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[1]薛彬,奚小冰,李飛躍,等.基于德爾菲法確立中醫(yī)手法治療腰椎間盤突出癥時筋骨評估的主要內(nèi)容[J].中醫(yī)正骨,2023,35(05):32-36,40.
　XUE Bin,XI Xiaobing,LI Feiyue,et al.Main contents of tendon and bone assessment in traditional Chinese medicine manipulation treatment of lumbar disc herniation based on Delphi method[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(05):32-36,40.
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基于德爾菲法確立中醫(yī)手法治療腰椎間盤突出癥時筋骨評估的主要內(nèi)容()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期數(shù):
2023年05期
頁碼:
32-36,40
欄目:
調(diào)查研究
出版日期:
2023-05-20

文章信息/Info

Title:
Main contents of tendon and bone assessment in traditional Chinese medicine manipulation treatment of lumbar disc herniation based on Delphi method
作者:
薛彬1; 奚小冰1; 李飛躍1; 周鑫2; 孔令軍2; 朱清廣2; 房敏3
(1.上海交通大學醫(yī)學院附屬瑞金醫(yī)院,上海 200025; 2.上海中醫(yī)藥大學附屬岳陽中西醫(yī)結(jié)合醫(yī)院,上海 200437; 3.上海中醫(yī)藥大學附屬曙光醫(yī)院,上海 201203)
Author(s):
XUE Bin1; XI Xiaobing1; LI Feiyue1; ZHOU Xin2; KONG Lingjun2; ZHU Qingguang2; FANG Min3
1.Ruijin Hospital Affiliated to School of Medicine,Shanghai Jiao Tong University,Shanghai 200025,China 2.Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China 3.Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China
關(guān)鍵詞:
腰椎;  椎間盤移位;  正骨手法;  筋骨評估;  德爾菲技術(shù)
Keywords:
lumbar vertebrae;  intervertebral disc displacement;  bone setting manipulation;  tendon and bone assessment;  Delphi Technique
摘要:
目的:確立采用中醫(yī)手法治療腰椎間盤突出癥時筋骨評估的主要內(nèi)容。方法:采用文獻回顧、臨床經(jīng)驗總結(jié)和專家討論的方法建立中醫(yī)手法治療腰椎間盤突出癥時的筋骨評估條目池,采用德爾菲法確立中醫(yī)手法治療腰椎間盤突出癥時筋骨評估的主要內(nèi)容。結(jié)果:建立的中醫(yī)手法治療腰椎間盤突出癥時筋骨評估條目池包括肌張力、壓痛點、關(guān)節(jié)主動活動度和姿勢體位4個方面的內(nèi)容,肌張力評估方面包括豎脊肌、臀大肌、臀中肌、腓腸肌,壓痛點評估方面包括腰椎間盤突出節(jié)段棘間、腰椎間盤突出節(jié)段夾脊穴、居髎穴、委中穴,關(guān)節(jié)主動活動度評估方面包括腰椎前屈后伸、側(cè)屈、旋轉(zhuǎn)活動度及直腿抬高角度,姿勢體位評估方面包括腰椎前凸、腰椎側(cè)傾、骨盆側(cè)傾、骨盆傾斜角、下肢力線。第1輪問卷調(diào)查共遴選出20名專家; 發(fā)放問卷20份,收回有效問卷20份,有效問卷回收率100%; 專家權(quán)威系數(shù)為0.923; 根據(jù)專家認同度平均值和變異系數(shù),剔除臀大肌、骨盆傾斜角、下肢力線3項條目,形成第2輪調(diào)查問卷。第2輪問卷調(diào)查共遴選出30名專家; 發(fā)放問卷30份,收回有效問卷30份,有效問卷回收率100%; 專家權(quán)威系統(tǒng)為0.958; 第2輪問卷調(diào)查所有條目的變異系數(shù)均<0.5,調(diào)查結(jié)束并確立中醫(yī)手法治療腰椎間盤突出癥時筋骨評估的主要內(nèi)容。結(jié)論:中醫(yī)手法治療腰椎間盤突出癥時筋骨評估的主要內(nèi)容包括肌張力、壓痛點、關(guān)節(jié)主動活動度和姿勢體位4個方面,其中肌張力評估內(nèi)容包括豎脊肌、臀中肌和腓腸肌,壓痛點評估內(nèi)容包括腰椎間盤突出節(jié)段棘間、腰椎間盤突出節(jié)段夾脊穴、居髎穴和委中穴,關(guān)節(jié)主動活動度評估內(nèi)容包括腰椎前屈后伸、側(cè)屈、旋轉(zhuǎn)活動度及直腿抬高角度,姿勢體位評估內(nèi)容包括腰椎前凸、腰椎側(cè)傾、骨盆側(cè)傾。
Abstract:
Objective:To establish the main contents of tendon and bone assessment in the treatment of lumbar disc herniation(LDH)with traditional Chinese medicine(TCM)manipulation.Methods:The tendon and bone assessment item pool of TCM manipulation in the treatment of LDH was established through literature review,clinical experience summary,and expert discussion.The main contents of the tendon and bone assessment of TCM manipulation in the treatment of LDH were determined using the Delphi