神经松动术治疗神经性疼痛的机制进展和临床应用拓展

Mechanism and Clinical Application of Nerve Mobilization in the Treatment of Neuropathic Pain

神经松动术作为一种基于神经组织结构、生理功能和生物力学的手法治疗技术,在上个世纪80年代最早用于腕管综合征和胸廓出口综合征的治疗,后广泛运用于周围神经损伤、坐骨神经痛和脑卒中后遗症等疾病的康复。神经松动术改善神经粘连、减缓慢性疼痛效果显著,极大丰富了现代康复治疗手段。近年,神经松动术在临床康复上不断推陈出新,逐渐拓展了神经松动术的临床应用,神经松动术联合其他康复手段、医疗方法和药物治疗在临床上也逐步得到推广,并取得了良好效果,但其作用机制尚不完全明确。笔者通过查阅文献资料,对近年来神经松动术的研究进行整理,主要从神经松动术改善神经水肿、改善神经血管的血流状况、对神经位置和长度的改变、改善关节运动范围、促进神经修复和再生等方面进行论述,旨在阐明神经松动术的作用机制,为实验研究、临床研究和临床应用提供参考。

Nerve mobilization was first used in the treatment of carpal tunnel syndrome and thoracic outlet syndrome in the 1980 s as a manipulative treatment technique based on nerve tissue structure, physiological function and biomechanics,and then widely used in the rehabilitation of peripheral nerve injury, sciatica, sequela of stroke, and other diseases.Nerve mobilization can improve nerve adhesion and significantly relieve chronic pain, which greatly enriches modern rehabilitation treatment methods. In recent years, nerve mobilization continues to bring forth new ideas in clinical rehabilitation and gradually expands in the clinical application. Nerve mobilization combined with other rehabilitation means, medical methods and drug therapy has been gradually popularized in clinical practice and achieved good results.But the mechanism of action is not completely clear. The author has reviewed the researches on nerve mobilization in recent years from the aspects of nerve mobilization improving nerve edema, improving the blood flow of neurovascular,changing the position and length of the nerve, improving the range of joint motion, and promoting nerve repair and regeneration, etc. The purpose of this study is to clarify the mechanism of nerve mobilization and provide a reference for experimental research, clinical research and clinical application.