目的 观察推拿功法"少林内功"对阳虚体质者督脉红外热像的效应,从督脉代谢热值的角度探讨推拿功法"少林内功"的效应机制.方法 纳入阳虚质志愿者30名(男16,女14名),先进行推拿功法"少林内功"的规范化培训后开始试验.功法训练时间:每次训练60 min,每周5次,共持续12周.采用红外热像技术分别于干预前后检测红外辐射轨迹以及大椎穴、命门穴与督脉循行体表的温度.结果 干预后受试者的督脉循经红外辐射轨迹被诱发,与干预前相比,长度更长、范围更大、更加连续.干预后大椎穴、命门穴及督脉线上体表代谢温度较干预前明显升高(P<0.01).结论 推拿功法"少林内功"可以提高阳虚质者督脉的经穴皮肤温度,增强督脉经络能量代谢.

Objective:Based on the Muli-Cervical Unit(MCU)and three-dimensional finite element analysis(3D-FEA),this study explored whether the"Tuo tian zhuang"exercise in the Southern Shaolin Yi Jin Jing can improve the efficacy of electroacupuncture in the treatment of cervical spondylosis.Methods:Patients who met the inclusion criteria for cervical spondylosis of cervical type were randomized assigned by age stratification into control group and experimental group. A total of effective cases were 156 with 78 cases in each group. Both the control group and the experimental group were treated with electroacupuncture for 4 weeks, and the experimental group was continued to practise the Southern Shaolin Yi Jin Jing"Tuo tian zhuang"exercise for 12 weeks. A finite element model, the visual and analogue scale(VAS)of pain and MCU were used to compare the pain changes, including cervical spine mobility in all directions, disc stress between C4-C7during forward flexion and joint capsule stress in the hooks of the two groups before and after treatment.Results:After 4 weeks of electroacupuncture treatment, the VAS scores of both groups were improved significantly compared with scores before treatment(P<0.05), with no significant differences between the ages groups within the group and the subgroups between the groups(all P>0.05). After 12 weeks of treatment, VAS scores were lower in the experimental group and in all subgroups than in the control group(P<0.05 and P<0.017, respectively);and there was a statistical difference in the degree of pain relief in each age subgroup(P<0.05), suggesting that young patients had better pain relief than middle-aged and elderly patients. Patients in both groups showed varying degrees of increase in cervical mobility and muscle strength in all directions(P<0.05), 12 weeks of treatment with significant differences between the experimental and control groups and between subgroups(P<0.05 and P<0.017, respectively);the C4-C7disc stress and C4-C7crotal joint capsule stress were reduced to varying degrees between age subgroups compared to the pre-treatment period in this group. The stresses in the C4-C7 disc and C4-C7capsular joint were reduced to varying degrees between the ages subgroups compared with those before treatment(P<0.05).Conclusion:The combination of electroacupun-cture with the Southern Shaolin Yi Jin Jing"Tuo tian zhuang"is more effective than electroacupuncture alone in relieving pain, impro-ving the mobility of the cervical spine, improving muscle strength and reducing stress in the cervical. The young group of patients have the best therapeutic effect.

目的 基于三维有限元分析,观察易筋经托天桩式对颈型颈椎病患者临床效果以及颈椎生物力学的改变情况.方法 选取62例颈型颈椎病患者,按年龄分为青年组、中年组各31例,2组均进行为期12周的易筋经托天式练习.结果 练习12周后,2组VAS评分均较练习前明显降低(P<0.05);有限元分析加载一定的力矩使模型作前屈、后伸、侧屈、旋转的动作,2组练习后C4-7椎间盘应力、关节突关节囊应力均低于练习前(P<0.05).结论 通过练习易筋经托天桩可缓解颈型颈椎病患者疼痛,使患椎部位应力分布更加良好.

目的 观察矫形按摩结合南少林易筋经“托天式”治疗颈型颈椎病的疗效. 方法 将60例颈型颈椎病患者随机分为对照组和观察组,2组均为30例.对照组采用矫形按摩手法,观察组在对照组基础上配合易筋经“托天式”,治疗时间为8周.采用疼痛视觉模拟评分法(VAS)以及颈椎多功能训练评估系统(MCU),检测2组治疗前后疼痛情况、颈椎活动度以及最大肌力. 结果 与治疗前比较,2组治疗后VAS评分、颈椎关节活动度、颈椎肌力均明显改善(P＜0.05),且观察组改善程度优于对照组(P＜0.05). 结论 矫形按摩结合易筋经“托天式”能更好地缓解颈型颈椎病患者的颈部疼痛,改善颈部肌肉力量和颈椎活动度.

