推拿手法操作参数的规范化研究

目的：本研究旨在拟定手法操作参数规范。方法：应用三维运动解析系统和推拿手法测试系统同步采集受试者的手法操作数据。受试者为每一种研究纳入手法专家3名；研究纳入手法法、一指禅推 法、掌摩法、掌按法、指按法、掌揉法、鱼际揉法、侧击法、拍法、四指拿法、指振法及掌擦法12种手法；手法操作严格按照手法操作标准的要求进行，每种手法按照受试者个人临床经验按用力大小分为轻、中、重三型进行采集，同一手法类型每个受试者操作2遍，每遍30 s，中间间隔10 min。在测试采样全部结束后，回放采样曲线和数据，选择连续周期稳定的数据，用自行开发的配套数据分析软件进行数据处理，分析手法的三维力、周期和频率。结果：拟定了法、一指禅推法、掌摩法、掌按法、指按法、掌揉法、鱼际揉法、侧击法、拍法、四指拿法、指振法及掌擦法等12种手法力与频率的操作参数规范。结论：力与频率是推拿手法的主要特征，但并不是力量越大、频率越快，手法的疗效就越好，每一种手法有其一定的施力范围和频率范围。

Study on Standardization of Tuina Manipulation Parameters

This study was aimed to develop the standardization of Tuina manipulation parameters. The three-dimensional motion analysis system and manipulation test system were used simultaneously to collect the data of manipulation. There were 3 Tuina manipulation specialists for each trial subject. There were 12 kinds of main manipulations in this study, which were the rolling manipulation, dhyana-thumb-pushing, palm circular-rubbing, palm-pressing, thumb-press, palm-kneading, thenar-kneading, palm edge knocking, patting, grasping, tremble manipulation with finger and linear-rubbing. These manipulations were operated in strict accordance with the standard of performance. The data of each kind of manipulation were collected in accordance with the clinical experiences of the operator, which were divided into mild, moderate and strong type by force. The same type of manipulation was operated twice, 30 seconds for each time with 10 minutes interval. After all the test samples were completed, the stabile and continuous cycle was selected and processed with self-developed analysis software. The three-dimensional force of manipulation, cycle and frequency of manipulation were analyzed. The results showed that the standardization of manipulation parameters on force and frequency were developed to the 12 kinds of main manipulations, which were the rolling manipulation, dhyana-thumb-pushing, palm circular-rubbing, palm-pressing, thumb-press, palm-kneading, thenar-kneading, palm edge knocking, patting, grasping, tremble manipulation with finger and linear-rubbing. It was concluded that the force and frequency were the main features of Tuina manipulation. However, the stronger force or faster frequency may not lead to better efficacy. Each manipulation has its own range on force and frequency.