[1]董文阳,孙武权,朱清广,等.不同时长法对腰肌劳损患者腰背部肌电信号的影响[J].中医正骨,2023,35(06):49-52,58.
 DONG Wenyang,SUN Wuquan,ZHU Qingguang,et al.Effects of rolling manipulation with different durations on lumbodorsal electromyographic signals in patients with lumbar muscle strain[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(06):49-52,58.
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不同时长法对腰肌劳损患者腰背部肌电信号的影响()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期数:
2023年06期
页码:
49-52,58
栏目:
临床研究
出版日期:
2023-06-20

文章信息/Info

Title:
Effects of rolling manipulation with different durations on lumbodorsal electromyographic signals in patients with lumbar muscle strain
作者:
董文阳1孙武权2朱清广2张帅攀3单一鸣2刘元红4陈金田2
(1.上海中医药大学附属龙华医院,上海 200032; 2.上海中医药大学附属岳阳中西医结合医院,上海 200437; 3.上海中医药大学针灸推拿学院,上海 201203; 4.上海同仁医院,上海 200336)
Author(s):
DONG Wenyang1SUN Wuquan2ZHU Qingguang2ZHANG Shuaipan3SHAN Yiming2LIU Yuanhong4CHEN Jintian2
1.Longhua Hospital Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China 2.Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China 3.School of Acupuncture-Moxibustion and Tuina,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China 4.Shanghai Tongren Hospital,Shanghai 200336,China
关键词:
腰肌 扭伤和劳损 滚法推拿疗法 肌电描记术 临床试验
Keywords:
psoas muscles sprains and strains rolling manipulation electromyography clinical trial
摘要:
目的:观察不同时长法对腰肌劳损患者腰背部肌电信号的影响。方法:将75例符合要求的腰肌劳损患者随机分为3组,每组25例。3组患者均于腰背部足太阳膀胱经循行处(两侧竖脊肌和腰方肌)行法治疗,法时长分别为5 min(短时间组)、10 min(中等时间组)、15 min(长时间组)。法的前摆垂向力为50~70 N、回摆垂向力为20~40 N,法频率为138次·min-1。每周治疗3次,连续治疗2周。分别于治疗前及末次治疗后采用表面肌电仪采集两侧竖脊肌和腰方肌的表面肌电信号,比较3组患者的两侧竖脊肌和腰方肌表面肌电信号频率。结果:3组患者均有4例退出,其中短时间组4例均为不愿继续参加试验,中等时间组1例为不按要求治疗、3例为不愿继续参加试验,长时间组2例为不按要求治疗、2例为不愿继续参加试验。治疗前和末次治疗后,3组患者左侧竖脊肌、右侧竖脊肌、左侧腰方肌、右侧腰方肌的表面肌电信号频率比较,组间差异均无统计学意义[治疗前:H=2.611,P=0.271; H=3.417,P=0.181; H=1.934,P=0.380; H=2.440,P=0.295; 末次治疗后:H=5.805,P=0.055; H=3.159,P=0.206; H=3.530,P=0.171; H=2.511,P=0.285]; 3组患者左侧竖脊肌、右侧竖脊肌表面肌电信号频率治疗前后的差异均无统计学意义(左侧竖脊肌:Z=0.243,P=0.808; Z=-1.234,P=0.217; Z=-0.295,P=0.768; 右侧竖脊肌:Z=0.678,P=0.498; Z=1.443,P=0.149; Z=-0.280,P=0.779); 短时间组和长时间组患者左侧腰方肌、右侧腰方肌表面肌电信号频率治疗前后的差异无统计学意义(左侧腰方肌:Z=0.000,P=1.000; Z=-0.653,P=0.513; 右侧腰方肌:Z=0.608,P=0.543; Z=-0.591,P=0.555),中等时间组患者末次治疗后左侧腰方肌、右侧腰方肌的表面肌电信号频率较治疗前增高[左侧腰方肌:(77.2,23.6)Hz,(86.7,31.1)Hz,Z=-2.240,P=0.025; 右侧腰方肌:(81.3,29.9)Hz,(81.3,32.5)Hz,Z=-2.833,P=0.005]。结论:在前摆垂向力为50~70 N、回摆垂向力为20~40 N、频率为138次·min-1的条件下,法改善腰肌劳损患者局部肌肉疲劳的最佳时长为10 min。
Abstract:
Objective:To observe the effects of rolling manipulation with different durations on lumbodorsal electromyographic(EMG)signals in patients with lumbar muscle strain(LMS).Methods:Seventy-five patients with LMS were enrolled in the study and were randomly divided into 3 groups,25 cases in each group.The patients were treated with rolling manipulation 138 times in a minute along the lumbodorsal bladder meridian of Foot-Taiyang,that was to say bilateral erector spinae muscle(ESM)and quadratus lumborum muscle(QLM)),for 5 minutes(short time group),10 minutes(medium time group)and 15 minutes(long time group)respectively.The front-swing vertical force and back-swing vertical force of the manipulation were 50-70 N and 20-40 N respectively.All patients in the 3 groups were treated three times a week for consecutive 2 weeks.The surface EMG signals of bilateral ESM and QLM were collected by using surface electromyography before the treatment and after the last treatment respectively,and the surface EMG signal frequencies were compared among the 3 groups.Results:Four patients in short time group,3 cases in medium time group and 2 cases in long time group dropped out of the trial for unwilling to continue the trial,while 1 patient in medium time group and 2 cases in long time group dropped out for failing to be treated as required.There was no statistical difference in surface EMG signal frequencies of left ESM,right ESM,left QLM and right QLM among the 3 groups before the treatment and after the last treatment respectively(pretreatment:H=2.611,P=0.271; H=3.417,P=0.181; H=1.934,P=0.380; H=2.440,P=0.295; after the last treatment:H=5.805,P=0.055; H=3.159,P=0.206; H=3.530,P=0.171; H=2.511,P=0.285).Furthermore,the differences in surface EMG signal frequencies of left ESM and right ESM between pre-treatment and post-treatment were not statistically significant in the 3 groups(left ESM:Z=0.243,P=0.808; Z=-1.234,P=0.217; Z=-0.295,P=0.768; right ESM:Z=0.678,P=0.498; Z=1.443,P=0.149; Z=-0.280,P=0.779),and the differences in surface EMG signal frequencies of left QLM and right QLM between pre-treatment and post-treatment were not statistically significant in short time group and long time group(left QLM:Z=0.000,P=1.000; Z=-0.653,P=0.513; right QLM:Z=0.608,P=0.543; Z=-0.591,P=0.555),while the surface EMG signal frequencies of left QLM and right QLM increased after the last treatment compared to pre-treatment in medium time group(left QLM:(77.2,23.6)vs(86.7,31.1)Hz,Z=-2.240,P=0.025; right QLM:(81.3,29.9)vs(81.3,32.5)Hz,Z=-2.833,P=0.005).Conclusion:The optimal duration of rolling manipulation is 10 minutes for improving local muscle fatigue of LMS patients,with front-swing vertical force,back-swing vertical force and frequency as 50-70 N,20-40 N and 138 times/minute respectively.

