[1]付洋 彭齐峰 江恒 向涛 樊效鸿 葛远鑫 周杰.巴渝正骨推拿流派柔筋正骨手法治疗脊柱退行性疾病的中枢调控机制研究[J].中国中医骨伤科杂志,2026,34(05):83-90.[doi:10.20085/j.cnki.issn1005-0205.260512]
　FU Yang,PENG Qifeng,JIANG Heng,et al.Study on the Central Regulatory Mechanism of Roujin Zhenggu Manipulation of Bayu Bone-Setting Massage School in the Treatment of Spinal Degenerative Diseases[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2026,34(05):83-90.[doi:10.20085/j.cnki.issn1005-0205.260512]
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巴渝正骨推拿流派柔筋正骨手法治疗脊柱退行性疾病的中枢调控机制研究()

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

卷:
第34卷
期数:
2026年05期
页码:
83-90
栏目:
临床研究
出版日期:
2026-05-10

文章信息/Info

Title:
Study on the Central Regulatory Mechanism of Roujin Zhenggu Manipulation of Bayu Bone-Setting Massage School in the Treatment of Spinal Degenerative Diseases
文章编号:
1005-0205(2026)05-0083-08
作者:
付洋 彭齐峰 江恒 向涛 樊效鸿 葛远鑫 周杰
1重庆市中医院(重庆,400021)
2重庆市江北区中医院
3成都中医药大学附属医院
Author(s):
FU Yang1; PENG Qifeng1; JIANG Heng1; XIANG Tao2; FAN Xiaohong3; GE Yuanxin3; ZHOU Jie1△
1Chongqing Traditional Chinese Medicine Hospital,Chongqing 400021,China; 2Chongqing Jiangbei District Traditional Chinese Medicine Hospital,Chongqing 400025,China; 3Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China.
关键词:
脊柱退行性疾病;  柔筋正骨手法;  默认网络(DMN);  静息态功能磁共振(rs-fMRI);  筋骨平衡
Keywords:
spinal degenerative diseases;  Roujin Zhenggu manipulation;  default mode network(DMN);  resting-state functional magnetic resonance imaging(rs-fMRI);  muscle-bone balance
分类号:
R681.5
DOI:
10.20085/j.cnki.issn1005-0205.260512
文献标志码:
A
摘要:
目的:揭示巴渝正骨推拿流派柔筋正骨手法治疗脊柱退行性疾病的中枢调控机制,为中医“筋骨平衡”理论提供神经影像学证据,并为脊柱退行性疾病精准治疗奠定基础。方法:采用前瞻性自身前后对照设计,纳入神经根型颈椎病、退行性腰椎滑脱症、骶髂关节紊乱症患者各20例(疾病组)及健康对照者20例(健康对照组)。疾病组接受柔筋正骨手法治疗(30 min/次,连续6次),于治疗前(T1)、首次治疗后即刻(T2)、治疗完成后(T3),结合健康对照组基线数据,利用静息态功能磁共振(rs-fMRI)技术,以默认网络(DMN)核心脑区(内侧前额叶皮质(mPFC)、后扣带回皮质(PCC))为种子点,分析低频振幅(ALFF)及功能连接(FC)变化,并关联疼痛视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)评分等临床疗效指标。结果:脊柱退行性疾病患者基线默认网络存在特征性异常,表现为内侧前额叶皮质与前扣带回连接减弱、后扣带回皮质与岛叶连接增强,且左侧初级感觉皮层、前额叶背外侧低频振幅值升高,后扣带回皮质的低频振幅值降低(P<0.05); 经柔筋正骨手法治疗后,默认网络功能连接逐步改善,其中内侧前额叶皮质与前扣带回连接增强、后扣带回皮质与岛叶连接减弱、后扣带回皮质与初级运动皮层连接增强(P<0.05),且上述脑功能指标变化与VAS评分及ODI评分改善显著相关(r=-0.72～0.61,P<0.01)。结论:柔筋正骨手法可通过调控默认网络核心脑区的功能连接与活动强度,激活疼痛下行抑制系统,减轻中枢敏化并改善运动网络协调性,从而实现镇痛与功能恢复的双重效应,可为中医“筋骨平衡”理论提供科学依据。
Abstract:
Objective:To explore the central regulatory mechanism of Roujin Zhenggu manipulation from the Bayu bone-setting massage school in the treatment of spinal degenerative diseases(SDD),provide neuroimaging evidence for the traditional Chinese medicine(TCM)theory of “muscle-bone balance”,and lay a foundation for the precise treatment of SDD.Methods:A prospective self-controlled study design was adopted,including 20 patients with each of radiculopathy cervical spondylosis,degenerative lumbar spondylolisthesis,and sacroiliac joint disorder(disease group)and 20 healthy controls(control group).Patients in the disease group received Roujin Zhenggu manipulation treatment(30 min per session,6 consecutive sessions).Resting-state functional magnetic resonance imaging(rs-fMRI)was performed on the disease group before treatment(T1),immediately after the first treatment(T2),and after the completion of all treatments(T3),combined with the baseline data of the control group.Using the core brain regions of the default mode network(DMN)(medial prefrontal cortex(mPFC),posterior cingulate cortex(PCC))as seed points,changes in amplitude of low-frequency fluctuation(ALFF)and functional connectivity(FC)were analyzed,and their correlations with clinical efficacy indicators such as visual analogue scale(VAS)and Oswestry disability index(ODI)were explored.Results:SDD patients showed characteristic abnormalities in the baseline DMN,manifested as weakened connectivity between mPFC and anterior cingulate cortex,enhanced connectivity between PCC and insula,increased ALFF values in the left primary sensory cortex and dorsolateral prefrontal cortex,and decreased ALFF value in PCC(all P<0.05).After treatment with Roujin Zhenggu manipulation,the functional connectivity of DMN was gradually improved,including enhanced connectivity between mPFC and anterior cingulate cortex,weakened connectivity between PCC and insula,and enhanced connectivity between PCC and primary motor cortex(all P<0.05).Moreover,the changes in these brain function indicators were significantly correlated with the improvement of VAS and ODI scores(r=-0.72 to -0.61,all P<0.01).Conclusion:Roujin Zhenggu manipulation from the Bayu bone-setting massage school can regulate the functional connectivity and activity intensity of the core brain regions of DMN through the synergistic effect of “relaxing muscles,setting bones,and dredging meridians”.It can activate the descending pain inhibition system by enhancing mPFC-anterior cingulate cortex connectivity,reduce central sensitization by weakening PCC-insula connectivity,and improve somatic function by optimizing PCC-primary motor cortex connectivity,thereby achieving the dual effects of analgesia and functional recovery.This study provides scientific evidence for the TCM theory of “muscle-bone balance” and clarifies the central targets of Roujin Zhenggu manipulation in the treatment of SDD,offering a basis for the precise treatment of SDD.

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(收稿日期:2025-11-12)

备注/Memo

备注/Memo:
基金项目:重庆市科卫联合中医药科研项目(2024ZYZD006)
△通信作者 E-mail:zhoujie202406@126.com
更新日期/Last Update: 2026-05-15