中国组织工程研究

中国组织工程研究 ›› 2025, Vol. 29 ›› Issue (3): 486-492.doi: 10.12307/2025.111

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

颈椎定点旋转手法在体生物力学量化及影响因素分析

梁基耀1，周红海2，3，4，韦贵康2，苏少亭1，陈龙豪2，5，何心愉1，刘粮酺1   

  1. 1广西中医药大学研究生院，广西壮族自治区南宁市   530001；2广西中医药大学骨伤学院，广西壮族自治区南宁市  530001；3广西中医骨伤科生物力学与损伤修复重点实验室，广西壮族自治区南宁市  530001；4国医大师韦贵康学术思想与临床诊疗传承发展研究中心，广西壮族自治区南宁市   530001；5浙江中医药大学附属第三临床医学院，浙江省杭州市   310000
  • 收稿日期:2023-11-07 接受日期:2023-12-18 出版日期:2025-01-28 发布日期:2024-06-03
  • 通讯作者: Liang Jiyao, Master candidate, Graduate School of Guangxi University of Chinese Medicine, Nanning 530001, Guangxi Zhuang Autonomous Region, China
  • 作者简介:梁基耀，男，1999年生，广西中医药大学在读硕士，主要从事脊柱与四肢退行性疾病的中医防治研究。
  • 基金资助:
    广西自然科学基金项目(2023GXNSFAA026297)，项目负责人：周红海；广西中医药大学自治区级硕士研究生科研创新项目(YCSW2023375)，项目负责人：梁基耀；广西卫生厅医疗卫生重点课题(ZD200857)，项目负责人：周红海；广西教育厅课题(200420)，项目负责人：周红海

Quantification of in vivo biomechanics and analysis of influencing factors in cervical spine fixed-point rotation manipulation

Liang Jiyao1, Zhou Honghai2, 3, 4, Wei Guikang2, Su Shaoting1, Chen Longhao2, 5, He Xinyu1, Liu Liangpu1   

  1. 1Graduate School of Guangxi University of Chinese Medicine, Nanning 530001, Guangxi Zhuang Autonomous Region, China; 2Orthopedic College, Guangxi University of Chinese Medicine, Nanning 530001, Guangxi Zhuang Autonomous Region, China; 3Guangxi Key Laboratory of Biomechanics and Injury Repair in Traditional Chinese Medicine Orthopedics and Traumatology, Nanning 530001, Guangxi Zhuang Autonomous Region, China; 4Research Center for the Inheritance and Development of Academic Thought and Clinical Diagnosis and Treatment of Wei Guikang Master of Traditional Chinese Medicine, Nanning 530001, Guangxi Zhuang Autonomous Region, China; 5Third Clinical Medical College Affiliated to Zhejiang Chinese Medical University, Hangzhou 310000, Zhejiang Province, China 
  • Received:2023-11-07 Accepted:2023-12-18 Online:2025-01-28 Published:2024-06-03
  • Contact: Zhou Honghai, MD, Professor, Orthopedic College, Guangxi University of Chinese Medicine, Nanning 530001, Guangxi ZhuangAutonomous Region, China; Guangxi Key Laboratory of Biomechanics and Injury Repair in Traditional Chinese Medicine Orthopedics and Traumatology, Nanning 530001, Guangxi Zhuang Autonomous Region, China; Research Center for the Inheritance and Development of Academic Thought and Clinical Diagnosis and Treatment of Wei Guikang Master of Traditional Chinese Medicine, Nanning 530001, Guangxi Zhuang Autonomous Region, China
  • About author:周红海，博士，教授，广西中医药大学骨伤学院，广西中医骨伤科生物力学与损伤修复重点实验室，国医大师韦贵康学术思想与临床诊疗传承发展研究中心，广西壮族自治区南宁市 530001
  • Supported by:
    Guangxi Natural Science Foundation Project, No. 2023GXNSFAA026297 (to ZHH); Guangxi University of Chinese Medicine Autonomous Region Master’s Research Innovation Project, No. YCSW2023375 (to LJY); Key Medical and Health Project of Guangxi Health Department, No. ZD200857 (to ZHH); a grant from Guangxi Department of Education, No. 200420 (to ZHH) 

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摘要：

文题释义：

颈椎定点旋转手法：是治疗颈椎病及颈椎小关节紊乱等颈椎疾病常用的一种手法，由于其操作安全简便，疗效肯定，广泛应用于临床。
生物力学：基本思想是运用数学与物理力学相结合的方法，对人体在各个活动过程中所产生的各种力学问题进行分析。

