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[1]范志鴻,張賢,周鑫,等.劉氏骨傷手法聯(lián)合導(dǎo)引功法治療腰椎間盤突出癥臨床應(yīng)用專家推薦意見的調(diào)查研究[J].中醫(yī)正骨,2023,35(11):44-47,52.
　FAN Zhihong,ZHANG Xian,ZHOU Xin,et al.A survey of expert recommendations for clinical application of Liu's orthopedic manipulation combined with Chinese Daoyin therapy in treatment of lumbar disc herniation[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(11):44-47,52.
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劉氏骨傷手法聯(lián)合導(dǎo)引功法治療腰椎間盤突出癥臨床應(yīng)用專家推薦意見的調(diào)查研究()
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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11期
頁碼:
44-47,52
欄目:
調(diào)查研究
出版日期:
2023-11-20

文章信息/Info

Title:
A survey of expert recommendations for clinical application of Liu's orthopedic manipulation combined with Chinese Daoyin therapy in treatment of lumbar disc herniation
作者:
范志鴻1; 張賢1; 周鑫2; 李超1
1.無錫市中醫(yī)醫(yī)院,江蘇 無錫 214000; 2.上海中醫(yī)藥大學(xué)附屬岳陽中西醫(yī)結(jié)合醫(yī)院,上海 200437
Author(s):
FAN Zhihong1; ZHANG Xian1; ZHOU Xin2; LI Chao1
1.Wuxi Hospital of Traditional Chinese Medicine,Wuxi 214000,China 2.Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China
關(guān)鍵詞:
椎間盤移位;  腰椎;  手法;  導(dǎo)引;  調(diào)查問卷;  德爾菲法
Keywords:
intervertebral disc displacement;  lumbar vertebrae;  manipulation;  daoyin;  surveys and questionnaires;  delphi method
摘要:
目的:確立劉氏骨傷手法聯(lián)合導(dǎo)引功法治療腰椎間盤突出癥(lumbar disc herniation,LDH)的臨床應(yīng)用專家推薦意見。方法:結(jié)合文獻(xiàn)和劉氏骨傷手法治療LDH的臨床經(jīng)驗(yàn),經(jīng)小組討論和專家咨詢,構(gòu)建劉氏骨傷手法聯(lián)合導(dǎo)引功法治療LDH的臨床應(yīng)用問題條目池,遴選中醫(yī)骨傷、推拿、康復(fù)專業(yè)的相關(guān)專家,采用德爾菲法進(jìn)行專家問卷調(diào)查。第1輪問卷調(diào)查完成后,根據(jù)專家意見修改或刪除部分條目,形成下一輪專家調(diào)查問卷。每輪問卷調(diào)查周期均為1周。根據(jù)問卷調(diào)查的結(jié)果確立專家推薦意見。結(jié)果:構(gòu)建的劉氏骨傷手法聯(lián)合導(dǎo)引功法治療LDH的臨床應(yīng)用問題條目池共有18條相關(guān)條目。共經(jīng)2輪專家問卷調(diào)查。第1輪專家問卷調(diào)查共遴選出專家33位,發(fā)放問卷33份,回收有效問卷33份; 第2輪專家問卷調(diào)查共遴選出專家28位,發(fā)放問卷28份,回收有效問卷28份; 兩輪問卷調(diào)查專家積極性均為100%,專家權(quán)威系數(shù)分別為0.91、0.96,專家權(quán)威性較高。兩輪專家問卷調(diào)查,各條目的專家認(rèn)同度均較高。第1輪問卷調(diào)查共刪除專家意見不一致的導(dǎo)引功法相關(guān)條目3條,修改手法相關(guān)條目2條; 第2輪問卷調(diào)查共刪除專家意見不一致的導(dǎo)引功法相關(guān)條目1條。調(diào)查結(jié)束后,共保留專家認(rèn)同度較高、意見較一致的條目14條。結(jié)論:對于劉氏骨傷手法聯(lián)合導(dǎo)引功法治療LDH的臨床應(yīng)用,專家推薦LDH的手法治療應(yīng)強(qiáng)調(diào)“筋”的重要性,以“筋強(qiáng)則骨堅(jiān),筋順則骨正”為指導(dǎo),重理筋、微調(diào)骨; 手法操作應(yīng)遵循“松解-整復(fù)”的順序進(jìn)行,松解類手法以“按、揉、點(diǎn)”為主,針對不同的病變節(jié)段整復(fù)手法應(yīng)有所變化; 對于合并嚴(yán)重骨質(zhì)疏松的LDH患者及巨大型LDH患者應(yīng)慎用整復(fù)類手法; LDH急性期治療以松解類手法為主,緩解期和恢復(fù)期宜選擇手法結(jié)合導(dǎo)引功法治療; 聯(lián)合應(yīng)用的導(dǎo)引功法動作有八段錦中的五勞七傷往后瞧、太極拳中的云手及五禽戲中的虎舉和鹿奔。
Abstract:
Objective:To establish the expert recommendations for the clinical application of Liu's orthopedic manipulation combined with Chinese Daoyin therapy in treatment of lumbar disc herniation(LDH).Methods:According to the available articles and clinical experience of Liu's orthopedic manipulation in treating LDH,seminars and experts consultation were conducted to build a question pool for the clinical application of Liu's orthopedic manipulation combined with Chinese Daoyin therapy in treating LDH.The experts in traditional