按动推拿法治疗菱形肌损伤经验浅析

菱形肌损伤(Rhomboid muscle injury)也叫做菱形肌紊乱综合征,是由于急性损伤或者慢性劳损而导致菱形肌局部渗出、肿胀、痉挛甚至粘连而产生的特有症状及体征,主要表现为背部脊柱和肩胛骨脊柱缘之间有明显的疼痛点,有时局部肿胀,背部沉重如负重,严重者翻身困难,难以入睡。该病是引起肩背痛的主要原因之一。对本病的治疗,笔者在思考菱形肌损伤发病特点的同时,结合自身临床经验,总结出按动推拿法,该法利用推拿与按动结合,以恢复肩背部动、静力稳定结构为基础,配合中医的分经辨证,最终达到恢复肌肉骨节平衡体系的目的。在临床适用,疗效满意,现介绍如下。

电针联合按动推拿对腓总神经麻痹患者运动功能障碍及神经电生理指标的影响

目的探讨电针联合按动推拿法对腓总神经麻痹患者运动功能障碍及神经电生理指标的影响。方法将2019年5月—2020年6月在江汉油田总医院治疗的82例腓总神经麻痹患者随机分成对照组和观察组,对照组41例给予甲钴胺片、维生素B_(1)、按动推拿法治疗,观察组41例在对照组治疗基础上给予电针治疗,2组均治疗4周。观察2组治疗前后踝关节主动背屈角度、腓总神经麻痹评分、下肢运动功能分级及神经电生理指标,并比较2组总有效率和治疗方案的安全性。结果治疗后2组踝关节主动背屈角度、腓总神经麻痹评分、复合肌肉动作电位(CAMP)波幅、感觉神经动作电位(SNAP)波幅、感觉传导速度均明显增加(P均<0.05),且观察组治疗后以上指标改善情况均明显优于对照组(P均<0.05);治疗后2组CAMP潜伏期均明显缩短(P均<0.05),且观察组明显短于对照组(P<0.05);治疗后2组下肢运动功能分级均得到明显改善(P均<0.05),观察组改善情况明显优于对照组(P<0.05);观察组总有效率为87.8%(36/41),明显高于对照组的68.3%(28/41),差异有统计学意义(P<0.05);2组治疗期间均未出现严重药物不良反应及针刺不良事件。结论电针联合按动推拿法能够改善腓总神经麻痹患者运动功能障碍,调节患者神经电生理指标,保护神经,且安全。

Clinical observation of tendon-regulating manipulation plus core stability training for non-specific low back pain

Objective： To evaluate the clinical efficacy of tendon-regulating manipulation plus kinesiotherapy in treating low back pain. Methods： Sixty patients were randomized into a treatment group and a control group by using the random number table, 30 cases in each group. The treatment group was intervened by tendon-regulating manipulation plus kinesiotherapy, while the control group was by the tendon-regulating manipulation alone. The lumbar lordosis was measured by X-ray （side view）, the pain was evaluated by analgesy meter, the lumbar range of motion was by using goniometer, and the function was judged by Oswestry disability index （ODI） before and after treatment, and the therapeutic efficacy was also observed. Results： After treatment, the pain level was significantly reduced, lumbar lordosis was significantly increased, the lumbar range of motion was markedly improved, and the ODI score significantly dropped （all P^O.05） in both groups; the improvement of each item in the treatment group was more significant than that in the control group （all P〈O.05）. The total effective rate was 90.0% in the treatment group versus 63.3% in the control group, and the difference was statistically significant （P〈0.05）. Conclusion＂ In the treatment of low back pain, tendon-regulating manipulation plus kinesiotherapy can mitigate topical pain, improve the motion of low back, enhance the quality of life, and produce a more significant therapeutic efficacy compared to tendon-regulating manipulation alone.

Therapeutic observation of manipulation plus exercise therapy in treating upper crossed syndrome postures of primary school students

Objective:To observe the therapeutic efficacy of sinew-bone balancing manipulation plus exercise therapy in treating postures of primary school students with upper crossed syndrome(UCS).Methods:Sixty pupils with UCS were divided into an exercise group and a combination group using the random number table method,with 30 cases in each group.The combination group received treatments of sinew-bone balancing manipulation plus exercise therapy,while the exercise group received exercise therapy alone.The two groups received interventions once every other day,for a total of 1 month.The sagittal static posture assessment total score,forward head angle(FHA)and forward shoulder angle(FSA)were compared before and after treatment;the sagittal static assessment total score,FHA and FSA were compared between the exercise group and the combination group.Results:Before treatment,there were no significant differences comparing the sagittal static posture assessment total score,FHA and FSA between the two groups(all P>0.05);after treatment,the sagittal static posture assessment total score,FHA and FSA decreased in the two groups,with intra-group statistical significance(all P<0.01),and were lower in the combination group than in the exercise group,with inter-group statistical significance(all P<0.01).Conclusion:Sinew-bone balancing manipulation plus exercise therapy can notably improve the FHA and FSA and reduce the sagittal static posture total score in pupils with UCS,so as to correct the bad postures and adjust UCS physique.It can produce more significant efficacy compared with exercise therapy alone.

