基于多刚体力学模型腰椎推拿斜扳法的优化

目的综合考虑推拿的有效性和安全性,提出一种评价振荡激励和脉冲激励腰椎推拿斜扳法优劣的方法,并对振荡激励腰椎推拿斜扳法进行优化。方法建立多刚体胸-腰椎生物力学模型,手法作用力作为模型的输入力,运用MATLAB/Simulink进行仿真,模拟得到腰椎各节段位移和加速度随时间变化的情况,对腰椎推拿手法行优化时,改变推拿作用力的核心要素频率f和操作次数n,比较腰椎各节段最大相对位移和最大加速度,并提出一种新的指标z,对推拿手法的有效性和安全性进行综合评价。结果两种激励腰椎推拿斜扳法作用时,腰椎各节段最大相对位移没有差异;振荡激励腰椎推拿斜扳法作用时,腰椎各节段的最大加速度均明显小于脉冲激励腰椎推拿斜扳法作用时的最大加速度。当f=1~2.5 Hz时,推拿整体效果比较好,且整体效果与操作数无关,推拿作用力持续1个操作数即可;当f=3.33 Hz,n≥5时,推拿治疗效果最好,但此时腰椎各节段承受力也相对较大;当f≥5 Hz时,推拿整体表现不佳。结论振荡激励腰椎推拿斜扳法比脉冲激励腰椎推拿斜扳法更安全,研究结果为医生提供一个比较合理的振荡激励腰椎推拿斜扳法操作参数的范围。

推拿定点斜扳法联合针刺远端腧穴治疗急性腰扭伤疗效观察

目的:观察推拿定点斜扳法联合针刺远端腧穴治疗急性腰扭伤的疗效。方法:96例采用数字表法随机均分为观察组和对照组各48例,观察组给予推拿定点斜扳法联合针刺远端腧穴治疗,对照组仅给予推拿定点斜扳法治疗,观察两组疼痛程度、腰部活动功能、近期疗效、远期疗效。结果:治疗后两组疼痛程度、腰部活动度改善显著优于治疗前(P<0.05),观察组疼痛程度、腰部活动度改善显著优于对照组(P<0.05);近期疗效、远期疗效观察组均好于对照组(P<0.05)。结论:推拿定点斜扳法联合针刺远端腧穴治疗急性腰扭伤能够缓解疼痛程度,提高腰部活动能力,且近期疗效及远期疗效均良好。

改良腰椎斜扳法治疗以小关节错位为主的急性腰扭伤临床体会

目的探讨改良腰椎斜扳法在治疗以小关节错位为主的急性腰扭伤中的临床疗效。方法在推拿松解组织的基础上,运用改良腰椎斜扳法治疗以小关节错位为主的急性腰扭伤。结果30例中治愈18例,好转10例,未愈2例,总有效率93.33%。结论改良腰椎斜扳法治疗以小关节错位为主的急性腰扭伤疗效确切。

49例俄罗斯腰椎间盘出症患者的推拿、针灸疗法

本文介绍了运用中医推拿、针灸治疗 49例俄罗斯人腰椎间盘突出症 ,临床治愈加好转率为 73.5 %。分析了腰部斜扳法、腰部成角、旋转踝下牵引和突出椎间盘侧强力震颤按压法的应用 ,认为斜扳法使用时 ,应充分虑及因神经根受压不同类型而出现的脊柱侧偏凸情况 ,选择适宜的体位和扳动方向。并提出应根据腰椎间盘与神经根出囊位置关系、神经根受压类型等 ,加强对斜扳等推拿手法作用机理的研究。

Comparison of biomechanical effect between oblique Ban-pulling manipulation and lumbar erection-rotation manipulation in sitting position for lumbar intervertebral disc herniation

Objective： To compare the biomechanical effects between oblique Ban-pulling manipulation and lumbar erection-rotation manipulation in sitting position in treating lumbar intervertebral disc herniation （LIDH）. Methods： A three-dimensional finite element model of L3-S1 was developed to carry out a comparative study between oblique Ban-pulling manipulation and lumbar erection and rotation manipulation in sitting position. The disc protrusion was assumed to be on the rear left of L4 disc, and the manipulations were performed on the right side. The loading process was simulated by two steps, in the first step, only the compression loading was imposed, and in the second step, both the compression loading and axial rotation moment were imposed. The displacement and stress distribution in L4 disc were investigated. Results： The values of stress and displacement in the second step were lower than those in the first step in each manipulation. The stress and displacement differences between the two steps were respectively 1.79 times and 3.03 times larger in oblique Ban-pulling manipulation than those in lumbar erection-rotation manipulation in sitting position. Conclusion： Oblique Ban-pulling manipulation may result in a better biomechanical effect than lumbar erection-rotation manipulation in sitting position for LIDH.