摘要
目的：观察脊柱推拿治疗对腰椎间盘突出症患者脑功能活动的影响。方法：招募11例腰椎间盘突出症患者，8例受试者完成了研究。所有患者接受6次腰部脊柱推拿治疗，并在脊柱推拿治疗前、后对患者进行颅脑功能核磁共振成像检测，评估患者脑功能活动的改变及与疗效关系。结果：4例腰椎间盘突出症患者脊柱推拿治疗有效，4例无效。脊柱推拿有效患者治疗前、后产生视觉模拟评分（VAS）为50分时的疼痛压力值分别为（7.43±1.47）kg和（10.53±0.55）kg（P＜0.05），而无效患者的则无明显差异（P＞0.05）。颅脑功能核磁共振成像检测结果提示，脊柱推拿治疗有效患者的脑功能活动以抑制为主，抑制区域主要位于右侧前额叶及小脑区域；而脊柱推拿治疗无效患者的脑功能活动以增强为主。结论：脊柱推拿能够影响腰椎间盘突出症患者的脑功能活动，其治疗有效患者的抑制区域主要在额叶及小脑。
Objective： To investigate the effects of spinal manipulation （ SM） on brain functional activity in patients with lumbar disc herniation （ LDH ） .Methods：Eleven patients with LDH were recruited in the study .All patients received 6 times of lumbar SM treatment and then clinical efficacy was evaluated .All patients received brain functional magnetic resonance imaging （ fMRI ） scans before and after SM treatment.Results： Three subjects dropped out and 8 subjects completed the study , among whom 4 cases were effective and 4 ineffective after SM treatment .The required pressure value producing the same level （ VAS 50 ） pain was （ 7 .43 ±1 .47 ） kg and （10.53 ±0.55） kg before and after SM treatment in effective patients （ P〈0.05）;however , there was no significant difference in ineffective patients （ P〉0 .05 ） . Compared to pre-treatment level, the brain functional activity in effective patients was mainly inhibited , the inhibited areas were located in the right side of prefrontal cortex and cerebellum;while the brain functional activity was generally enhanced in ineffective patients.Conclusion：SM can affect the brain functional activity of patients with LDH , the inhibited areas is mainly located in prefrontal cortex and cerebellum when SM treatment is effective .
出处
《浙江大学学报（医学版）》
CAS
CSCD
北大核心
2015年第2期124-130,137,共8页
Journal of Zhejiang University(Medical Sciences)
基金
中医骨伤科学国家重点学科(100508)
国家自然科学基金(81403414)
上海市“杏林新星”计划(ZYSNXD011-RC-XLXX-20130049)
上海领军人才项目(041)
上海高校“中医脊柱病损研究”创新团队建设项目(2009-26)
上海市卫生局科研项目(20124082)
关键词
推拿
脊柱
腰椎
椎间盘移位按/摩疗法
磁共振成像
脑
疼痛
治疗结果
Manipulation,spinal
Lumbar vertebrae
Intervertebral disk displacement /AN MO LIAO FA
Magnetic resonance imaging
Brain
Pain
Treatment outcome