摘要
背景：颈椎定点旋转手法属于技术要求较高的力学操作，但目前其生物力学还缺少相关量化数据；且颈椎定点旋转手法的影响因素研究包括了众多参数并且存在差异性，需要进一步对其影响因素进行分析，以完善其相关数据。
目的：量化颈椎定点旋转手法在体生物力学参数，探讨各生物力学参数之间的相关性，及研究对象个体特征差异对手法力学参数的影响。
方法：选取35例颈椎病患者为测试对象，均为广西中医药大学第一附属医院仁爱分院骨伤科门诊就诊者。术者佩戴穿戴式力学测量手套采集手法力学参数，包括拇指预加载力、拇指最大推力、掌心预加载力、掌心旋扳力和掌心旋扳最大作用力。并采集患者个人特征参数，包括年龄、身高、体质量和颈围。对手法操作过程中的关键力学参数进行特征分析及不同个体特征进行量化，对力学指标参数进行Spearman相关性分析；分析不同个体特征参数对生物力学可能存在的影响。
结果与结论：①双侧力学参数相比，左侧操作与右侧操作无显著差异性(P > 0.05)。②拇指预加载力均值为(7.21±1.19) N、拇指最大推力均值为(28.40±4.48) N、掌心预加载力均值为(5.67±2.49) N、掌心旋扳力均值为(10.90±5.11) N、掌心旋扳最大作用力均值为(16.00±7.27) N。③掌心预加载力和掌心旋扳力存在显著正相关(Rs=0.812，P < 0.01)；掌心预加载力和掌心旋扳最大作用力存在显著正相关(Rs=0.773，P < 0.01)；掌心旋扳力和掌心旋扳最大作用力存在显著正相关(Rs=0.939，P < 0.01)。④患者体质量与拇指预加载力、掌心预加载力、掌心旋扳力及掌心旋扳最大作用力之间存在显著正相关(P < 0.05)。⑤结果证实，颈椎定点旋转手法治疗颈椎病操作中生物力学有一定的标准量值。该手法左右侧操作无显著差异性，具有较好的一致性和可重复性。掌心预加载力、掌心旋扳力及掌心旋扳最大作用力3种力之间存在一致性和协调性，对于治疗效果的贡献是相近的。患者的体质量是影响颈椎定点旋转手法重要的因素。


https://orcid.org/0009-0002-4328-9687(梁基耀)；https://orcid.org/0000-0002-2382-5916(周红海)


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: 颈椎定点旋转手法, 生物力学, 影响因素分析, 量化研究, 颈椎病, 正骨手法, 保守治疗, 个体特征

Abstract: BACKGROUND: Fixed-point rotation manipulation of cervical spine is a mechanical operation with high technical requirements, but the biomechanics of fixed-point manipulation of cervical spine still lacks relevant quantitative data. Moreover, the research on the influencing factors of cervical fixed-point rotation manipulation includes many parameters and there are differences, so it is necessary to further analyze its influencing factors to improve its related data.
OBJECTIVE: To quantify the biomechanical parameters of cervical spine fixed-point rotation manipulation, explore the correlation between different biomechanical parameters, and the influence of individual characteristics of the subjects on the biomechanical parameters of cervical spine fixed-point rotation manipulation.
METHODS: Totally 35 cases of cervical spondylosis were Outpatients from Orthopedic Department of Renai Branch of the First Affiliated Hospital of Guangxi University of Chinese Medicine and selected as the subjects investigated. Wearable mechanical measuring gloves were used to collect biomechanical parameters of cervical spine fixed-point rotation manipulation, including: thumb preload, thumb maximum thrust, palm preload, palm wrench force, and palm wrench maximum force. Personal characteristic parameters were collected, including age, height, weight, and neck circumference. The key biomechanical parameters in the process of cervical spine fixed-point rotation manipulation were analyzed and different individual characteristics were quantified. The results of biomechanical parameters were analyzed using Spearman correlation analysis. The possible effects of different individual characteristic parameters on biomechanics were analyzed.
RESULTS AND CONCLUSION: (1) Compared with bilateral mechanical parameters, there was no significant difference between left manipulation and right manipulation (P > 0.05). (2) The average of thumb preload force was (7.21±1.19) N; the average of thumb maximum thrust was (28.40±4.48) N; the average of palm preload was (5.67±2.49) N; the average of palm wrench force was (10.90±5.11) N, and the average of palm wrench maximum force was (16.00±7.27) N. (3) There was a significant positive correlation between palm preload and palm wrench force (Rs=0.812, P < 0.01). There was a significant positive correlation between palm preload and palm wrench maximum force (Rs=0.773, P < 0.01). There was a significant positive correlation between palm wrench force and palm wrench maximum force (Rs=0.939, P < 0.01). (4) The weight was positively correlated with thumb preload, palm preload, palm wrench force and palm wrench maximum force (P < 0.05). (5) These findings confirm that there is a certain biomechanical standard value in the operation of cervical spine fixed-point rotation manipulation to treat cervical spondylosis. There is no significant difference between the left and right manipulations, which indicates that the manipulation has good consistency and repeatability. There is consistency and coordination among palm preload force, palm wrench force, and palm wrench maximum force. Their contributions to the therapeutic effect are similar. Body weight is an important factor affecting cervical spine fixed-point rotation manipulation.

Key words: cervical spine fixed-point rotation manipulation">, biomechanics">, influencing factor analysis">, quantitative research">, cervical spondylosis">, bone-setting manipulation">, conservative treatment">, individual characteristics

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