[1]符碧峰 张威 张超 李远栋 刘爱峰 陈立江 左涌丽 王平 黄朋涛△.基于多维度力学分析坐位腰椎旋扳法生物力学特征及其对椎间盘纵向位移的影响[J].中国中医骨伤科杂志,2025,33(07):78-84+89.[doi:10.20085/j.cnki.issn1005-0205.250714 ]
　FU Bifeng ZHANG Wei ZHANG Chao LI Yuandong LIU Aifeng CHEN Lijiang ZUO Yongli WANG Ping HUANG Pengtao.Biomechanical Characteristics of Sitting Lumbar Rotational Manipulation Based on Multi-Dimensional Mechanical Analysis and Its Impact on Longitudinal Displacement of Intervertebral Discs[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2025,33(07):78-84+89.[doi:10.20085/j.cnki.issn1005-0205.250714 ]
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基于多维度力学分析坐位腰椎旋扳法生物力学特征及其对椎间盘纵向位移的影响()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第33卷
期数:
2025年07期
页码:
78-84+89
栏目:
临床论著
出版日期:
2025-07-15

文章信息/Info

Title:
Biomechanical Characteristics of Sitting Lumbar Rotational Manipulation Based on Multi-Dimensional Mechanical Analysis and Its Impact on Longitudinal Displacement of Intervertebral Discs
文章编号:
1005-0205(2025)07-0078-07
作者:
符碧峰1; 2; 3 张威1; 2; 3 张超1; 2; 3 李远栋1; 2; 3 刘爱峰1; 2; 3 陈立江4 左涌丽5 王平1; 2; 3 黄朋涛1; 2; 3△
1天津中医药大学第一附属医院(天津,300381)
2国家中医针灸临床医学研究中心
3国家中医药管理局区域中医骨伤科诊疗中心
4青县中医医院
5北京中医医院
Author(s):
FU Bifeng1; 2; 3 ZHANG Wei1; 2; 3 ZHANG Chao1; 2; 3 LI Yuandong1; 2; 3 LIU Aifeng1; 2; 3 CHEN Lijiang4 ZUO Yongli5 WANG Ping1; 2; 3 HUANG Pengtao1; 2; 3△
1First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300381,China; 2National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin 300381,China; 3Regional TCM Orthopedics Diagnosis and Treatment Center,National Administration of Traditional Chinese Medicine,Tianjin 300381,China; 4Qingxian Hospital of Traditional Chinese Medicine,Qingxian 062650,Hebei China; 5Beijing Hospital of Traditional Chinese Medicine,Beijing 100010,China.
关键词:
腰椎坐位旋扳法;  力学同步模块;  有限元分析;  生物力学机制;  标准化
Keywords:
lumbar sitting rotational manipulation;  mechanical synchronization module;  finite element analysis;  biomechanical mechanism;  standardization
分类号:
R681.5
DOI:
10.20085/j.cnki.issn1005-0205.250714
文献标志码:
A
摘要:
目的:运用力学同步模块和运动捕捉系统对坐位旋扳法进行量化研究,并利用有限元模拟手法工况解析其对椎间盘及脊柱结构的生物力学作用。方法:结合力学同步模块与运动捕捉技术,量化10名健康受试者的手法操作动力学与运动学参数,并基于有限元模型模拟三种加载工况下的腰椎生物力学响应。结果:动力学分析表明,垂直力是手法三维空间作用的核心(最大作用力为(36.02±13.77)N),整体椎间盘的位移方向由向下位移改为向上位移趋势,下切力可能通过降低椎间盘应力(最大位移0.222 μm)及提升椎间孔高度(位移变化0.018 2 μm)实现神经根松解; 预加载力与瞬时旋扳力的比值(1.55:1)反映了手法的“巧力寸劲”特征,符合中医“形神兼备”的操作原则。运动学参数显示,旋转角度(69.69°±13.52°)显著主导,而侧屈角度变化(20.40°±10.00°)与脊柱动态耦合运动相关。结论:垂直力是坐位旋扳法从二维空间拓展至三维空间的关键因素,下切力可能是旋扳力及最大作用力产生的重要原因; 其作用机制可能通过减轻椎间盘应力、提升椎间孔高度、松解神经根压力,同时避免椎体旋转侧弯耦合运动对腰椎间盘的剪切力损伤,为中医骨伤科手法治疗提供了生物力学依据。
Abstract:
Objective:This study utilized a mechanical synchronization module and motion capture system to quantify the lumbar sitting rotational manipulation and employed finite element simulation to analyze its biomechanical effects on intervertebral discs and spinal structures.Methods:Kinematic and dynamic parameters of the manipulation were quantified in 10 healthy subjects using the mechanical synchronization module and motion capture technology.A finite element model was established to simulate lumbar biomechanical responses under three loading conditions.Results:Dynamic analysis revealed that vertical force was the core three-dimensional spatial effector(maximum force(36.02±13.77)N).The displacement direction of the intervertebral disc shifted from downward to upward,and the inferior shear force may achieve nerve root decompression by reducing disc stress(maximum displacement 0.222 μm)and increasing intervertebral foramen height(displacement change 0.018 2 μm).The ratio of preload force to instantaneous rotational force(1.55:1)reflected the “skillful force with sudden impulse” characteristic of the manipulation,aligning with the traditional Chinese medicine(TCM)principle of “integration of form and spirit”. Kinematic parameters indicated that rotational angle(69.69°±13.52°)was dominant,while lateral bending angle variation(20.40°±10.00°)correlated with spinal dynamic coupling motion.Conclusion:Vertical force is key to extending the lumbar sitting rotational manipulation from two-dimensional to three-dimensional space,and inferior shear force may contribute to generating rotational force and maximum efficacy.The mechanism likely involves reducing disc stress,increasing intervertebral foramen height,and decompressing nerve roots while avoiding shear damage to lumbar discs caused by coupled vertebral rotation and lateral bending.This study provides biomechanical evidence for TCM orthopedic manual therapies.