method.Results:The established item pool of tendon and bone assessment of TCM manipulation in the treatment of LDH is comprised of muscle tension,tender points,joint active range of motion,and posture.In the muscle tension assessment,the items include erector spinae,gluteus maximus,gluteus medius,and gastrocnemius muscle.In the tender point assessment,items include interspinous process of the herniated lumbar disc segment,Jiaji(EX B2)points of the herniated lumbar disc segment,Juliao(GB29)points,and Weizhong(BL40)points.In the joint active range of motionassessment,items include forward bending,backward extension,lateral bending and rotational range of motion of lumbar vertebrae,and straight leg raise angle.In the posture assessment,items include the lumbar lordosis,lumbar lateral tilt,lateral pelvic tilt,pelvic tilt angle,and mechanical axis of the lower limb.In the first round of questionnaire survey,20 experts were enrolled.Twenty questionnaires were distributed and 20 valid ones were collected with a response rate of 100%.The authority coefficient of the experts was 0.923.Based on the average degree of expert consensus and the coefficient of variation,three items including the gluteus maximus,pelvic tilt angle,and mechanical axis of the lower limb were eliminated to form the second round of questionnaire survey.In the second round of questionnaire survey,30 experts were enrolled.Thirty questionnaires were distributed and 30 valid questionnaires were collected with a response rate of 100%.The authority coefficient of the experts was 0.958.The coefficients of variation of all items in the second round of questionnaire survey were less than 0.5,suggesting the completion of the survey,and the main contents of tendon and bone assessment of TCM manipulation in the treatment of LDH were established.Conclusion:The main contents of tendon and bone assessment of TCM manipulation in the treatment of LDH consist of muscle tension,tender points,joint active range of motion,and posture.The items in the muscle tension assessment include erector spinae,gluteus medius,and gastrocnemius muscle.The items in the tender point assessment include interspinous process of the herniated lumbar disc segment,Jiaji(EX B2)points of the herniated lumbar disc segment,Juliao(GB29)points,and Weizhong(BL40)points.The items in the joint active range of motion assessment include forward bending,backward extension,lateral bending,rotational range of motion of lumbar vertebrae,and straight leg raise angle.The items in the posture assessment include lumbar lordosis,lumbar lateral tilt,and lateral pelvic tilt.

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備注/Memo

備注/Memo:
基金項目:中醫(yī)藥創(chuàng)新團隊及人才支持計劃國家中醫(yī)藥傳承創(chuàng)新團隊項目(ZYYCXTD-C-202008); 上海市臨床重點專科建設(shè)項目(shslczdzk04802); 上海市科技計劃項目(21Y21920300、20YF1427500); 上海市衛(wèi)生健康委員會中醫(yī)藥科研項目(2022QN026) 通訊作者:房敏 E-mail:[email protected]
更新日期/Last Update: 1900-01-01