Chinese medicine orthopedics,Tuina and rehabilitation were selected,and a questionnaire survey was conducted among them by using the Delphi method.After the first round of questionnaire survey was finished,the questionnaire was modifed with some items adjusted or deleted based on expert opinions to form a new questionnaire for the next round of expert survey.Each round of questionnaire survey lasted for one week,and the expert recommendations were established based on the results of the questionnaire survey.Results:There were 18 items in the question pool for the clinical application of Liu's orthopedic manipulation combined with Chinese Daoyin therapy in treating LDH.Two rounds of expert questionnaire surveys were conducted.In the first round of expert questionnaire survey,33 experts were selected,and 33 questionnaires were handed out,all of which were returned and valid.In the second round of expert questionnaire survey,28 experts were selected,and 28 questionnaires were handed out,all of which were returned and valid.The experts showed the participation rates of 100% in both rounds of questionnaire surveys,with the expert authority coefficients of 0.91 and 0.96,respectively,which indicating a high level of expert authority.The experts presented high degrees of recognition for each item in the questionnaires in the two rounds of surveys.In the first round of expert questionnaire survey,3 items with inconsistent expert opinions on Chinese Daoyin therapy were deleted,and 2 items associated with manipulation were adjusted.In the second round of expert questionnaire survey,1 item with inconsistent expert opinions on Chinese Daoyin therapy was deleted.After the the end of surveys,14 items with high degrees of expert recognition and consistent opinions were retained.Conclusion:For the clinical application of Liu's orthopedic manipulation combined with Chinese Daoyin therapy in treatment of LDH,experts recommended that tendons should be emphasized in the orthopedic manipulation for treatment of LDH.According to the principle of strong tendons leading to firm bones and smooth tendons leading to bone alignment,the treatment should focus on regulating sinews and bones.The manipulation should follow the sequence of relaxation and restitution,with the former focusing on“pressing,kneading and acupoint pressing”and the latter varying according to different diseased segments.For the LDH patients with severe osteoporosis or giant LDH,caution should be exercised when using restitution manipulation.Furthermore,in treatment of LDH,relaxation manipulation is mainly adopted in the acute phase,and combination of manipulation with Chinese Daoyin therapy in the remission and recovery phases.The co-applied Chinese Daoyin therapy includes the steps of“turn your head back to treat five consumptions and seven damages”(五勞七傷往后瞧)in Baduanjin(八段錦),Yunshou(云手)in Tai Chi,and“raising the tiger's paws”(虎舉)and“running like a deer”(鹿奔)in Wuqinxi(五禽戲).

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備注/Memo

備注/Memo:
基金項(xiàng)目:無錫市科技發(fā)展資金項(xiàng)目(Y20222009)
通訊作者:張賢 E-mail:[email protected]
更新日期/Last Update: 1900-01-01