目的:观察穴位埋线结合易筋经托天桩治疗颈型颈椎病的临床疗效.方法:将颈型颈椎病患者60例随机分为对照组和治疗组,对照组采用单纯穴位埋线治疗,治疗组在对照组的基础上联合易筋经托天桩练习.两组均干预2个月,干预前后采用颈椎多功能评估训练系统(Multi-Cervical Unit,MCU)评测,以颈椎活动度、最大肌力、疼痛评分为观察指标.结果:治疗组脱落3例,对照组脱落2例.治疗组颈椎活动度、最大肌力、疼痛评分的改善程度明显优于对照组,差异有统计学意义(P<0.05).结论:穴位埋线结合易筋经托天桩治疗优于单纯穴位埋线治疗,具有一定临床推广价值.

Objective To explore the clinical curative effect of myofascial chain training in treatment of cervical instability. Methods 60 cases of cervical instability patients were selected. They were randomLy divided into the observation group and the control group, 30 cases in each group. The observation group was given myofascial chain training while the control group was treated with traditional massage. Clinical effects, isometric strength, activity and pain index of patients in two groups were observed. Results Isometric strength, activity and pain degree before treatment had no significant difference. After treatment, it showed that isometric strength, activity and pain degree of most patients all had improvement of different degrees (P<0.05). Isometric strength, activity and pain degree after treatment of the observation group were significantly better than those of the control group (P<0.05). Conclusion Myofascial chain training in treatment of cervical instability has a good clinical curative effect.

目的 观察易筋经"托天桩"对大学生阳虚型体质的影响.方法 经体质评分与判定,纳入本校阳虚质志愿者40名,随机分为练功组和对照组,20名/组.练功组进行为期12周的易筋经"托天桩"规范化练习;对照组不作任何处理.于干预前、12周练功后,进行阳虚体质转化分、症状积分的评分.结果 练功组干预前后阳虚体质转化分、手脚冰凉、畏寒、腰膝酸冷积分比较,具有统计学差异(P<0.01或P<0.05),腹泻便溏积分比较,无统计学差异(P>0.05);对照组干预前后阳虚体质转化分、手脚冰凉、畏寒、腰膝酸冷、腹泻便溏积分比较,均无统计学差异(P>0.05);2组干预后阳虚体质转化分、畏寒、腰膝酸冷积分比较,具有统计学差异(P<0.01或P<0.05),手脚冰凉、腹泻便溏积分比较,无统计学差异(P>0.05).结论 易筋经"托天桩"可改善阳虚体质的偏颇状态,尤其对畏寒、腰膝酸冷症状的改善作用较为明显.

目的:结合表面肌电监测,观察手法对颈椎病家兔骨骼肌肌张力变化和卫星细胞增殖的影响,分析手法治疗颈椎病和肌卫星细胞增殖的相关性.方法:取6-7月龄日本大耳白兔40只建立空白对照组、模型对照组、药物治疗组、推拿治疗组,每组10只.于造模后第2天进行相关干预,疗程10天.结果:造模90天后,模型组、药物组和推拿组肌张力波幅均较正常组显著升高(P<0.01);治疗后,药物组、推拿组较治疗前肌张力显著降低(P<0.01),药物组与推拿组波幅均较模型组肌张力显著降低(P<0.01);治疗后,推拿组治疗效果显著优于药物组(P<0.01);模型组肌卫星细胞计数较正常组显著升高(P<0.01);治疗后,药物组与推拿组肌卫星细胞计数显著高于正常组、模型组(P<0.01);推拿组治疗效果优于药物组,但两者无显著差异(P>0.05).结论:推拿手法通过改善颈椎病的高张力状态和肌卫星细胞的增值情况,能促进损伤后的肌肉修复,有效治疗颈椎病.

目的:研究温针灸阳陵泉联合等速肌力训练膝关节骨性关节炎患者的疗效与对视觉模拟评分法(VAS)、Lysholm膝关节评分的影响.方法:选取2015年2月至2016年7月福建中医药大学附属康复医院收治的膝关节骨性关节炎患者80例.根据随机数字表法分成观察组与对照组,每组40例.对照组予以等速肌力训练治疗,观察组则在对照组的基础上加用温针灸阳陵泉穴治疗.分别比较2组临床疗效,治疗前后VAS与Lysholm膝关节评分,膝关节屈曲度与伸直度变化情况.结果:观察组治疗总有效率为92.50％(37/40),高于对照组的75.00％(30/40),差异有统计学意义(P<0.05).治疗后2组VAS评分均低于治疗前,而观察组低于对照组,差异有统计学意义(均P<0.05).治疗后2组Lysholm膝关节评分均低于治疗前,而观察组低于对照组,差异有统计学意义(均P<0.05).治疗后观察组膝关节屈曲度、伸直度分别为(120.4±17.9)％、(-3.1±0.8)％,均高于对照组的(92.5±5.9)％、(-6.0±1.1)％,差异有统计学意义(均P<0.05).结论:温针灸阳陵泉穴联合等速肌力训练治疗膝关节骨性关节炎的临床疗效显著,可有效缓解患者疼痛,促进膝关节功能的恢复.

