Xie Yunxing, Du Honggen, Liang An, Yao Juncheng, Qu Jianpeng, Zeng Xiayang
Tui Na Department, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, People's Republic of China.
Tui Na Department, Zhejiang Hospital, Hangzhou, People's Republic of China.
J Pain Res. 2025 May 12;18:2379-2392. doi: 10.2147/JPR.S523613. eCollection 2025.
Lumbar disc herniation (LDH) is a prevalent clinical chronic pain disorder characterized by low back pain, lower limb pain, numbness, and claudication, among other symptoms. Lever positioning manipulation (LPM) has been demonstrated to alleviate pain by stimulating the paraspinal muscles and improving vertebral mechanical balance. Additionally, it has been shown to influence functional changes in the brain by acting on lumbar vertebral proprioceptors.
This was a randomized controlled study in which 60 eligible participants were randomly assigned to one of three groups: an observation group (LPM group), a control group (Inclined plate manipulation (IPM) group) and a normal control group (No Intervention Group). The ratio of participants in each group was 1:1:1. The LPM and IPM groups received treatment for five sessions per week over two weeks. The control group did not receive any form of intervention. The primary observation was rs-fMRI imaging of functional brain areas, whereas the secondary observations included surface electromyography, lumbar proprioceptive function, and VAS and JOA scores. All of these parameters were assessed before and after treatment. All analyses were conducted in accordance with the principles of treatment. Once data collection is complete, data will be analysed using SPSS 20.0 with ANOVA and rank-sum tests for comparisons. We will conduct follow-up monitoring at the first and third month after the end of treatment.
The objective of this study was to observe the changes in the relevant brain regions of LDH patients through LPM treatment of LDH patients, combined with rs-fMRI and lumbar proprioceptor detection, to elaborate the neural pathways of cortical changes, and to provide new ideas and methods for the treatment of LDH.
Chinese Clinical Trial Registry ChiCTR2400082255 on 25 March 2024.
腰椎间盘突出症（LDH）是一种常见的临床慢性疼痛疾病，其特征为腰痛、下肢疼痛、麻木及间歇性跛行等症状。杠杆定位手法（LPM）已被证明可通过刺激椎旁肌肉和改善椎体力学平衡来减轻疼痛。此外，它还被证明可通过作用于腰椎本体感受器来影响大脑的功能变化。
这是一项随机对照研究，60名符合条件的参与者被随机分配到三组之一：观察组（LPM组）、对照组（斜板手法（IPM）组）和正常对照组（无干预组）。每组参与者的比例为1:1:1。LPM组和IPM组在两周内每周接受5次治疗。对照组未接受任何形式的干预。主要观察指标是功能性脑区的静息态功能磁共振成像（rs-fMRI），次要观察指标包括表面肌电图、腰椎本体感觉功能以及视觉模拟评分（VAS）和日本骨科学会（JOA）评分。所有这些参数在治疗前后均进行评估。所有分析均按照治疗原则进行。一旦数据收集完成，将使用SPSS 20.0进行数据分析，采用方差分析（ANOVA）和秩和检验进行比较。我们将在治疗结束后的第一个月和第三个月进行随访监测。
本研究的目的是通过对LDH患者进行LPM治疗，结合rs-fMRI和腰椎本体感受器检测，观察LDH患者相关脑区的变化，阐述皮层变化的神经通路，为LDH的治疗提供新的思路和方法。
2024年3月25日在中国临床试验注册中心注册，注册号为ChiCTR2400082255。
