中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2014年
44期
7211-7216
,共6页
李具宝%熊启良%屈尚可%贺竟哲%邓颖%贾涛%李琰%易红赤
李具寶%熊啟良%屈尚可%賀竟哲%鄧穎%賈濤%李琰%易紅赤
리구보%웅계량%굴상가%하경철%산영%가도%리염%역홍적
植入物%脊柱植入物%推拿手法%腰椎间盘突出症%潜在应用规律%文献%国家自然科学基金
植入物%脊柱植入物%推拿手法%腰椎間盤突齣癥%潛在應用規律%文獻%國傢自然科學基金
식입물%척주식입물%추나수법%요추간반돌출증%잠재응용규률%문헌%국가자연과학기금
背景：目前中医推拿手法治疗腰椎间盘突出症的相关文献以临床观察研究、回顾性研究、临床经验总结为主，在研究设计、病例选择、评价指标等诸多方面存在不足之处及差异性；其综述类文章作者对参考文献选择的随意性及倾向性很强，且对文献质量未做分析及评估，导致文章的观点存在偏倚及缺乏客观性。<br> 目的：通过检索万方、维普、CNKI数据库，探讨近10年文献中中医推拿手法治疗腰椎间盘突出症的应用规律。<br> 方法：以“腰椎间盘突出症”、“中医”、“推拿”、“手法”、“按摩”、“康复”、“弹拨”、“点压”、“按压”、“指压”为关键词，通过万方、CNKI、维普3个中文数据库对推拿手法治疗腰椎间盘突出症近10年文献进行检索，并采用分层聚类统计方法统计分析治疗腰椎间盘突出症的前20种手法。<br> 结果与结论：治疗腰椎间盘突出症的前20种推拿手法频次及分层聚类的结果表明：中医推拿治疗腰椎间盘突出症的手法主要有以下几大类，第一类为作用于人体的软组织类手法：法、拿法、推法、压法；第二类为点压穴位类手法：以足太阳膀胱经(肾俞穴、大肠俞穴、关元俞穴、秩边穴、承扶穴、委中穴、承山穴、昆仑穴)，足少阳胆经(环跳穴、阳陵泉穴)、督脉(腰阳关穴)、足阳明胃经(足三里穴)腧穴及压痛点(阿是穴)为主；第三类为作用于人体骨与关节的手法：腰部斜扳法、腰部背伸法、骨盆牵引法、直腿抬高法。可见推拿手法治疗腰椎间盘突出症的潜在应用规律是以点压穴位(足太阳膀胱经、足少阳胆经、督脉、足阳明胃经腧穴及阿是穴)为主，并配合作用于人体软组织类手法(法、拿法、推压脊柱法)及骨与关节类手法(腰部斜扳法、腰部背伸法、骨盆牵引法、直腿抬高法)为辅。
揹景：目前中醫推拿手法治療腰椎間盤突齣癥的相關文獻以臨床觀察研究、迴顧性研究、臨床經驗總結為主，在研究設計、病例選擇、評價指標等諸多方麵存在不足之處及差異性；其綜述類文章作者對參攷文獻選擇的隨意性及傾嚮性很彊，且對文獻質量未做分析及評估，導緻文章的觀點存在偏倚及缺乏客觀性。<br> 目的：通過檢索萬方、維普、CNKI數據庫，探討近10年文獻中中醫推拿手法治療腰椎間盤突齣癥的應用規律。<br> 方法：以“腰椎間盤突齣癥”、“中醫”、“推拿”、“手法”、“按摩”、“康複”、“彈撥”、“點壓”、“按壓”、“指壓”為關鍵詞，通過萬方、CNKI、維普3箇中文數據庫對推拿手法治療腰椎間盤突齣癥近10年文獻進行檢索，併採用分層聚類統計方法統計分析治療腰椎間盤突齣癥的前20種手法。<br> 結果與結論：治療腰椎間盤突齣癥的前20種推拿手法頻次及分層聚類的結果錶明：中醫推拿治療腰椎間盤突齣癥的手法主要有以下幾大類，第一類為作用于人體的軟組織類手法：法、拿法、推法、壓法；第二類為點壓穴位類手法：以足太暘膀胱經(腎俞穴、大腸俞穴、關元俞穴、秩邊穴、承扶穴、委中穴、承山穴、昆崙穴)，足少暘膽經(環跳穴、暘陵泉穴)、督脈(腰暘關穴)、足暘明胃經(足三裏穴)腧穴及壓痛點(阿是穴)為主；第三類為作用于人體骨與關節的手法：腰部斜扳法、腰部揹伸法、骨盆牽引法、直腿抬高法。可見推拿手法治療腰椎間盤突齣癥的潛在應用規律是以點壓穴位(足太暘膀胱經、足少暘膽經、督脈、足暘明胃經腧穴及阿是穴)為主，併配閤作用于人體軟組織類手法(法、拿法、推壓脊柱法)及骨與關節類手法(腰部斜扳法、腰部揹伸法、骨盆牽引法、直腿抬高法)為輔。
배경：목전중의추나수법치료요추간반돌출증적상관문헌이림상관찰연구、회고성연구、림상경험총결위주，재연구설계、병례선택、평개지표등제다방면존재불족지처급차이성；기종술류문장작자대삼고문헌선택적수의성급경향성흔강，차대문헌질량미주분석급평고，도치문장적관점존재편의급결핍객관성。<br> 목적：통과검색만방、유보、CNKI수거고，탐토근10년문헌중중의추나수법치료요추간반돌출증적응용규률。<br> 방법：이“요추간반돌출증”、“중의”、“추나”、“수법”、“안마”、“강복”、“탄발”、“점압”、“안압”、“지압”위관건사，통과만방、CNKI、유보3개중문수거고대추나수법치료요추간반돌출증근10년문헌진행검색，병채용분층취류통계방법통계분석치료요추간반돌출증적전20충수법。<br> 결과여결론：치료요추간반돌출증적전20충추나수법빈차급분층취류적결과표명：중의추나치료요추간반돌출증적수법주요유이하궤대류，제일류위작용우인체적연조직류수법：법、나법、추법、압법；제이류위점압혈위류수법：이족태양방광경(신유혈、대장유혈、관원유혈、질변혈、승부혈、위중혈、승산혈、곤륜혈)，족소양담경(배도혈、양릉천혈)、독맥(요양관혈)、족양명위경(족삼리혈)수혈급압통점(아시혈)위주；제삼류위작용우인체골여관절적수법：요부사반법、요부배신법、골분견인법、직퇴태고법。가견추나수법치료요추간반돌출증적잠재응용규률시이점압혈위(족태양방광경、족소양담경、독맥、족양명위경수혈급아시혈)위주，병배합작용우인체연조직류수법(법、나법、추압척주법)급골여관절류수법(요부사반법、요부배신법、골분견인법、직퇴태고법)위보。
