[1]樊金辉,翟绅,宋永伟△,等.辨“肩腿失衡态”针刺法治疗颈椎病急性期疼痛及肌筋膜链平衡失调的随机对照研究[J].中国中医骨伤科杂志,2026,34(06):36-41.[doi:10.20085/j.cnki.issn1005-0205.260605]
　FAN Jinhui,ZHAI Shen,SONG Yongwei,et al.Effect of Acupuncture Therapy for “Shoulder-Leg Imbalance State” on Treating Acute Cervical Spondylotic Pain and Myofascial Chain Imbalance:A Randomized Controlled Trial[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2026,34(06):36-41.[doi:10.20085/j.cnki.issn1005-0205.260605]
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辨“肩腿失衡态”针刺法治疗颈椎病急性期疼痛及肌筋膜链平衡失调的随机对照研究()

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

卷:
第34卷
期数:
2026年06期
页码:
36-41
栏目:
椎间盘疾病
出版日期:
2026-06-15

文章信息/Info

Title:
Effect of Acupuncture Therapy for “Shoulder-Leg Imbalance State” on Treating Acute Cervical Spondylotic Pain and Myofascial Chain Imbalance:A Randomized Controlled Trial
文章编号:
1005-0205(2026)06-0036-06
作者:
樊金辉1; 翟绅2; 宋永伟1; 2△; 胡闯北1; 石淇允1; 王甜1
1河南省洛阳正骨医院(河南省骨科医院)(河南 洛阳,471002)
2河南中医药大学骨伤学院
Author(s):
FAN Jinhui1; ZHAI Shen2; SONG Yongwei1; 2△; HU Chuangbei1; SHI Qiyun1; WANG Tian1
1Luoyang Orthopedic-Traumatological Hospital of Henan Province(Henan Provincial Orthopedic Hospital),Luoyang 471002,Henan China; 2School of Orthopedics and Traumatology,Henan University of Chinese Medicine,Zhengzhou 450046,China.
关键词:
颈椎病;  肌筋膜链;  肩腿失衡态;  针刺疗法;  随机对照试验
Keywords:
cervical spondylosis;  myofascial chains;  shoulder-leg imbalance state;  acupuncture therapy;  randomized controlled trial
分类号:
R245.3
DOI:
10.20085/j.cnki.issn1005-0205.260605
文献标志码:
A
摘要:
目的:观察基于肌筋膜链理论的辨“肩腿失衡态”针刺法治疗神经根型颈椎病急性期疼痛及姿势代偿性失衡的临床疗效。方法:采用随机、评估者盲、传统针刺对照设计。将2023年5月至2025年5月收治的40例伴有“肩腿失衡态”(表现为双肩不等高等代偿体征)的神经根型颈椎病急性期患者,随机分为观察组与对照组(各20例)。观察组采用辨“肩腿失衡态”针刺法(高肩短腿型取后溪、阴陵泉、地机,低肩长腿型取合谷、三叉三、足三里),对照组采用局部循经取穴针刺法。两组均治疗4次/周,共1周。主要结局指标为疼痛视觉模拟量表(VAS)评分,次要结局指标包括颈椎活动度及双肩高度差。结果:治疗后,两组VAS评分均较治疗前显著降低(P<0.05),但观察组评分(0.96±0.76)分显著低于对照组(2.85±1.21)分,差异有统计学意义(t=5.915 4,P<0.001)。在颈椎各方向活动度及双肩高度差的改善方面,观察组亦显著优于对照组,差异有统计学意义(P<0.05)。治疗过程中仅2例出现轻微皮下出血,未发生其他严重不良反应。结论:辨“肩腿失衡态”针刺法能安全、有效地缓解神经根型颈椎病急性期疼痛,改善颈椎活动功能并纠正代偿性姿势失衡,其疗效优于传统局部取穴针刺法。该法体现了中医整体观念与现代筋膜力学的结合,为治疗颈椎病急性期体态失衡提供了新思路。
Abstract:
Objective:To observe the clinical efficacy of the innovative acupuncture method based on myofascial chain theory,termed “pattern differentiation of shoulder-leg imbalance state” acupuncture,in treating acute pain and compensatory postural imbalance in patients with acute cervical spondylotic radiculopathy(CSR).Methods:A randomized,assessor-blinded,controlled trial with traditional acupuncture as control was conducted.Forty patients with acute CSR presenting with the “shoulder-leg imbalance state”(manifested as compensatory signs such as shoulder asymmetry),who were admitted between May 2023 and May 2025,were randomly assigned to either the observation group or the control group(20 cases per group).The observation group received “pattern differentiation of shoulder-leg imbalance state” acupuncture(for the high-shoulder-short-leg pattern,Houxi(SI3),Yinlingquan(SP9),Diji(SP8); for the low-shoulder-long-leg pattern,Hegu(LI4),Sanchasan,Zusanli(ST36)).The control group received local acupoint selection based on meridian theory.Both groups received treatment 4 times per week for 1 week.The primary outcome measure was the pain visual analogue scale(VAS)score.Secondary outcome measures included cervical range of motion(ROM)and bilateral shoulder height difference.Results:After treatment,VAS scores decreased significantly in both groups compared to pre-treatment levels(all P<0.05).However,the reduction was significantly greater in the observation group(0.96±0.76)points than in the control group(2.85±1.21)points(t=5.915 4,P<0.001).Improvements in cervical ROM in all directions and the shoulder height difference were also significantly superior in the observation group than in the control group(all P<0.05).During treatment,only 2 cases experienced mild subcutaneous hemorrhage,and no other serious adverse reactions occurred.Conclusion:The “pattern differentiation of shoulder-leg imbalance state” acupuncture method is safe and effective in alleviating pain,improving cervical mobility,and correcting compensatory postural imbalance in patients with acute CSR,demonstrating superior efficacy compared to traditional local acupuncture.This method embodies the integrative concept of traditional Chinese medicine's holistic approach and modern fascial mechanics,offering a new strategy for treating postural imbalance in the acute phase of cervical spondylosis.

