中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (9): 2208-2216.doi: 10.12307/2026.535

• 骨与关节生物力学Bone and joint biomechanics • 上一篇    下一篇

龙氏牵引下正骨法对颈椎功能单元的力学影响：头颈生物力学模型定量分析

蔡其锐1，戴小玮2，郑晓斌1，简思莉1，卢绍平2，刘特熹1，刘国科1，林远方1，2   

  1. 1深圳市中医院，广东省深圳市  518033；2广州中医药大学第四临床医学院，广东省深圳市  518033
  • 收稿日期:2024-11-14 接受日期:2025-01-20 出版日期:2026-03-28 发布日期:2025-09-05
  • 通讯作者: 林远方，硕士，主任医师，硕士生导师，中华医药学会整脊分会主任委员，全国整脊联盟理事长，深圳市中医院，广东省深圳市 518033；广州中医药大学第四临床医学院，广东省深圳市 518033
  • 作者简介:蔡其锐，男，1986年生，广东省丰顺县人，汉族，2012年南方医科大学毕业，主治医师，主要从事龙氏牵引下正骨法治疗脊柱疾病方面的研究。
  • 基金资助:
    广东省深圳市科技计划项目基础研究专项(自然科学基金)(JCYJ20210324111212035)，项目负责人：林远方；广东省深圳市政府医疗卫生三名工程项目(SZZYSM202311006)，项目负责人：林远方

Mechanical effects of Long’s traction orthopedic method on cervical functional units: quantitative analysis of biomechanical model of head and neck

Cai Qirui1, Dai Xiaowei2, Zheng Xiaobin1, Jian Sili1, Lu Shaoping2, Liu Texi1, Liu Guoke1, Lin Yuanfang1, 2   

  1. 1Shenzhen Traditional Chinese Medicine Hospital, Shenzhen 518033, Guangdong Province, China; 2The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen 518033, Guangdong Province, China
  • Received:2024-11-14 Accepted:2025-01-20 Online:2026-03-28 Published:2025-09-05
  • Contact: Lin Yuanfang, MS, Chief physician, Master’s supervisor, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen 518033, Guangdong Province, China; The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen 518033, Guangdong Province, China
  • About author:Cai Qirui, Attending physician, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen 518033, Guangdong Province, China
  • Supported by:
    Guangdong Province Shenzhen Science and Technology Plan Project Basic Research Project (Natural Science Foundation), No. JCYJ20210324111212035 (to LYF); Guangdong Province Shenzhen Government Medical and Health Three Engineering Project, No. SZZYSM202311006 (to LYF)

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摘要：

文题释义：
龙氏牵引下正骨法：龙氏牵引法是由中国广州脊椎相关疾病研究所副所长龙层花教授所创立的治疗手法，因为牵引时椎间隙相应增宽，在此基础上进行正骨手法复位，结合了牵引和正骨的优势，对于神经根型颈椎病的治疗更有效。
颈椎单元单位：是指由相邻的2个颈椎骨、椎间盘、韧带、关节以及相关肌肉等组成的一个结构单元，负责颈部的运动和承受外界负荷。每个颈椎功能单位的作用不仅包括支撑脊柱和保护脊髓，还涉及到对运动的调节和力的传递。


