拔戳揉捻手法治疗肱骨外上髁炎生物力学分析及影响因素研究

Study on the biomechanical analysis and influencing factors study for the treatment of humeral epicondylitis by Bachuorounian manipulation

目的:量化拔戳揉捻手法治疗肱骨外上髁炎的生物力学参数,探讨患者个体特征对手法操作的影响。方法:选取2019年7月至2020年2月就诊的肱骨外上髁炎患者40例,男18例,女22例,年龄20~50(34.37±8.41)岁,病程1~11(6.05±2.71)个月,采用生物力学传感器测量同一手法术者对患者患侧肘关节实施拔戳揉捻手法的生物力学参数,量化生物力学参数并研究参数间可能存在的相关性,同时采集患者个体特征学参数,分析不同患者个体特征对生物力学参数的影响。结果:拔戳揉捻手法各阶段生物力学参数量化结果,旋后揉捻力(31.17±2.99)N,屈曲拔按力(44.99±2.38)N,旋前揉捻力(31.03±2.75)N,拔直戳按力(48.75±2.09)N,参数相关性分析显示旋后揉捻力与旋前揉捻力参数间存在显著正相关,屈曲拔按力与拔直戳按力参数间存在显著正相关。对患者个体特征参数与手法生物力学参数进行多元线性回归分析显示,患者的体重与旋后揉捻力间呈显著相关,患者肘部压痛值与屈曲拔按力存在显著相关,患者病程与拔直戳按力呈显著相关。结论:拔戳揉捻手法治疗肱骨外上髁炎在体操作力大小具有一定的标准,手法各阶段术者操作的作用力趋势具有系统性,患者的体重、患肘压痛情况与病程是影响拔戳揉捻手法操作的重要因素。

Objective:To quantitatively study the biomechanical parameters of Bachuorounian manipulation in the treatment of humeral epicondylitis,and discuss the effects of individual characteristics on the biomechanical parameters were discussed. Methods:From July 2019 to February 2020,40 patients with external humeral epicondylitis were selected,including 18 males and 22 females,ranging in age from 20 to 50 years old,with an average of (34.37±8.41) years old;and the course of disease ranged from 1 to 11 months,with a mean of (6.05±2.71) months. The biomechanical parameters of the elbow joint of the affected side were measured by using the biomechanical sensor. At the same time,the individual characteristic parameters of patients were collected to analyze the influence of different individual characteristics of patients on biomechanical parameters. Results:The results of mechanical analysis in each stage of the bachuorounian manipulation were as follows:the rolling back-rotation force was (31.17±2.99) N;the buckling bending drawing force was (44.99±2.38) N;the rolling pre-rotation force was (31.03±2.75) N;and stretching drawing force was (48.75±2.09) N. The correlation analysis between the parameters showed that there was a significant positive correlation between the buckling bending drawing force and the stretching drawing force parameters,and a significant positive correlation between the rolling force back-rotation force and the rolling pre-rotation force parameters. The multivariate linear regression analysis on the parameters of influencing factors and manipulative biomechanics showed that there was a significant correlation between body weight and rolling back-rotation force,significant correlation between elbow tenderness and the buckling bending drawing force,and significant correlation between disease duration and the stretching drawing force. Conclusion:The bachuorounian manipulation of humeral epicondylitis has a certain range of operating force. Manipulation of each stage has a correlation and systematic. The patient's weight,elbow tenderness and disease course are important factors affecting the bachuorounian manipulation.