参考文献/References:

[1] 陈恒,薛丛洋,陈双,等.颈椎病的中医认识和经方治疗策略[J].中国中药杂志,2025,50(9):2596-2604.
[2] 陈伟健,陈泽华,吴佳涛,等.新型肌肉定量评估仪评估神经根型颈椎病患者两侧肩颈肌肉的性能失衡[J].中国组织工程研究,2022,26(3):430-434.
[3] BECKWORTH W J,ABRAMOFF B A,BAILEY I M,et al.Acute cervical radiculopathy outcomes:soft disc herniations vs osteophytes[J].Pain Medicine,2021,22(3):561-566.
[4] ELDAYA R W,PARSONS M S,HUTCHINS T A,et al.ACR appropriateness criteria cervical pain or cervical radiculopathy:2024 update[J].Journal of the American College of Radiology,2025,22(5):S136-S162.
[5] CHU E C,NG L.Dystonic tremor as an atypical presentation of cervical radiculopathy[J].Cureus,2024,16(1):e51441.4.
[6] 王幸云,贾志平,丁文晶,等.施罗斯脊柱侧凸矫正体操联合三维牵引对青少年特发性脊柱侧凸患者脊柱-骨盆重塑的效果[J].中国脊柱脊髓杂志,2025,35(9):914-922.
[7] 涂欣乐,陈锴,李明,等.脊柱-骨盆矢状面平衡的研究热点和趋势:20年文献分析[J].中国脊柱脊髓杂志,2025,35(2):156-169.
[8] ABDELLATIF M M,MOUSTAFA I M,ALSUBIHEEN A M,et al.Three-dimensional spinal and pelvic alignment as determinants of anticipatory core muscle activation[J].Journal of Clinical Medicine,2025,14(23):8432.
[9] 中华中医药学会骨伤科分会.神经根型颈椎病:ZYYXH/T409-2012[S].北京:中国中医药出版社,2012.
[10] 神经根型颈椎病诊疗规范化研究专家组.神经根型颈椎病诊疗规范化的专家共识[J].中华外科杂志,2015,53(11):812-814.
[11] 翟绅,胡闯北,石淇允,等.超声引导神经阻滞联合颈椎牵引治疗神经根型颈椎病[J].实用骨科杂志,2025,31(9):800-804.
[12] 张杰,胡闯北,徐竟菲,等.顺势牵引联合定点旋提推突手法治疗急性期神经根型颈椎病临床观察[J].中国中医急症,2025,34(7):1226-1229.
[13] 陆晔庆,高明,沈洁,等.针刺联合牵引治疗神经根型颈椎病[J].中医正骨,2025,37(10):66-68.
[14] 周方园,刘敏,周友龙.针刺镇痛在神经根型颈椎病根性疼痛缓解中的应用进展[J/OL].中华中医药学刊,1-10[2025-11-09].https://link.cnki.net/urlid/21.1546.R.20251020.1651.019.
[15] 汪华侨.功能解剖学[M].3版.北京:人民卫生出版社,2018.
[16] KRAUSE F,WILKE J,VOGT L,et al.Intermuscular force transmission along myofascial chains:a systematic review[J].Journal of Anatomy,2016,228(6):910-918.
[17] SEKIYA T,AOTA Y,YAMADA K,et al.Evaluation of functional and structural leg length discrepancy in patients with adolescent idiopathic scoliosis using the EOS imaging system:a prospective comparative study[J].Scoliosis and Spinal Disorders,2018,13(1):7.
[18] VAZ G,ROUSSOULY P,BERTHONNAUD E,et al.Sagittal morphology and equilibrium of pelvis and spine[J].European Spine Journal,2002,11(1):80-87.
[19] TERAGUCHI M,KAWAKAMI M,ISHIMOTO Y,et al.Sagittal imbalance of the spine-pelvis-lower extremity axis associated with back-related disability[J].Journal of Orthopaedic Science,2021,26(6):986-991.