摘要

背景：龙氏牵引下正骨法治疗神经根型颈椎病的临床疗效确切、应用广泛，但对于其生物力学起效机制尚未有明确报道。
目的：基于三维有限元分析技术探讨龙氏牵引下正骨法改善颈椎椎间孔形变的生物力学依据。
方法：基于之前开发并验证的耦合头颈部骨骼肌的有限元模型，将模型导入 LS-DYNA软件，分别对经典颈椎牵引与龙氏牵引下正骨法的3个手法(推正法、扳按法及摇正法)进行仿真模拟。C5作为目标节段，设置相关边界条件，在200 N牵引力的前提下，先后对颈椎施加向前、向左下拉力及向左侧轴向旋转的扭矩以模拟手法实施，记录分析椎间孔相对位移、相对角度、侧屈位移、椎间盘位移方向及应变。
结果与结论：①推正法对椎间孔的相对位移作用最为显著，其中C5的位移可达15.6 mm，导致椎间孔容积增大；此外，椎间孔的相对角度变化整体更为明显，峰值可达22.9°；②在整体节段侧屈相对位移的改变中，摇正法产生的位移为扳按法的2.4倍，而推正法与经典颈椎牵引在椎体侧屈位移的改变上较为细微；③各正骨手法下的椎间盘位移方向均表现为向前，推正法、扳按法和摇正法在Y轴方向的位移分别为11.56，9.94和7.73 mm；④正骨手法使椎间盘产生向前的滑移应变，释放了后方受压节段的椎间孔容积；⑤相对而言，经典颈椎牵引对上述改变的效果不如正骨手法显著，无法达到相同程度的改变；⑥因此，龙氏牵引下正骨法相对于经典颈椎牵引更能够增大颈椎椎间孔间隙，改善椎间孔形变，原因在于其增加了颈椎椎间孔相对位移、相对角度和侧屈位移，增大了椎间盘位移并产生向前应变，从而使责任节段的神经得到释放，缓解其症状，达到良好的治疗效果。


中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 龙氏牵引下正骨法, 神经根型颈椎病, 椎间孔容积, 有限元分析, 生物力学, 相对位移, 相对角度, 椎间盘应变

Abstract: BACKGROUND: Long’s traction orthopedic method has demonstrated clear clinical efficacy in cervical spondylotic radiculopathy and is widely applied; however, its biomechanical mechanism of action has not been clearly reported. 
OBJECTIVE: To explore the biomechanical basis for how Long’s traction orthopedic method improves cervical intervertebral foramen deformation using three-dimensional finite element analysis. 
METHODS: Based on a previously developed and validated finite element model coupling the musculoskeletal system of the head and neck, the model was imported into LS-DYNA software to simulate classical cervical traction and three manipulative techniques of Long’s traction orthopedic method: the pushing technique, the pulling technique, and the shaking technique. C5 was designated as the target segment, with relevant boundary conditions set under a traction force of 200 N. Forward and downward leftward pulling forces, as well as left axial rotation torque, were sequentially applied to simulate the techniques. The relative displacement, angle, and lateral bending displacement of the cervical intervertebral foramen, direction of intervertebral disc displacement, and strain were recorded and analyzed. 
RESULTS AND CONCLUSION: (1) The pushing technique produced the most significant effect on the relative displacement of the intervertebral foramen, with C5 displacement reaching up to 15.6 mm, resulting in an increased intervertebral foramen volume. Additionally, relative angle changes in the foramen were more pronounced, with a peak value of 22.9°. (2) In terms of relative displacement during lateral bending of the overall segment, the shaking technique was 2.4 times more effective than the pulling technique, while pushing technique and classical cervical traction showed minimal changes in lateral bending displacement. (3) In all orthopedic method, the direction of intervertebral disc displacement showed a forward tendency, with Y-axis displacements of 11.56 mm (pushing), 9.94 mm (pulling), and 7.73 mm (shaking), respectively. (4) The orthopedic method induced forward sliding strain in the intervertebral disc, which released the compressed intervertebral foramen volume in the posterior segments. (5) In comparison, classical cervical traction was less effective in achieving these changes and could not reach the same degree of alteration. (6) Therefore, Long’s traction orthopedic method is more effective than classical cervical traction in increasing the cervical intervertebral foramen gap and improving foramen deformation. Biomechanically, this is attributed to the increased relative displacement, angle, and lateral bending displacement of the cervical intervertebral foramen, as well as greater disc displacement and forward strain, thereby relieving nerve compression in the affected segments, alleviating symptoms, and achieving a positive therapeutic effect.


Key words: Long’s traction orthopedic method, cervical spondylotic radiculopathy, intervertebral foramen volume, finite element analysis, biomechanics, relative displacement, relative angle, intervertebral disc strain

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