BACKGROUND:The currently published literatures about Tuina manipulation for lumbar disc herniation include clinical observations, retrospective study and summary of clinical experience, which have shortcomings in the study design, choice of cases and outcome measures. Reviews may enrol randomized and intended references, and has no analysis or evaluation on the quality of involved literatures, leading to the bias and subjective views. <br> OBJECTIVE:To research the application laws of Tuina manipulation for treating lumbar disc herniation through literature analysis within 10 years. <br> METHODS:The key words of“lumbar disc herniation, traditional Chinese medicine, Tuina, manipulation, massage, rehabilitation, poking channels, point pressing, palpating pressing, and finger pressing”in Chinese were used to search the literature about Tuina manipulation in treatment of lumbar disc herniation within recent 10 years published in the Wanfang database, Vip database and CNKI database. The top 20 manipulations of Tuina for lumbar disc herniation were and statistical analyzed with hierarchical clustering statistical method. <br> RESULTS AND CONCLUSION:The hierarchical clustering analysis results showed that, Tuina manipulations for lumbar disc herniation are as fol ows:(1) manipulations acted on soft tissue, including rol ing, holding, pushing and pressing;(2) manipulations acted on acupuncture point, including Urinary Bladder Meridian of Foot-Taiyang acupuncture points (Shengshu, Dachangshu, Guanyuanshu, Zhibian, Chengfu, Weizhong, Chengshan and Kunlun), Gal Bladder Meridian of Foot-Shaoyang acupuncture points (Huantiao and Yanglingquan), Yaoyangguan point in Du Meridian, Zusanli point in Stomach Meridian of Foot-Yangming, and tender points;(3) manipulations acted on human bones and joints, including waist inclined pul method, waist back-stretching method, pelvic traction method and straight-leg raising method. The findings indicate that the potential application laws of Tuina manipulation for treating lumbar disc herniation are given priority to pressing acupuncture points (Urinary Bladder Meridian of Foot-Taiyang acupuncture point, Gal Bladder Meridian of Foot-Shaoyang acupuncture point, Du Meridian, Stomach Meridian of Foot-Yangming acupuncture point and tender points), at the same time companied with manipulations acted on soft tissue (rol ing, holding, pushing spinal method), and bones and joints (waist inclined pul method, waist back-stretching method, pelvic traction method and straight-leg raising method).
