| 引用本文:程国杰，杨春，吕发明，沈明球.“以松治痛”推拿手法治疗腰部慢性软组织损伤的疗效及机制[J].世界中医药,2018,(07):. |
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| “以松治痛”推拿手法治疗腰部慢性软组织损伤的疗效及机制 |
| Investigation on Efficacy and Mechanism of Tuina Technique of “Loosing in Treating Pain” in Treating Waist Soft Tissue Injury |
| 投稿时间：2018-01-29 |
| DOI：10.3969/j.issn.1673-7202.2018.07.045 |
| 中文关键词: 慢性软组织损伤 腰部 推拿手法 中医 以松治痛 临床疗效 RhoA/ROCK信号通路 炎性反应递质 作用机制 |
| English Keywords:Chronic soft tissue injury Waist Tuina technique Traditional Chinese medicine Loosing in treating pain Clinical curative effect RhoA/ROCK signaling pathway Inflammatory mediators Mechanism of action |
| 基金项目:新疆维吾尔自治区自然科学基金面上项目（2015211C139) |
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| 中文摘要: |
| 目的：观察“以松治痛”手法治疗腰部慢性软组织损伤的疗效，同时评价其对外周血RhoA/ROCK信号通路表达的影响。方法：选取2013年1月至2016年12月新疆维吾尔自治区中医医院收治的慢性疼痛患者70例，随机分为对照组和观察组，每组35例。对照组予以复方氯唑沙宗及功能锻炼，观察组在对照组治疗方案基础上加用松筋止痛推拿手法及柔筋补脾中药，2组均连续干预14 d，疗程结束后比较2组患者简易McGill疼痛评分、Oswestry功能障碍指数、汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)量表评分以及腰肌表面肌电图信号变化以及RhoA/ROCK信号通路变化情况。结果：治疗后2组患者McGill疼痛评分、Oswestry功能障碍指数均有不同程度下降，与治疗前比较，差异有统计学意义（P<0.05），观察组下降得趋势大于对照组，差异有统计学意义（P<0.05）。2组患者负性情绪均有明显改善，其中观察组优于对照组（P<0.05）。治疗后2组患者竖脊肌及多裂肌的平均肌电值（AEMG）均有所上调，平均功率频率(MPF)低于治疗前，差异有统计学意义（P<0.05），观察组改善的幅度均较对照组明显（P<0.05）。2组患者治疗后外周血单核细胞的RhoA、ROCK蛋白水平均有所下降，观察组下降较对照组明显，差异均有统计学意义（P<0.05）。结论：“以松治痛”手法可明显改善慢性软组织损伤的临床症状，其作用机制可能与介导RhoA/Rho信号通路有关。 |
| English Summary: |
| To observe the curative effect of “Loosing in Treating Pain” technique on chronic soft tissue damage to the waist, and evaluate its impact on peripheral blood RhoA/ROCK signal pathway.Methods:A total of 70 patients with chronic soft tissue injury in the lumbar region in our hospital from January 2013 to December 2016 were divided into the control group and the treatment group (35 cases in each group).The control group was treated with compound chlorzoxazone and functional exercise, and the observation group was added “Loosing in Treating Pain” technique and Chinese medicine of softening tendon and tonifying spleen.Two groups were received continuous 14 d intervention after the end of treatment.The simple McGill pain score, Oswestry disability index, Hamilton anxiety scale (HAMA) score and Hamilton Depression Scale (HAMD) score and lumbar muscle surface electromyography signal changes and the changes of RhoA/ROCK signal pathway concentration scales of two groups of patients were compared.Results:1) After treatment, the McGill pain score and Oswestry disability index of the two groups decreased to different degrees, and the difference was statistically significant compared with that before treatment (P<0.05), and the trend of the treatment group decreased more than the control group.The difference was statistically significant (P<0.05).2) The negative emotion of the two groups was obviously improved, and the treatment group was better than the control group (P<0.05).3) After treatment, the average electromyographic value (AEMG) of the erector and multi split muscles in the two groups were all increased.The average power frequency (MPF) was lower than that before treatment.The difference was statistically significant (P<0.05), and the improvement rate in the treatment group was significantly higher than that in the control group (P<0.05).4) ELISA results showed that the concentrations of RhoA and ROCK of peripheral blood mononuclear cells in two groups decreased after treatment.The difference between the treatment group and the control group was statistically significant (P<0.05).Conclusion:The “Loosing in Treating Pain” technique can significantly improve the clinical symptoms of chronic soft tissue injury, and its mechanism may be mediated by RhoA/Rho signal transduction pathway. |
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