目的 观察推拿手法对颈椎病家兔骨骼肌肌张力变化和ATP mRNA表达的影响. 方法 取40只6～7月龄日本大耳白家兔随机分为正常组、模型组、药物组及推拿组各10只,并建立低头位颈椎病模型.于造模后第2d进行干预治疗,药物组予颈复康颗粒灌胃,推拿组采用一指禅推法在大椎穴进行推拿,疗程均为10 d,对照组和模型组未进行干预.观察干预后4组表面肌电及ATP mRNA表达的变化. 结果 与正常组比较,模型组肌张力明显升高(P＜0.01),ATP mRNA表达明显降低(P＜0.01);与模型组比较,药物组和推拿组干预后的肌张力明显降低(P＜0.01),以推拿组变化最为显著(P＜0.01),推拿组ATP mRNA表达明显提高(P＜0.05). 结论 推拿手法通过改善颈椎病的高张力状态和提高ATP mRNA的表达,减轻或避免肌细胞的损伤,有效治疗颈椎病.

目的 观察三步七法推拿治疗腰椎间盘突出症的疗效. 方法 按照信封随机方法,治疗组30例用三步七法推拿治疗,对照组30例用仰卧位电动牵引法治疗. 结果 治疗组在JOA评分、下肢步态时间-距离参数比较上优于对照组. 结论 三步七法推拿治疗腰椎间盘突出症疗效较好,可改善腰椎间盘突出症患者的下肢步态.

目的:观察刃针阿是穴定点散刺治疗神经根型颈椎病的临床疗效.方法:将60例颈椎病患者随机分为治疗组和对照组各30例.治疗组以刃针阿是穴定点散刺法,每周治疗1次;对照组用毫针穴位针刺治疗,每周治疗5次.两组均治疗4周后进行疗效评价.结果:两组治疗后田中靖久颈椎病症状量表评分均较治疗前增加(P＜0.05).治疗后治疗组评分(17.67±2.02)高于对照组(15.96±1.77),差异有显著性意义(P＜0.01).两组VAS评分均较治疗前减少,差异有统计学意义(P＜0.05);但治疗组评分少于对照组,差异有统计学意义(P＜0.05).结论:刃针阿是穴定点散刺治疗神经根型颈椎病与传统毫针针刺治疗相比具有更好的疗效.

目的 观察易筋经“托天桩”对阳虚质志愿者督脉红外热成像影响的远期效应,从经络代谢热值的角度探讨其效应机制.方法 经中医体质分类与判定后,纳入阳虚质志愿者19名(男8名,女11名),进行易筋经“托天桩”的规范化培训,于功法训练前常态下、3个月练功后,应用热扫描成像系统进行红外辐射轨迹及大椎、至阳、命门穴及督脉线体表代谢热值(温度)的观察,共2次.结果 ①红外辐射轨迹观察:通过易筋经“托天桩”的练习,可诱发受试者的督脉循经红外辐射轨迹,并使原有的轨迹变得更长、更宽、更加连续.②各检测区体表代谢热值:3个月练功后督脉线上体表代谢热值较功法训练前常态下明显升高,具有统计学差异(P＜0.01或P＜0.05).结论 易筋经“托天桩”可提高阳虚质志愿者督脉的体表代谢热值,为经络参与人体功能的调控提供了有利条件.

Objective To observe the effect of Yijinjing "Supporting Pile" on the superficial microcirculation blood perfusion units (MBPU) on Du meridian in subjects with yang-deficiency constitution.Methods After the classification and determination of constitution according to the traditional Chinese medicine,19 volunteers (8 males and 11 females) with Yang-deficiency constitution were selected and provided with standard Yijinjing "Supporting Pile" training for 3 months.The laser Doppler flowmeter system was used to detect the superficial MBPU on the acupoints of Du meridian including Dazhui,Zhiyang and Mingmen,Results Before the training,the average MBPU value of Zhiyang was higher than Mingmen,but lower than Dazhui (P＜0.05,P＜0.01).After the training,the average MBPU value of all the acupoints increased significantly (P＜0.01).Conclusion Yijinjing "Supporting Pile"can improve the superficial MBPU of Du meridian in subjects with Yang-deficiency constitution,and regulate the energy metabolism of the Du meridian.