Clinical observation on warm needling moxibustion plus tuina for cervical spondylosis of vertebral artery type

Objective: To observe the clinical effect of warm needling moxibustion plus Kai Qing Long Suo tuina therapy (opening the Qing Long lock, one type of 'Eight and a Half Locks' tuina therapy) for cervical spondylosis of vertebral artery type (CSA). Methods: Sixty patients with CSA were randomly allocated into an observation group or a control group, with 30 cases in each group. The observation group was treated with warm needling moxibustion plus Kai Qing Long Suo tuina therapy, while the control group was treated with warm needling moxibustion alone. Warm needling moxibustion was conducted once every other day and tuina was con ducted once a day, 7-day treatme nts for one course. The clin ical efficacy and vertebral artery blood flow was observed after one course of treatment. Results: After treatment, the total effective rate was 93.3% in the observation group versus 80.0% in the control group, and there was a significant differenee between the two groups (P<0.05). After treatment, the systolic blood flow velocity of vertebral artery increased in both groups, with statistical significanee compared with that before treatment (both P<0.05), and the blood flow velocity in the observation group was faster than that in the control group, with statistical significanee between the two groups (P<0.05). Conclusion: Both warm needling moxibustion plus Kai Qing Long Suo tuina therapy and warm needling moxibustion alone are both effective for CSA, can improve the systolic blood flow velocity of vertebral artery. The curative effect of warm needling moxibusiton plus Kai Qing Long Suo tuina therapy is better than that of warm needling moxibustion alone.

Observation on the therapeutic efficacy of Tuina plus“three-bridge”exercise for non-specific low back pain

Objective To investigate the efficacy of Tuina(Chinese therapeutic massage)plus“three-bridge”exercise for non-specific low back pain(NSLBP).Methods A total of 80 patients with NSLBP were randomly divided into a control group and an observation group according to the random number table method,with 40 cases in each group.The two groups received Tuina treatment,and the observation group received an additional“three-bridge”exercise.The treatment lasted 4 weeks,and a follow-up evaluation was carried out 6 months after treatment.The visual analog scale(VAS),Oswestry disability index(ODI),and the Japanese Orthopaedic Association(JOA)scores for low back pain were used to evaluate patients’conditions before treatment,after 4-week treatment,and at the 6-month follow-up.Results The total effective rate was 92.5%and 85.0%in the observation group,respectively,after 4-week treatment and at the 6-month follow-up,significantly different from the control group(P<0.05).After 4-week treatment and at the 6-month follow-up,the VAS,ODI,and JOA scores of the two groups were improved compared with those before treatment(P<0.05),and all the indicators in the observation group were significantly better than those in the control group(P<0.05).At the 6-month follow-up,the VAS,ODI,and JOA scores in the two groups were improved compared with those before treatment(P<0.05).Conclusion Tuina plus“three-bridge”exercise can effectively alleviate pain,improve function,and have relatively sound long-term effects in treating patients with NSLBP.

Effect of Governor Vessel-unblocking and mind- refreshing acupuncture plus functional training on neural development in infants with brain damage

Objective： To observe the effect of Governor Vessel-unblocking and mind-refreshing acupuncture plus functional training on neural development in infants with brain damage and seek an effective method for early intervention of infantile brain damage. Methods： Eighty infants with brain injury were recruited and allocated to a treatment group and a control group by their visiting sequence, with 40 cases in each group. The control group received exercise training, 40 min each session and 6 sessions a week, and tuina treatment, 30 min each time and 6 times a week. Based on the treatment protocol for the control group, the treatment group additionally received Governor Vessel-unblocking and mind-refreshing acupuncture, 3 times a week and 10 sessions as a course at a 2-week interval. Before the treatment and after 14-week treatment, the gross motor function measure （GMFM） and developmental quotient （DQ） of Bejing Gesell developmental scale were used to evaluate the development of the infants. Results： After the treatment, the GMFM score and DOs of Gesell scale all increased by different levels in the two groups, and the intra-group differences were statistically significant （all P〈0.05）; the scores of the treatment group were superior to those of the control group, and the between-group differences were statistically significant （all P〈0.05）. Conclusion： Governor Vessel-unblocking and mind-refreshing acupuncture plus functional training can significantly promote the development of gross motor and cognitive functions in infants with brain damage, and it is an early and effective intervention for infantile brain damage.

Clinical observation of sinew-regulating bone-setting manipulations plus exercise therapy for chronic non-specific low back pain

Objective:To evaluate the clinical efficacy of sinew-regulating bone-setting manipulations plus exercise therapy in treating chronic non-specific low back pain(CNLBP).Methods:A total of 65 CNLBP patients were divided into two groups by the random number table method.Thirty-three cases in the treatment group were intervened by sinew-regulating bone-setting manipulations plus exercise therapy;32 cases in the control group were intervened by medium-frequency electrotherapy plus exercise therapy.Before and after treatment,visual analog scale(VAS),dynamic and static muscle endurance of low back,median frequency(MF)of surface electromyography(sEMG)and Oswestry disability index(ODI)were used to evaluate the low back function.The therapeutic efficacy was estimated after treatment.Results:The two groups each had 2 dropouts during the study.The total effective rate was 90.3%in the treatment group versus 66.7%in the control group,and the between-group difference was statistically significant(P<0.05).After treatment,the VAS score,dynamic and static muscle endurance of low back,MF of sEMG and ODI score all changed significantly in both groups(all P<0.05);all the items in the treatment group were significantly different from those in the control group(all P<0.05).Conclusion:Sinew-regulating bone-setting manipulations plus exercise therapy can effectively release pain in CNLBP patients,increase muscle endurance of the low back and improve the quality of life,and its therapeutic efficacy is more significant than that of medium-frequency electrotherapy plus exercise therapy.