[1]薛彬,奚小冰,李飞跃,等.基于德尔菲法确立中医手法治疗腰椎间盘突出症时筋骨评估的主要内容[J].中医正骨,2023,35(05):32-36,40.
　XUE Bin,XI Xiaobing,LI Feiyue,et al.Main contents of tendon and bone assessment in traditional Chinese medicine manipulation treatment of lumbar disc herniation based on Delphi method[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(05):32-36,40.
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基于德尔菲法确立中医手法治疗腰椎间盘突出症时筋骨评估的主要内容()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期数:
2023年05期
页码:
32-36,40
栏目:
调查研究
出版日期:
2023-05-20

文章信息/Info

Title:
Main contents of tendon and bone assessment in traditional Chinese medicine manipulation treatment of lumbar disc herniation based on Delphi method
作者:
薛彬1; 奚小冰1; 李飞跃1; 周鑫2; 孔令军2; 朱清广2; 房敏3
(1.上海交通大学医学院附属瑞金医院,上海 200025; 2.上海中医药大学附属岳阳中西医结合医院,上海 200437; 3.上海中医药大学附属曙光医院,上海 201203)
Author(s):
XUE Bin1; XI Xiaobing1; LI Feiyue1; ZHOU Xin2; KONG Lingjun2; ZHU Qingguang2; FANG Min3
1.Ruijin Hospital Affiliated to School of Medicine,Shanghai Jiao Tong University,Shanghai 200025,China 2.Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China 3.Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China
关键词:
腰椎;  椎间盘移位;  正骨手法;  筋骨评估;  德尔菲技术
Keywords:
lumbar vertebrae;  intervertebral disc displacement;  bone setting manipulation;  tendon and bone assessment;  Delphi Technique
摘要:
目的:确立采用中医手法治疗腰椎间盘突出症时筋骨评估的主要内容。方法:采用文献回顾、临床经验总结和专家讨论的方法建立中医手法治疗腰椎间盘突出症时的筋骨评估条目池,采用德尔菲法确立中医手法治疗腰椎间盘突出症时筋骨评估的主要内容。结果:建立的中医手法治疗腰椎间盘突出症时筋骨评估条目池包括肌张力、压痛点、关节主动活动度和姿势体位4个方面的内容,肌张力评估方面包括竖脊肌、臀大肌、臀中肌、腓肠肌,压痛点评估方面包括腰椎间盘突出节段棘间、腰椎间盘突出节段夹脊穴、居髎穴、委中穴,关节主动活动度评估方面包括腰椎前屈后伸、侧屈、旋转活动度及直腿抬高角度,姿势体位评估方面包括腰椎前凸、腰椎侧倾、骨盆侧倾、骨盆倾斜角、下肢力线。第1轮问卷调查共遴选出20名专家; 发放问卷20份,收回有效问卷20份,有效问卷回收率100%; 专家权威系数为0.923; 根据专家认同度平均值和变异系数,剔除臀大肌、骨盆倾斜角、下肢力线3项条目,形成第2轮调查问卷。第2轮问卷调查共遴选出30名专家; 发放问卷30份,收回有效问卷30份,有效问卷回收率100%; 专家权威系统为0.958; 第2轮问卷调查所有条目的变异系数均<0.5,调查结束并确立中医手法治疗腰椎间盘突出症时筋骨评估的主要内容。结论:中医手法治疗腰椎间盘突出症时筋骨评估的主要内容包括肌张力、压痛点、关节主动活动度和姿势体位4个方面,其中肌张力评估内容包括竖脊肌、臀中肌和腓肠肌,压痛点评估内容包括腰椎间盘突出节段棘间、腰椎间盘突出节段夹脊穴、居髎穴和委中穴,关节主动活动度评估内容包括腰椎前屈后伸、侧屈、旋转活动度及直腿抬高角度,姿势体位评估内容包括腰椎前凸、腰椎侧倾、骨盆侧倾。
Abstract:
Objective:To establish the main contents of tendon and bone assessment in the treatment of lumbar disc herniation(LDH)with traditional Chinese medicine(TCM)manipulation.Methods:The tendon and bone assessment item pool of TCM manipulation in the treatment of LDH was established through literature review,clinical experience summary,and expert discussion.The main contents of the tendon and bone assessment of TCM manipulation in the treatment of LDH were determined using the Delphi method.Results:The established item pool of tendon and bone assessment of TCM manipulation in the treatment of LDH is comprised of muscle tension,tender points,joint active range of motion,and posture.In the muscle tension assessment,the items include erector spinae,gluteus maximus,gluteus medius,and gastrocnemius muscle.In the tender point assessment,items include interspinous process of the herniated lumbar disc segment,Jiaji(EX B2)points of the herniated lumbar disc segment,Juliao(GB29)points,and Weizhong(BL40)points.In the joint active range of motionassessment,items include forward bending,backward extension,lateral bending and rotational range of motion of lumbar vertebrae,and straight leg raise angle.In the posture assessment,items include the lumbar lordosis,lumbar lateral tilt,lateral pelvic tilt,pelvic tilt angle,and mechanical axis of the lower limb.In the first round of questionnaire survey,20 experts were enrolled.Twenty questionnaires were distributed and 20 valid ones were collected with a response rate of 100%.The authority coefficient of the experts was 0.923.Based on the average degree of expert consensus and the coefficient of variation,three items including the gluteus maximus,pelvic tilt angle,and mechanical axis of the lower limb were eliminated to form the second round of questionnaire survey.In the second round of questionnaire survey,30 experts were enrolled.Thirty questionnaires were distributed and 30 valid questionnaires were collected with a response rate of 100%.The authority coefficient of the experts was 0.958.The coefficients of variation of all items in the second round of questionnaire survey were less than 0.5,suggesting the completion of the survey,and the main contents of tendon and bone assessment of TCM manipulation in the treatment of LDH were established.Conclusion:The main contents of tendon and bone assessment of TCM manipulation in the treatment of LDH consist of muscle tension,tender points,joint active range of motion,and posture.The items in the muscle tension assessment include erector spinae,gluteus medius,and gastrocnemius muscle.The items in the tender point assessment include interspinous process of the herniated lumbar disc segment,Jiaji(EX B2)points of the herniated lumbar disc segment,Juliao(GB29)points,and Weizhong(BL40)points.The items in the joint active range of motion assessment include forward bending,backward extension,lateral bending,rotational range of motion of lumbar vertebrae,and straight leg raise angle.The items in the posture assessment include lumbar lordosis,lumbar lateral tilt,and lateral pelvic tilt.

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备注/Memo

备注/Memo:
基金项目:中医药创新团队及人才支持计划国家中医药传承创新团队项目(ZYYCXTD-C-202008); 上海市临床重点专科建设项目(shslczdzk04802); 上海市科技计划项目(21Y21920300、20YF1427500); 上海市卫生健康委员会中医药科研项目(2022QN026) 通讯作者:房敏 E-mail:fangmin19650510@163.com
更新日期/Last Update: 1900-01-01