Health Qigong is a method with characteristic of traditional Chinese sports.Its benign adjustment effect to human body health and mind has been confirmed by modem science.Yijinjing is one of the types which has been studied a lot.The author carried on the summary of Yijinjing modern application research in recent years as following aspects.Yijinjing has positive fitness on heart effect,performing for physiological function,the shape of the human body,mental state,the movement system diseases in all aspects,which is an ideal mode of exercise.Increasing Yijinjing exercise can significantly improve the clinical efficacy.Yijinjing plays its role in disease prevention and treatment,being related to characteristics that natural breathing,keeping within the spirit and power of variation bones.

目的 观察腰椎间盘突出症患者使用中药针刀治疗的康复效果.方法 选择2015年1月1日至2016年1月1日我院接诊的120例腰椎间盘突出症患者进行疗效观察,随机分为观察组和对照组.观察组60例采用中药针刀治疗,对照组60例采用中药针灸结合的方法 治疗.参照国家中医药管理局发布的《中医病证诊断疗效标准》于治疗后进行评估.结果 观察组治疗的有效率为86.67%明显高于对照组(65.0%),两组比较有统计学意义(χ2=7.6847,P=0.0056).观察组治疗的电击感、麻木感、出血、红肿出现的效率为13.33%明显低于对照组(41.67%),两组比较有统计学意义(χ2=10.5062,P=0.0012)结论 中药针刀治疗腰椎间盘突出康复效果显著,并发症发生率较低,安全可靠,值得临床推广.

颈椎病是目前临床常见的脊柱相关性疾病之一,其病因主要包括颈椎间盘退行性改变、颈椎肥厚增生以及颈部损伤等引起的颈椎骨质增生、椎间盘突出、韧带增厚刺激或者压迫颈部神经.颈型颈椎病为多种类型颈椎病的发病早期病变,临床表现以颈部疼痛为主,针灸可有效缓解疼痛症状,但远期疗效不佳,因此临床常配合其他手段进行干预.南少林易筋托天桩可以改善骨性增生、减轻疼痛,改善颈椎软组织生物力学环境,增进和恢复颈椎的活动功能,不失为一种有效的防治结合的养生功法.

目的 观察艾灸命门对阳虚质督脉红外热像的影响,从经脉代谢热值角度探讨经络与体质的相关性,并为艾灸干预阳虚质的可行性提供实验依据.方法 经中医体质判定后,纳入阳虚质志愿者11名,采用红外热像仪观察艾灸命门过程中督脉红外热成像的改变,比较艾灸前、艾灸10min、艾灸20min检测区代谢热值,红外图像每隔2min采集1次,共11次.结果 ①红外辐射轨迹(IRRTM)观察:自然状态下,2例志愿者可见与督脉线一致的IRRTM,艾灸命门后使该轨迹更加连续规整,并且可以使其余9例阳虚质者诱发沿督脉线2/3以上的IRRTM,其中3例可达督脉线全程;②检测区温度变化:至阳、脊中、腰阳关穴区温度在艾灸10min、艾灸20min温度均有上升,差异具有统计学意义(P＜0.01或P＜0.05),身柱穴在艾灸时穴区温度较前升高,艾灸20min较前略有下降,但均无统计学差异(P＞0.05).③检测区时间-温度变化关系:艾灸干预后,检测穴区温度平稳上升,于艾灸后10min左右达到一个峰值,而后趋于平稳,并持续至艾灸结束后.结论 阳虚质具有与正常人相同的经络传热特性,艾灸命门可使阳虚质者督脉代谢热值升高,可作为阳虚质的干预方法,艾灸时间以大于10min为宜,一般10 ～ 15min.

诸多研究表明经络具有客观存在性,但其实质尚不明确,它的热学特性是研究的一个方向,笔者对近年来腧穴的红外辐射特性以及循经红外辐射轨迹进行了以下几方面的总结归纳.腧穴区具有高温和低电阻特性,而经脉线上穴区的ATP能量代谢及导热性高于非穴区,表明腧穴具有较多特殊的生理功能,承载着重要的生理病理信息.循经红外辐射轨迹是人群中普遍存在的现象,与皮肤的微循环和经脉线下的传热通道有关,并且处于动态变化的过程,其诱发方式以温和灸最佳.

目的 观察早期针刺结合现代康复训练对小儿脑瘫临床疗效. 方法 纳入小儿脑性瘫痪患者72例,随机分为治疗组和对照组各36例,治疗组予头皮针、点刺加康复训练治疗,对照组予单纯康复训练治疗,3个月为1个疗程,3个疗程后进行疗效评定. 结果 对照组显效5例,有效20例,无效11例,总有效率69.4％;治疗组显效8例,有效22例,无效6例,总有效率83.3％,2组疗效比较具有统计学意义(P＜0.05). 结论 早期针刺结合现代康复训练治疗小儿脑瘫疗效确切,优于单纯康复训练,值得临床推广.