Zhu Qing-Guang, Fang Min, Pan Lei
Institute of Massage, Shanghai Institute of Traditional Chinese Medicine, Shanghai.
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2012 Jul;32(7):922-5.
To study the mechanisms of tuina manipulation for treating the dislocation of bone in cervical spondylosis (CS) patients by observing the effects of tuina manipulation on the three-dimensional (3D) angles.
From August to December 2009 20 CS patients were assigned to Group 1 (10 cases, treated with relaxing manipulation) and Group 2 (10 cases, treated with relaxing manipulation and joint regulation). Besides, 10 healthy subjects were recruited as the normal group (treated with relaxing manipulation). Before and after manipulation intervention, all of them were scanned from the base of the skull to the first thoracic vertebra using Philips 64 spiral CT under equal conditions, thus obtaining the volume data. The 0.625 mm thickness was reconstructed using ITK reconstruction software provided by the digital medical laboratory, Software College of Shanghai Jiaotong University. The reconstruction of each cervical skeleton was finished referring to CT data. Changes of the 3D angles were compared among the three groups.
The regulation of the 3D C2 vertebra: Results of Group 2 were significantly larger than those of the normal group at X-, Y-, and Z-axis (P < 0.05). Results of Group 2 were significantly larger than those of Group 1 at X- and Z-axis (P < 0.05). But results of Group 1 were significantly larger than those of the normal group at Z-axis (P < 0.05). The regulation of the 3D C3 vertebra: Results of Group 2 were significantly larger than those of the normal group at X- and Y-axis (P < 0.05). Results of Group 2 were significantly larger than those of Group 1 at X-axis (P < 0.05). But results of Group 1 were significantly larger than those of the normal group at X-axis (P < 0.05). The regulation of the 3D C4 vertebra: Results of Group 2 were significantly larger than those of the normal group at X- and Y-axis (P < 0.05). Results of Group 2 were significantly larger than those of Group 1 at X- and Z-axis (P < 0.05). There were no significant difference among the three groups in the 3D spaces of C1, C5, C6, and C7. The larger 3D space was shown in Group 2 than in Group 1 and the normal group.
The relaxing manipulation combined with joint regulation significantly improved the 3D angles of C2, C3, and C4 in CS patients. The mechanism of tuina manipulation for treating the dislocation of bone in CS patients might lie in adjusting the 3D space of the cervical spine, and improving its functions.
通过观察推拿手法对三维（3D）角度的影响，探讨推拿手法治疗颈椎病（CS）患者椎体错位的机制。
2009年8月至12月，将20例CS患者分为第1组（10例，采用放松手法治疗）和第2组（10例，采用放松手法并结合关节调整治疗）。此外，招募10名健康受试者作为正常组（采用放松手法治疗）。在手法干预前后，所有受试者均在相同条件下使用飞利浦64层螺旋CT从颅底扫描至第一胸椎，从而获得容积数据。使用上海交通大学软件学院数字医学实验室提供的ITK重建软件重建0.625mm厚度的图像。参照CT数据完成每个颈椎骨骼的重建。比较三组之间3D角度的变化。
C2椎体的三维调整：第2组在X、Y和Z轴上的结果显著大于正常组（P<0.05）。第2组在X和Z轴上的结果显著大于第1组（P<0.05）。但第1组在Z轴上的结果显著大于正常组（P<0.05）。C3椎体的三维调整：第2组在X和Y轴上的结果显著大于正常组（P<0.05）。第2组在X轴上的结果显著大于第1组（P<0.05）。但第1组在X轴上的结果显著大于正常组（P<0.05）。C4椎体的三维调整：第2组在X和Y轴上的结果显著大于正常组（P<0.05）。第2组在X和Z轴上的结果显著大于第1组（P<0.05）。C1、C5、C6和C7的三维空间在三组之间无显著差异。第2组的三维空间大于第1组和正常组。
放松手法结合关节调整可显著改善CS患者C2、C3和C4的三维角度。推拿手法治疗CS患者椎体错位的机制可能在于调整颈椎的三维空间并改善其功能。
