不同腰椎退变程度下两种腰椎推拿斜扳法作用效果的比较研究

目的 比较研究腰椎不同退变程度下传统和改良腰椎推拿斜扳法的作用效果。方法 建立质量-弹簧-阻尼系统腰椎生物力学模型，采集专业推拿医生的推拿作用力，将作用力作为模型的输入力，通过增大弹簧的弹性系数和阻尼的阻尼系数模拟腰椎退变。运用MATLAB/Simulink仿真技术，得到不同腰椎退变程度下推拿斜扳法的作用效果(最大相对位移和最大加速度),并进行比较分析。结果 当腰椎未退变时，得到两种手法下各节段的最大相对位移和最大加速度。随着腰椎退变程度的增大，两种手法下各节段的最大相对位移和最大加速度均呈下降趋势，并得到两种手法下腰椎各节段最大相对位移和最大加速度的衰减速率。结论 当腰椎未退变时，传统斜扳法的有效性略优于改良斜扳法，但改良斜扳法的安全性明显优于传统斜扳法，宜采用改良斜扳法。随着腰椎退变程度加剧，两种手法的作用效果均呈幂函数式衰减，改良斜扳法有效性的衰减速率明显快于传统斜扳法，说明在腰椎退变的情况下不宜采用改良斜扳法。

The Action Effect of Two Kinds of Lumbar Massage Obliquity Manipulation with Different Lumbar Degeneration Degrees: A Comparative Study

Objective To compare the action effect of traditional and modified lumbar massage obliquity manipulation with different degrees of lumbar degeneration. Methods The biomechanical model of quality-spring-damping system lumbar spine was established and massage forces from professional massage doctors were collected. The force was used as input of the model, and lumbar degeneration was simulated by increasing elastic coefficient of the spring and damping coefficient of the damping in the model. By using MATLAB/ Simulink simulation technology, the effects of massage obliquity manipulation ( the maximum relative displacement and maximum acceleration) with different degrees of lumbar degeneration were obtained for comparative analysis.Results When the lumbar spine was degenerative, the maximum relative displacement and maximum acceleration of each segment were obtained under two manipulations. With the increase of lumbar degenerationdegree, the maximum relative displacement and maximum acceleration of each segment under two manipulations showed a downward trend, and the attenuation rate of the maximum relative displacement and maximum acceleration of each segment under two manipulations was obtained. Conclusions When degenerative changes in the spine do not occur, the effectiveness of traditional lumbar massage obliquity manipulation is slightly better than that of modified lumbar massage obliquity manipulation, but the safety of modified lumbar massage obliquity manipulation is obviously better than that of the traditional lumbar massage obliquity manipulation, so the modified lumbar massage obliquity manipulation should be used. With the aggravation of lumbar degeneration, the action effects of two manipulations are attenuated in a power function. The attenuation rate of effectiveness of modified lumbar massage obliquity manipulation is significantly faster than that of traditional lumbar massage obliquity manipulation, indicating that the modified lumbar massage obliquity manipulation should not be used in the case of lumbar degeneration.