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[1]張延海,呂杰,楊戈爾,等.基于仿真技術(shù)比較脈沖激勵手法和振蕩激勵手法治療腰椎疾患的有效性和安全性[J].中醫(yī)正骨,2020,32(06):1-6.
　ZHANG Yanhai,LYU Jie,YANG Geer,et al.A comparison of clinical efficacy and safety of pulse excitation manipulation and oscillation excitation manipulation for treatment of lumbar vertebral diseases based on simulation technology[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2020,32(06):1-6.
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基于仿真技術(shù)比較脈沖激勵手法和振蕩激勵手法治療腰椎疾患的有效性和安全性()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期數(shù):
2020年06期
頁碼:
1-6
欄目:
基礎(chǔ)研究
出版日期:
2020-06-20

文章信息/Info

Title:
A comparison of clinical efficacy and safety of pulse excitation manipulation and oscillation excitation manipulation for treatment of lumbar vertebral diseases based on simulation technology
作者:
張延海1; 呂杰2; 楊戈爾2; 徐軍2; 張培茗2; 呂強3; 周楠3; 郭婧1; 饒?zhí)m1; 張存亮1
(1.上海理工大學(xué)醫(yī)療器械與食品學(xué)院,上海200093; 2.上海健康醫(yī)學(xué)院醫(yī)療器械學(xué)院,上海201318; 3.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):
ZHANG Yanhai1; LYU Jie2; YANG Geer2; XU Jun2; ZHANG Peiming2; LYU Qiang3; ZHOU Nan3; GUO Jing1; RAO Lan1; ZHANG Cunliang1
1.School of Medical Instrument and Food Engineering of University of Shanghai for Science and Technology,Shanghai 200093,China 2.School of Medical Instruments of Shanghai University of Medicine & Health Sciences,Shanghai 201318,China 3.Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China
關(guān)鍵詞:
手法; 捏脊;  脈沖;  振蕩;  生物力學(xué);  仿真
Keywords:
manipulation; chiropractic;  pulse;  oscillation;  biomechanics;  simulation
摘要:
目的:比較脈沖激勵手法與振蕩激勵手法治療腰椎疾患的有效性與安全性。方法:選擇1名無腰椎疾患的健康志愿者。由2位推拿醫(yī)生分別對志愿者實施腰椎調(diào)整手法,其中一位采用作用力為脈沖力的脈沖激勵手法,另一位采用作用力為振蕩力的振蕩激勵手法。通過T4500高敏度觸覺壓力測量系統(tǒng)采集手法實施過程中的作用力,并進(jìn)行歸一化處理,使2種手法作用力的最大值保持一致。假設(shè)腰椎椎體為剛體,椎間盤、韌帶等周圍軟組織作為連接剛體的彈簧和阻尼器,建立五自由度振動系統(tǒng)腰椎生物力學(xué)模型,歸一化的作用力作為模型的輸入載荷。運用MatlabSimulink仿真技術(shù),模擬得到腰椎各節(jié)段在2種手法作用下的軸向位移和軸向加速度隨時間變化的情況,并進(jìn)行比較。結(jié)果:脈沖激勵手法作用時,L1～L5節(jié)段軸向最大位移的絕對值分別為0.154 1 m、0.123 3 m、0.092 5 m、0.061 7 m、0.030 9 m,軸向最大加速度的絕對值分別為3.721 2 m·s-2、2.940 3 m·s-2、2.206 7 m·s-2、1.444 4 m·s-2、0.731 0 m·s-2; 振蕩激勵手法作用時,L1～L5節(jié)段軸向最大位移的絕對值分別為0.160 0 m、0.128 1 m、0.096 1 m、0.064 1 m、0.032 0 m,軸向最大加速度的絕對值分別為2.788 3 m·s-2、2.243 1 m·s-2、1.634 9 m·s-2、1.125 1 m·s-2、0.536 1 m·s-2。在2種手法作用時,L1～L5節(jié)段的軸向最大位移絕對值相當(dāng); 在脈沖激勵手法作用時,L1～L5節(jié)段的軸向最大加速度絕對值均明顯高于振蕩激勵手法。結(jié)論:采用手法治療腰椎疾患時,在最大作用力保持一致的情況下,脈沖激勵手法和振蕩激勵手法的有效性幾乎一致,但振蕩激勵手法更加安全。
Abstract:
Objective:To compare the clinical efficacy and safety of pulse excitation manipulation versus oscillation excitation manipulation in treatment of lumbar vertebral diseases.Methods:A healthy volunteer without lumbar vertebral diseases was selected.The lumbar vertebrae adjustment was performed on the volunteer by two massagists using pulse excitation manipulation and oscillation excitation manipulation respectively.The acting forces were measured by using T4500 high-sensitivity tactile pressure measuring system during the implementation of the manipulation,and were normalized to make the maximum acting force of the two manipulations in consistency with each other.A five-degree-freedom vibration biomechanical model of lumbar vertebrae was built by assuming lumbar vertebral body as rigid-body and assuming surrounding soft tissues including intervertebral discs and ligaments as spring and damper which served as connection of rigid bodies.The normalized acting forces served as the input load of the model.The time-dependent changes of axial displacements and axial acceleration of each segment of lumbar vertebrae under the action of pulse excitation manipulation and oscillation excitation manipulation were measured by using MatlabSimulink simulation technology,and were compared between the 2 kinds of manipulations.Results:The absolute values of the maximum axial displacement of lumbar vertebrae from L1 to L5 were 0.154 1,0.123 3,0.092 5,0.061 7 and 0.030 9 metres respectively,and the absolute values of the maximum axial acceleration were 3.721 2,2.940 3,2.206 7,1.444 4 and 0.731 0 ms(2)respectively under the action of pulse excitation manipulation.The absolute values of the maximum axial displacement of lumbar vertebrae from L1 to L5 were 0.160 0,0.128 1,0.096 1,0.064 1 and 0.032 0 metres respectively,and the absolute values of the maximum axial acceleration were 2.788 3,2.243 1,1.634 9,1.125 1 and 0.536 1 ms(2)respectively under the action of oscillation excitation manipulation.The two kinds of manipulations were similar to each other in absolute values of the maximum axial displacement of lumbar vertebrae from L1 to L5,while the absolute values of the maximum axial acceleration of lumbar vertebrae from L1 to L5 were obviously higher under the action of pulse excitation manipulation compared to the action of oscillation excitation manipulation.Conclusion:The pulse excitation manipulation and oscillation excitation manipulation are almost the same in clinical efficacy if their maximum acting forces are consistent with each other in the treatment of lumbar vertebral diseases,however,the latter is better than the former in safety.

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備注/Memo

備注/Memo:
(收稿日期:2019-12-30本文編輯:李曉樂)基金項目:國家自然科學(xué)基金項目(81574096)通訊作者:呂杰E-mail:[email protected]
更新日期/Last Update: 2020-10-10