参考文献/References:

[1] 孙力盟,李长勤,姚健.腰肌劳损磁共振影像学研究现状及进展[J].泰山医学院学报,2016,37(1):116-120.
[2] 陈贤彪,林晓芳,王春富,等.中医外治法治疗慢性腰肌劳损研究进展[J].新中医,2018,50(11):32-35.
[3] 宋丰军,胡建锋,张红,等.推拿治疗慢性腰肌劳损的临床研究进展[J].中医正骨,2014,26(12):59-63.
[4] 国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,1994:213.
[5] 房敏,王金贵.推拿学[M].北京:中国中医药出版社,2021:208.
[6] 郭锐伟.不同作用时间肘按法对慢性腰肌劳损疼痛改善的对比研究[D].广州:广州中医药大学,2018.
[7] 沈夏虹.不同时长振腹法对寒湿凝滞型PD疗效及血清PGF2α的影响[D].广州:广州中医药大学,2019.
[8] 边雷.脾土穴推拿不同时长对脾虚腹泻患儿脑功能磁共振成像研究[D].天津:天津中医药大学,2020.
[9] 杨森,武文杰,杜诗宇,等.慢性非特异性下腰痛患者腰背肌力量和耐力与生活质量的相关性[J].广西医学,2020,42(5):529-532.
[10] 陈丽媛.推拿结合八段锦治疗慢性腰肌劳损的临床疗效观察[D].福州:福建中医药大学,2022.
[11] 陈丽媛,沈重庆,李长辉.基于肌肉力学性能探讨推拿治疗慢性腰肌劳损作用机制[J].智慧健康,2022,8(2):33-35.
[12] 井凤玲,常晓涛.推拿手法治疗慢性腰肌劳损的疗效研究[J].医学信息,2018,31(9):145-146.
[13] 张作军.手法治疗腰肌劳损疗效观察[J].实用中医药杂志,2018,34(12):1519-1520.
[14] 刘明军.通经调脏推拿手法治疗慢性腰肌劳损[J].长春中医药大学学报,2018,34(5):934-936.
[15] 郑锴鹏.通元推法治疗慢性腰肌劳损的临床研究[D].广州:广州中医药大学,2020.
[16] 吴邦宪,刘启华,唐宏亮,等.四步推拿法治疗慢性腰肌劳损36例的临床观察[J].右江民族医学院学报,2021,43(6):782-784.
[17] 梁健,施静,袁昕,等.核心稳定训练治疗非特异性腰痛的研究进展[J].中医正骨,2021,33(4):58-61.
[18] 刘婷婷,廖晓琴,曹铁炜,等.慢性腰痛病人疼痛灾难化研究进展[J].护理研究,2021,35(11):1954-1958.
[19] 朱承科,潘兰兰,郝增明,等.核心稳定性训练治疗地面机务人员下腰痛的研究[J].解放军医药杂志,2018,30(4):111-114.
[20] 王悦.细胞的应力松弛特性研究[D].郑州:郑州大学,2020.
[21] GUAN H,ZHAO L,LIU H,et al.Effects of intermittent pressure imitating rolling manipulation in traditional Chinese medicine on ultrastructure and metabolism in injured human skeletal muscle cells[J].Am J Transl Res,2020,12(1):248-260.
[22] 万小凤,唐成林,赵丹丹,等.推拿对失神经骨骼肌萎缩大鼠的治疗作用及其机制[J].中国应用生理学杂志,2019,35(3):223-227.

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[2]吴晓刚,潘茂才,徐国栋,等.针刀松解术治疗腰肌劳损124例[J].中医正骨,2015,27(09):48.
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备注/Memo

备注/Memo:
基金项目:国家自然科学基金项目(81874512) 通讯作者:孙武权 E-mail:drsunwuquan@126.com
更新日期/Last Update: 1900-01-01