CAJ | 학술논문

目的：观察脊柱推拿治疗对腰椎间盘突出症患者脑功能活动的影响。方法：招募11例腰椎间盘突出症患者，8例受试者完成了研究。所有患者接受6次腰部脊柱推拿治疗，并在脊柱推拿治疗前、后对患者进行颅脑功能核磁共振成像检测，评估患者脑功能活动的改变及与疗效关系。结果：4例腰椎间盘突出症患者脊柱推拿治疗有效，4例无效。脊柱推拿有效患者治疗前、后产生视觉模拟评分（VAS）为50分时的疼痛压力值分别为（7.43±1.47）kg和（10.53±0.55）kg（P＜0.05），而无效患者的则无明显差异（P＞0.05）。颅脑功能核磁共振成像检测结果提示，脊柱推拿治疗有效患者的脑功能活动以抑制为主，抑制区域主要位于右侧前额叶及小脑区域；而脊柱推拿治疗无效患者的脑功能活动以增强为主。结论：脊柱推拿能够影响腰椎间盘突出症患者的脑功能活动，其治疗有效患者的抑制区域主要在额叶及小脑。
목적：관찰척주추나치료대요추간반돌출증환자뇌공능활동적영향。방법：초모11례요추간반돌출증환자，8례수시자완성료연구。소유환자접수6차요부척주추나치료，병재척주추나치료전、후대환자진행로뇌공능핵자공진성상검측，평고환자뇌공능활동적개변급여료효관계。결과：4례요추간반돌출증환자척주추나치료유효，4례무효。척주추나유효환자치료전、후산생시각모의평분（VAS）위50분시적동통압력치분별위（7.43±1.47）kg화（10.53±0.55）kg（P＜0.05），이무효환자적칙무명현차이（P＞0.05）。로뇌공능핵자공진성상검측결과제시，척주추나치료유효환자적뇌공능활동이억제위주，억제구역주요위우우측전액협급소뇌구역；이척주추나치료무효환자적뇌공능활동이증강위주。결론：척주추나능구영향요추간반돌출증환자적뇌공능활동，기치료유효환자적억제구역주요재액협급소뇌。
Objective: To investigate the effects of spinal manipulation ( SM) on brain functional activity in patients with lumbar disc herniation ( LDH ) .Methods:Eleven patients with LDH were recruited in the study .All patients received 6 times of lumbar SM treatment and then clinical efficacy was evaluated .All patients received brain functional magnetic resonance imaging ( fMRI ) scans before and after SM treatment.Results: Three subjects dropped out and 8 subjects completed the study , among whom 4 cases were effective and 4 ineffective after SM treatment .The required pressure value producing the same level ( VAS 50 ) pain was ( 7 .43 ±1 .47 ) kg and (10.53 ±0.55) kg before and after SM treatment in effective patients ( P<0.05);however , there was no significant difference in ineffective patients ( P>0 .05 ) . Compared to pre-treatment level, the brain functional activity in effective patients was mainly inhibited , the inhibited areas were located in the right side of prefrontal cortex and cerebellum;while the brain functional activity was generally enhanced in ineffective patients.Conclusion:SM can affect the brain functional activity of patients with LDH , the inhibited areas is mainly located in prefrontal cortex and cerebellum when SM treatment is effective .