[1]高夕林,王明炜,谭军彦,等.坐位腰椎旋扳手法操作中腰椎的骨性耦合运动特征研究[J].中医正骨,2026,38(02):14-22.
　GAO Xilin,WANG Mingwei,TAN Junyan,et al.Study on the characteristics of bony coupled motion of lumbar spine during seated lumbar rotatory manipulation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2026,38(02):14-22.
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坐位腰椎旋扳手法操作中腰椎的骨性耦合运动特征研究()

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第38卷
期数:
2026年02期
页码:
14-22
栏目:
基础研究
出版日期:
2026-02-20

文章信息/Info

Title:
Study on the characteristics of bony coupled motion of lumbar spine during seated lumbar rotatory manipulation
作者:
高夕林; 王明炜; 谭军彦; 黄朋涛; 刘爱峰; 王平; 符碧峰
天津中医药大学第一附属医院,天津 300381
Author(s):
GAO Xilin; WANG Mingwei; TAN Junyan; HUANG Pengtao; LIU Aifeng; WANG Ping; FU Bifeng
The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China
关键词:
推拿; 脊柱;  腰椎;  生物力学现象;  限定因素分析
Keywords:
manipulation; spinal;  lumbar vertebrae;  biomechanical phenomena;  finite element analysis
摘要:
目的:分析坐位腰椎旋扳手法操作中腰椎的骨性耦合运动特征。方法:选取1名27岁健康男性志愿者,分别进行中立位和坐位腰椎旋扳手法终点位(以左侧手法操作为例)的腰椎CT扫描。基于CT扫描数据建立全腰椎骨骼结构三维模型。测量腰椎各节段相对于S1的侧弯角、屈伸角、旋转角和腰椎上位节段相对于下位节段的旋转角,并计算各个角度的变化值(手法终点位时的测量值与中立位时的测量值的差值)。结果:①腰椎各节段相对于S1的位置测量结果。冠状面上,中立位时,腰椎各节段相对于S1均向右轻度侧弯; 手法终点位时,腰椎各节段相对于S1的侧弯角增大,表现为向左偏移。矢状面上,中立位时,腰椎各节段相对于S1整体向前偏移,呈轻度前凸曲线; 手法终点位时,L1～L3节段相对于S1前凸屈伸角稍增加,L4和L5则向后偏移。水平面上,中立位时,腰椎各节段相对于S1呈轻度右旋; 手法终点位时,腰椎各节段相对于S1的旋转角增大,均向左旋转,但由上至下旋转角和旋转角变化值逐渐减小。②腰椎上位节段相对于下位节段的旋转角测量结果。手法操作中腰椎上位节段相对于下位节段均向左旋转。相对于L5,L1～L4的旋转角变化值由上至下递减。当参照点上移,除L3相对于L4的旋转角变化值大于其相对于L5的旋转角变化值,L1相对于L2的旋转角变化值大于其相对于L3的旋转角变化值外,上位节段相对于下位节段的旋转角变化值也逐渐递减。结论:坐位腰椎旋扳手法操作过程中,上腰椎(L1～L3)是响应手法作用的主要区域,有同侧的侧弯耦合和前凸耦合; 下腰椎(L4、L5)主要起到维持稳定的作用,有同侧的侧弯耦合和后伸耦合; 腰椎整体和各节段间有旋转耦合。
Abstract:
Objective:To analyze the characteristics of bony coupled motion of lumbar spine during seated lumbar rotatory manipulation.Methods:A 27-year-old healthy male volunteer was selected to undergo lumbar CT scans in the neutral position and at the endpoint of seated lumbar rotatory manipulation, respectively(taking the left-side manipulation as an example).A three-dimensional model of the entire lumbar bone structure was established based on CT scan data.The lateral bending angle, flexion-extension angle, and rotation angle of each lumbar segment relative to S1, and the rotation angle of the upper lumbar segment relative to the lower lumbar segment were measured, and the change values of each angle(the difference between the measured value at the manipulation endpoint and the measured value in the neutral position)were calculated.Results:①Measurement results of the position of each lumbar segment relative to S1.In the coronal plane, each lumbar segment showed mild right bending relative to S1 in the neutral position; at the manipulation endpoint, the lateral bending angle of each lumbar segment relative to S1 increased, showing a leftward shift.In the sagittal plane, lumbar segments shifted forward as a whole relative to S1 in the neutral position, presenting a mild lordotic curve; at the manipulation endpoint, the lordotic flexion-extension angle of L1-L3 segments relative to S1 increased slightly, while L4 and L5 shifted backward.In the horizontal plane, each lumbar segment showed mild right rotation relative to S1 in the neutral position; at the manipulation endpoint, the rotation angle of each lumbar segment relative to S1 increased, all rotating to the left, but the rotation angle and the change value of the rotation angle gradually decreased from top to bottom.②Measurement results of the rotation angle of the upper lumbar segment relative to the lower segment.During the manipulation, the upper lumbar segment relative to the lower segment all rotated to the left.Relative to L5, the change values of the rotation angle of L1-L4 decreased from top to bottom.When the reference point moved upward, except that the change value of the rotation angle of L3 relative to L4 was greater than that relative to L5, and the change value of the rotation angle of L1 relative to L2 was greater than that relative to L3, the change values of the rotation angle of the upper segment relative to the lower segment also gradually decreased.Conclusion:During the seated lumbar rotatory manipulation, the upper lumbar spine(L1-L3)is the main area responding to the manipulation, with ipsilateral lateral bending coupling and lordosis coupling; the lower lumbar spine(L4, L5)mainly plays a role in maintaining stability, with ipsilateral lateral bending coupling and extension coupling; there is rotational coupling in the lumbar spine as a whole and between each lumbar segment.

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备注/Memo

备注/Memo:
基金项目:国家重点研发计划(2021YFC1712802); 国家中医药管理局中医药循证能力建设项目(2019XZZX-GK006); 天津中医药大学第一附属医院“拓新工程”基金科研课题(院ZZ2024010)
通信作者:符碧峰 E-mail:452424671@qq.com
(收稿日期:2025-08-19 本文编辑:杨雅)
更新日期/Last Update: 2026-02-20