疏筋整复手法治疗寰枢关节紊乱症的力学量化研究

目的: 探讨疏筋整复手法治疗寰枢关节紊乱症生物力学参数的量效关系。方法: 自2022年10月至2023年5月收治寰枢关节紊乱症患者18例,其中男10例,女8例;年龄24~27(25.50±1.10)岁;颈椎CT示齿状突右侧偏歪16例,左侧偏歪2例。采用穿戴式按摩手法测量手套测量疏筋整复手法治疗寰枢关节紊乱症的力学参数,量化疏筋时力的大小、频率及力学曲线图和整复时启动力、扳动力、扳动时间及力学曲线图,比较患侧和对侧手法操作的差异性。结果: 疏筋手法实施中风池穴部位患侧最大作用力、频率为(19.82±2.02) N、(116.83±14.49)次/分,对侧分别为(13.87±2.19) N、(188.89±16.03)次/分;两侧最大作用力、频率比较,差异有统计学意义(P<0.05)。缺盆穴患侧最大作用力、频率为(14.44±3.27) N、(139.06±28.47)次/分,对侧为(9.41±1.38) N、(142.50±28.47)次/分;两侧最大作用力比较,差异有统计学意义(P<0.05)。整复手法实施中患侧启动力、扳动力、扳动时间分别为(14.16±5.98) N、(11.56±6.63) N、(0.14±0.03) s,对侧分别为(8.94±3.39) N、(8.30±4.64) N、(0.18±0.04) s;两侧启动力、扳动力、扳动时间比较,差异有统计学意义(P<0.05)。结论: 疏筋整复手法针对患侧施以轻巧的疏筋力即可恢复颈椎间的力学平衡,加强寰枢关节紊乱的恢复趋势,在此基础上再施以轻巧的旋扳力便能够使得寰枢椎齿状突回位,体现了手法安全性高的特点。

A quantitative study of mechanics in the treatment of atlantoaxial joint disorder by tendon relaxation manipulation

Objective To explore dose-effect relationship of biomechanical parameters in treating atlantoaxial joint disorder by slimming manipulation.Methods From October 2022 to May 2023,18 patients with atlantoaxial joint disorders were treated,including 10 males and 8 females;aged from 24 to 27 years old with an average of (25.50±1.10) years old;CT of cervical vertebra showed 16 patients with right side distortion and 2 patients with left side distortion. The mechanical parameters of treatment of atlantoaxial joint disorder by tendon relaxation manipulation were measured by wearing massage manipulation gloves. The magnitude,frequency and mechanical curve of force during tendon relaxation and starting force,pulling force,pulling time and mechanical curve during rehabilitation were quantified,the differences between the affected and contralateral manipulations were compared.Results The maximum force and frequency of Fengchi(GB20) on the affected side were (19.82±2.02) N and (116.83±14.49) times/min,and opposite side were (13.87±2.19) N and (188.89±16.03) times/min,respectively. There were statistically difference in the maximum force and frequency of both sides (P<0.05). The maximum force and frequency of Quepen (ST12) on the affected side were (14.44±3.27) N and (139.06±28.47) times/min,and those on the opposite side were (9.41±1.38) N and (142.50±28.47) times/min. There was difference in maximum force on both sides (P<0.05). The starting force,turning force and turning time of the affected side were (14.16±5.98) N,(11.56±6.63) N,(0.14±0.03) S,and the contralateral side were (8.94±3.39) N,(8.30±4.64) N,(0.18±0.04) S,respectively. The difference of starting force,turning force and turning time on both sides were statistically significant (P<0.05).Conclusion By applying a light relaxation force on the affected side,the mechanical balance between cervical vertebrae could be restored,and recovery trend of atlantoaxial joint disorder could be strengthened. On this basis,the atlantoaxial odontoid process could be reversed by applying a light rotation force,which reflects the characteristics of high safety of the manipulation.