[20] 王智勇,郭珈宜,李峰,等.平乐正骨平衡理论指导下的刃针综合疗法治疗早中期膝骨关节炎气滞血瘀证的临床研究[J].中医正骨,2025,37(6):19-27.
[21] 王芳玉,董宝强,宋杰.肌筋膜链理论在针刺治疗KOA中应用探析[J].辽宁中医药大学学报,2017,19(6):119-121.
[22] 范郁山,庞瑞康,贺彩,等.基于筋膜学理论探讨针刺效应的产生机制[J].中医杂志,2021,62(23):2046-2050.
[23] 王悦曦,解佳妮,王晓溶,等.肌肉链理论在脑卒中康复治疗中的研究进展[J].实用临床医药杂志,2020,24(21):128-132.
[24] 林星星,董宝强,纪天一,等.从筋膜连续性探讨经筋实质[J].中华中医药杂志,2023,38(5):1928-1932.
[25] MYERS T W.Anatomy trains:myofascial meridians for manual and movement therapists[M].London:Churchill Livingstone,Elsevier Health Science,2008.
[26] STECCO C,PRATT R,NEMETZ L D,et al.Towards a comprehensive definition of the human fascial system[J].Journal of Anatomy,2025,246(6):1084-1098.
[27] PURSLOW P P.The structure and role of intramuscular connective tissue in muscle function[J].Frontiers in Physiology,2020,11:495.
[28] 肖清明,吴昔钧,尹恒,等.基于肌筋膜链理论手法治疗退变性腰椎失稳的疗效观察[J].中国骨伤,2020,33(10):928-932.
[29] WILKE J,KRAUSE F,VOGT L,et al.What is evidence-based about myofascial chains:a systematic review[J].Archives of Physical Medicine and Rehabilitation,2016,97(3):454-461.
[30] WILKE J,VOGT L,NIEDERER D,et al.Is remote stretching based on myofascial chains as effective as local exercise?A randomised-controlled trial[J].Journal of Sports Sciences,2017,35(20):2021-2027.
[31] SCHULZE N B B,DO NASCIMENTO PAES BARRETO T,DE ALENCAR G G,et al.The effect of myofascial release of the physiological chains on the pain and health status in patients with fibromyalgia,compared to passive muscle stretching and a control group:a randomized controlled clinical trial[J].Disability and Rehabilitation,2024,46(16):3629-3642.
[32] BORDONI B,MYERS T.A review of the theoretical fascial models:biotensegrity,fascintegrity,and myofascial chains[J].Cureus,2020,12(2):e7092.
[33] 罗文轩,蔡秉洋,李佳玥,等.经筋学说与肌筋膜链理论相关性初探[J].中医杂志,2020,61(14):1220-1224.
[34] SMIT H J,STRONG P.Structural elements of the biomechanical system of soft tissue[J].Cureus,2020,12(4):e7895.
[35] BIANCO G.Fascial neuromodulation:an emerging concept linking acupuncture,fasciology,osteopathy and neuroscience[J].European Journal of Translational Myology,2019,29(3):8331.
(收稿日期:2025-10-28)

备注/Memo

备注/Memo:
基金项目:国家中医药管理局国家中医优势专科项目(中国中医药医政函〔2024〕90号)
河南省中医高水平专科建设项目(豫卫中医函〔2023〕63号)
河南省中医药重点学科建设项目(豫卫中医药科教〔2024〕1号)
河南省中医药科学研究专项课题(2021JDZX2132)
△通信作者 E-mail:zgyysyw@163.com
更新日期/Last Update: 2026-06-15