参考文献/References:

[1] 高春雨,王宝剑,冯敏山,等.运动捕捉坐位腰椎旋转手法运动力学参数及相关影响因素[J].中国骨伤,2019,32(9):802-806.~[2] 陈忻,于杰,朱立国,等.坐位腰椎旋转手法治疗退行性腰椎滑脱症的临床观察[J].北京中医药,2013,32(12):889-892.~[3] 冯敏山,韩昶晓,梁栋柱,等.旋提手法对下颈椎椎体位移影响的体外生物力学特征[J].中国组织工程研究,2023,27(18):2820-2823.~[4] 李建国,高春雨,冯敏山,等.运动捕捉摇拔戳手法治疗踝扭伤运动轨迹相关问题研究[J].中国中医骨伤科杂志,2018,26(9):19-22.~[5] 霍路遥,符碧峰,冯天笑,等.颈椎旋提手法教学机器人用于旋提手法规范化培训的自身对照研究[J].中国中医骨伤科杂志,2021,29(5):6-11.~[6] 王槐旌,王平,符碧峰,等.旋提手法智能模拟系统培训前后的左右侧提扳力差异分布研究[J].中国中医骨伤科杂志,2023,31(2):48-51.~[7] 朱立国,韩涛,于杰,等.中医骨伤科旋提手法规范化操作传承模式初探[J].中医杂志,2018,59(11):927-931.~[8] 赵文龙,温聪聪,韩昶晓,等.专家与初学者坐位腰椎旋转手法操作的生物力学特征分析[J].中国中医骨伤科杂志,2023,31(12):15-18.~[9] LITTLE J P,IZATT M T,LABROM R D,et al.An FE investigation simulating intra-operative corrective forces applied to correct scoliosis deformity[J].Scoliosis,2013,8(1):9.~[10] ELMASRY S S,ASFOUR S S,TRAVASCIO F.Finite Element Study to Evaluate the Biomechanical Performance of the Spine After Augmenting Percutaneous Pedicle Screw Fixation With Kyphoplasty in the Treatment of Burst Fractures[J].J Biomech Eng,2018,140(6).DOI:10.115/1.4039174~[11] LI L,JIANG S,ZHAO J,et al.Comparison of two internal fixation systems in lumbar spondylolysis by finite element methods[J].Comput Methods Programs Biomed,2022,218:106713.~[12] PATWARDHAN A G,SIELATYCKI J A,HAVEY R M,et al.Loading of the lumbar spine during transition from standing to sitting:effect of fusion versus motion preservation at L4-L5 and L5-S1[J].Spine J,2021,21(4):708-719.~[13] PANJABI M M,OXLAND T R,YAMAMOTO I,et al.Mechanical behavior of the human lumbar and lumbosacral spine as shown by three-dimensional load-displacement curves[J].J Bone Joint Surg Am,1994,76(3):413-424.~[14] XU M,YANG J,LIEBERMAN I H,et al.Lumbar spine finite element model for healthy subjects:development and validation[J].Comput Methods Biomech Biomed Engin,2017,20(1):1-15.~[15] 吴山,范志勇,吴震南.从形神兼备探讨岭南林氏正骨推拿手法质量控制[J].辽宁中医药大学学报,2022,24(6):1-4.~[16] 周晨烁,魏德健,曹慧,等.中医正骨仿真系统中正骨手法的评价[J].中华中医药学刊,2018,36(8):1826-1828.~[17] 齐伟,张艳美,谢海亮,等.基于运动学与动力学的法机制研究进展[J].中国老年学杂志,2017,37(21):5472-5473.~[18] MARCOTTE J,NORMAND M C,BLACK P.Measurement of the pressure applied during motion palpation and reliability for cervical spine rotation[J].J Manipulative Physiol Ther,2005,28(8):591-596.~[19] VAN ZOEST G G,GOSSELIN G.Three-dimensionality of direct contact forces in chiropractic spinal manipulative therapy[J].J Manipulative Physiol Ther,2003,26(9):549-556.~[20] DA S L,GONCALVES L,ALVES C P,et al.Comparison between eccentric vs.concentric muscle actions on hypertrophy:a systematic review and meta-analysis[J].J Strength Cond Res,2025,39(1):115-134.~[21] NUZZO J L,NOSAKA K.Eccentric muscle actions add complexity to an already inconsistent resistance exercise nomenclature[J].Sports Med Open,2023,9(1):118.~[22] 高春雨,冯敏山,朱立国,等.坐位腰椎旋转手法的在体力学参数及相关影响因素研究[J].中国中医骨伤科杂志,2018,26(8):21-25.~[23] 梁龙,银河,杨克新,等.腰椎旋转复位法治疗不同体重指数退行性腰椎滑脱症的疗效观察[J].中医药导报,2018,24(22):77-79.~[24] PENG Y,WANG S R,QIU G X,et al.Research progress on the etiology and pathogenesis of adolescent idiopathic scoliosis[J].Chin Med J(Engl),2020,133(4):483-493.~[25] 符碧峰,苏瑾,张超,等.旋提手法预置体位中颈椎耦合运动研究[J].中国中医骨伤科杂志,2023,31(4):20-24.~(收稿日期:2025-02-05)

备注/Memo

备注/Memo:
基金项目:中医药循证能力建设项目(2019XZZX-GK005)
国家重点研发计划中医药现代化研究项目(2021YFC1712800)
天津市教委课题(2023KJ156,2024KJO41)
天津中医药大学骨伤科研究所项目(2024GSQ02)
天津中医药大学第一附属医院“拓新工程”项目(院ZZ2024010)
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更新日期/Last Update: 2025-07-15