基于颈部软组织张力探讨悬吊循经弹拨结合麦肯基疗法对颈型颈椎病的疗效及机制

目的比较悬吊循经弹拨结合麦肯基疗法与两者分别单一治疗颈型颈椎病的临床疗效差异并探讨其疗效机制。方法将88例符合标准的患者按照随机数字表法分为综合组(29例)、对照1组(30例)、对照2组(29例)。对照1组采用悬吊循经弹拨法,对照2组采用麦肯基疗法,综合组将对照组的治疗方法相结合,5 d为1疗程,共观察2个疗程。应用颈椎病临床评价量表(clinical assessment scale for cervical spondylosis,CASCS)、利用表面肌电图比较2个疗程治疗前后颈椎功能情况以及胸锁乳突肌、斜方肌上部纤维平均功率频率(mean power frequency,MPF)和中位频率(median frequency,MF)数值变化(对应肌肉的疲劳度改变)。结果治疗结束后,综合组总有效率96.55%,优于对照1组总有效率80.00%和对照2组75.86%(P<0.05或P<0.01),且综合组颈椎功能情况及胸锁乳突肌、斜方肌上部纤维MPF、MF值的治疗效果均优于对照1组和对照2组,组间差异有统计学意义(P<0.05或P<0.01)。结论悬吊循经弹拨法结合麦肯基疗法能有效治疗颈型颈椎病,其效果优于单纯悬吊循经弹拨法和单纯麦肯基疗法,能更好地修复颈部软组织张力,实现生物力学平衡,恢复颈椎运动功能,因此临床上可推广此法治疗颈型颈椎病。     

针灸并用结合康复训练治疗中风后肩手综合征临床疗效观察

ObjectiveTo compare the clinical effects of body acupuncture, moxibustion, and body acupuncture plus moxibustion in the treatment of post-stroke shoulder hand syndrome (SHS).MethodsA total of 90 SHS patients after stroke were randomly divided into the body acupuncture group, the moxibustion group, and the body acupuncture plus moxibustion group, with 30 cases in each. On the basis of rehabilitation and routine treatment, the patients in different groups were treated with body acupuncture, moxibustion, and body acupuncture plus moxibustion respectively. Treatment was given once a day, 5 times a week, and 4 weeks in all. The visual analogue scale (VAS) scores, edema grading scores, and simplified Fugl-Meyer assessment (FMA) scores were evaluated before and after treatment, and the therapeutic effects of patients were evaluated as well.ResultsAfter treatment, the VAS and edema grading scores of the three groups were all lower and the FMA scores were all higher than those before treatment, with statistically significant differences (all P<0.05). The VAS and edema grading scores of the acupuncture plus moxibustion group were lower and the FMA score was higher than those of the body acupuncture group and the moxibustion group, with statistically significant differences (all P<0.05). The total effective rate of the acupuncture plus moxibustion group was 96.7%, higher than 80.0% of the body acupuncture group and 83.3% of the moxibustion group, with statistically significant differences (both P<0.05).ConclusionBody acupuncture, moxibustion, and body acupuncture plus moxibustion are all effective for post-stroke SHS, while the effect of acupuncture plus moxibustion is the best in relieving the pain and swelling, and improving effectively the joint movement of post-stroke SHS patients, which should be popularized in clinical practice.     

负重离心收缩诱导人体肱二头肌延迟性肌肉酸痛模型的实验研究

目的观察利用负重状态下离心收缩的方式是否诱导人体肱二头肌延迟性肌肉酸痛症(DOMS)模型。方法实验对象从在校大学生中招募志愿者60名,随机分为造模组和对照组,两组各30例;造模组做负重状态下离心收缩运动两组,每组25个,每个动作操作时间20秒,对照组不做任何处理,通过观察志愿者的血清磷酸肌酸激酶(CK)、主观酸痛阈、主观体力等级评定量表(RPE)、DOMS临床评价(CEC)等级来评价模型是否成功。结果造模组与对照组比较,试验后24 h和48 h主观酸痛阈低于对照组,试验后72 h CK高于对照组,试验后即刻、24 h、48 h、72 h RPE明显高于对照组,试验后即刻、24 h、48 h、72 h、120 h CEC高于对照组,差异均有统计学意义(P0.05)。造模组试验后与试验前比较,试验后24 h、48 h和72 h主观酸痛阈明显低于试验前,试验后48 h、72 h和120 h CK高于试验前,试验后即刻、24 h、48 h、72 h RPE明显高于试验前,试验后即刻、24 h、48 h、72 h、120 h CEC高于试验前,差异均有统计学意义(P0.05)。结论负重状态下离心收缩可以诱导肱二头肌DOMS模型,各项指标变化符合文献记载。