肌肉力,尤其是下肢前后侧肌群的肌肉力从而恢复屈伸肌群协调性有关,提示推拿治疗KOA除了纠正骨性结构紊乱外,还应该恢复下肢的肌肉失衡。

Objective To compare the changes and efficacy of the muscle force of the main muscle group of the lower limbs before and after the treatment of knee osteoarthritis patients by rolling Tuina.Methods The 15 KOA patients who were treated in the Department of Tuina,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,from January to June 2018 were selected and treated with rolling Tuina.The muscle force of the main muscle group of the lower limbs was analyzed by AnyBody simulation technology to compare the changes in muscle imbalance.Results After treatment with rolling Tuina,15 KOA patients had achieved treatment effect,the degree of muscle imbalance of the anterior,posterior and lateral muscle group of the lower limbs had a tendency to decrease,among which the degree of muscle imbalances of rectus femoris,biceps femoris longhead and peroneal longus were significantly smaller than those before treatment,the differences were statistically significant(all P<0.05).After treatment,the degree of muscle imbalance of medial muscle group showed an increasing trend,among which the degree of muscle imbalances of sartorius magnus were larger than that before treatment,but the degree of muscle imbalances of adductor magnus were smaller than that before treatment and the differences were statistically significant(all P<0.05).Conclusion Rolling Tuina can improve the imbalance of lower limbs muscle in KOA patients.Its effective mechanism may be related to improvement the muscle force of the lower limbs muscles of KOA patients,especially the muscle force of the anterior and posterior muscles of the lower limbs,which can restore the coordination of flexor and extensor muscles.It is suggested that Tuina therapy for KOA should not only correct the osseous structural disorder,but also restore the muscle imbalance of lower limbs.