推拿对一次性离心运动后延迟性肌肉酸痛影响及机制的随机对照试验

目的：观察比较运动前、后推拿及自然恢复对一次性离心运动所致延迟性肌肉酸痛（DOMS）的影响，并从氧自由基代谢方面对推拿的作用机制进行探讨。方法：本研究地点为南京中医药大学，时间2008年4—7月。将30名健康男性学生按照条件对等原则随机分成运动前推拿组（A）、运动后推拿组（B）和对照组（自然恢复组，即C组），每组各10名。A组学生于训练前在左上肢进行30inin推拿，推拿结束5min后开始训练；B组学生于训练后30min在左上肢进行30min推拿，并在此后的3d内按规定时间继续接受推拿治疗，每次30min，每日1次。C组学生仅参加训练，不做任何的准备活动或整理活动，也不接受任何治疗。分别于训练前、训练后即刻及训练后24、48、72h测定肌肉酸痛程度和持续时间、肌肉最大等长收缩力量、臂围、肘关节的屈伸度。血清肌酸激酶（CK）、血清超氧化物歧化酶（SOD）、血清丙二醛（MDA）测定安排在训练前1h、训练后即刻及训练后24、48h。同时观察酸痛消失的具体时间。结果：与C组相比，A组和B组酸痛峰值均降低（P〈0．01，P〈0．05）；运动后72h肘关节屈曲程度的恢复优于C组（P〈0．05，P〈0．01）；运动后48h的血清CK升高幅度低于C组（P〈0．01）。A组肌肉酸痛持续时间缩短（P〈0．01），运动后72h肌肉最大等长收缩力量的恢复优于C组（P〈0．01）；B组在运动后72h的肘关节伸直程度的恢复优于C组（P〈0．01）。A、B纽的臂围变化与对照组无明显差异。A、B组在运动后48h时的血清SOD、MDA和SOD／MDA变化程度与C组差异均有统计学意义（P〈0．01或0．05）。结论：运动前、后推拿能通过改善DOMS过程中氧自由基的代谢水平而分别对DOMS具有一定的预防和治疗作用。

Randomized controlled trials on the influence and mechanism of manipulation on delayed onset muscle soreness after eccentric exercise

Objective: To observe and compare the influence of pre-and post-exercise manipulation and natural recovery without any intervention on delayed onset muscle soreness(DOMS) after eccentric exercise and to explore the manipulation therapeutic mechanism on the metabolism of oxygen free radical(OFR). Methods: The study was carried on during Apr. to Jul. in 2008 at Nanjing University of TCM. The 30 healthy male students were divided into 3 groups randomly according to condition-equivalence principle including control group(C),pre-exercise manipulation group(A),post-exercise manipulation group(B). Before exercise,group A were intervened by manipulation for 30 minutes,which was followed by exercise 5 minutes later. While 30 minutes after exercise,group B accepted manipulation for 30 minutes and continued manipulation once a day for consecutive 3 days. Group C were not intervened by any approaches before or after exercise. The clinical manifestations,which include soreness intensity and lasting time,maximal isometric strength,arm girth,elbow range of motion,were evaluated at the 1st hour before exercise,immediately,24 th,48 th and 72 th hours after exercise. Meanwhile,serum creatine kinase(CK),serum superoxide dismutase(SOD),serum malonaldehyde(MDA) were determined at the 1st hour before exercise,immediately,24 th and 48 th hours after exercise. Results: Compared to group C,group A and B were manifested by significantly lower peak soreness(P<0.01,P<0.05),significantly better recovery of elbow flexing degree at the 72 th hour after exercise(P<0.05)and significantly lower rising range of serum CK at the 48 th hour after exercise(P<0.01). Comparing to group C,group A was manifested by significantly shorter lasting time of muscle soreness(P<0.01) and significantly better recovery of maximal isometric strength of the 72 th hour after exercise(P<0.01). Compared to group C, group B was manifested by significantly better recovery of elbow extending degree at the 72 th hour after exercise(P<0.01). There was no significant difference in the change of arm girth among the three groups. The level of Serum SOD,MDA and SOD/MDA at the 48 th hour after exercise in group A and B were significantly different from those in group C(P<0.01,P<0.01,P<0.05,P<0.01). Conclusion: Through improving the metabolism of OFR,pre-exercise and post-exercise manipulation can partially prevent and treat DOMS respectively. In addition,preventive effect by pre-exercise manipulation is better than curing effect by post-exercise manipulation,which proves the TCM thought,that is,prevention superior to treatment.