中国全科医学 ›› 2023, Vol. 26 ›› Issue (27): 3450-3455.DOI: 10.12114/j.issn.1007-9572.2022.0804

所属专题: 中医最新文章合集

• 医工结合研究 • 上一篇    下一篇

基于可穿戴式惯性传感器对中医综合疗法治疗气滞血瘀型腰椎间盘突出症的疗效评价研究

姚俊杰1, 商强强2,*(), 王宇峰2, 栗嘉徽1, 刘畅1, 庞婷婷1   

  1. 1.130117 吉林省长春市,长春中医药大学针灸推拿学院
    2.130021 吉林省长春市,吉林省中医院 长春中医药大学附属医院推拿科
  • 收稿日期:2022-07-28 修回日期:2023-01-15 出版日期:2023-09-20 发布日期:2022-12-02
  • 通讯作者: 商强强

  • 作者贡献:姚俊杰提出研究思路,负责数据收集、数据整理、论文撰写;王宇峰负责数据整理、提供统计学设计思路、协助编辑与修改;栗嘉徽、刘畅负责数据收集;庞婷婷进行统计分析;商强强进行项目管理、思路指导并对文章监督管理和审查,对文章负责。
  • 基金资助:
    国家中医药管理局中医药创新团队及人才支持计划项目(ZYYCXTD-D-202001); 吉林省教育厅科学研究项目(JJKH20220870KJ); 吉林省中医药科技项目(2022020)

Wearable Inertial Sensors-based Efficacy Evaluation of Comprehensive Traditional Chinese Medicine Therapy for Lumbar Disc Herniation Due to Qi-stagnation and Blood-stasis

YAO Junjie1, SHANG Qiangqiang2,*(), WANG Yufeng2, LI Jiahui1, LIU Chang1, PANG Tingting1   

  1. 1. College of Acupuncture and Tuina, Changchun University of Chinese Medicine, Changchun 130117, China
    2. Department of Tuina, Jilin Provincial Hospital of Traditional Chinese Medicine/the Affiliated Hospital of Changchun University of Chinese Medicine, Changchun 130021, China
  • Received:2022-07-28 Revised:2023-01-15 Published:2023-09-20 Online:2022-12-02
  • Contact: SHANG Qiangqiang

摘要: 背景 临床中,中医保守治疗对腰椎间盘突出症(LDH)患者有明确疗效,其起效机制和生物力学效应是目前研究的热点。 目的 应用可穿戴式惯性传感器对气滞血瘀型LDH患者治疗前后的步态进行分析,通过生物力学的方法验证中医综合疗法的作用优势。 方法 纳入2020年6月—2021年12月在长春中医药大学附属医院推拿科住院治疗且入院诊断为LDH的40例患者为研究对象,采用中医综合治疗方法进行治疗。收集患者的年龄、性别、下肢疼痛侧、基线BMI、住院时间、患者治疗前后的腰痛相关量表评分,并于治疗前后采用可穿戴式惯性传感器收集步态分析相关参数。 结果 40例患者中,男18例,女12例,18例下肢疼痛侧在左侧,8例下肢疼痛侧在右侧,14例下肢疼痛侧为双侧。患者平均年龄(52.3±15.2)岁,平均BMI(25.2±4.2)kg/m2,平均住院时间(17.5±6.2)d。治疗后共35例有效或显效,5例无效,总体有效率为87.5%。与治疗前相比,患者治疗后疼痛视觉模拟评分、腰椎Oswestry功能障碍指数降低,日本骨科协会评估治疗分数升高(P<0.05);患者治疗后步频、步速、步幅、步行周期、摆动相占比、胫骨和足底冲击力升高,支撑相占比降低(P<0.05);患者治疗后髋关节内收外展、髋关节旋转、膝关节内外翻、膝关节旋转、踝关节旋转活动度下降(P<0.05);患者治疗后骨盆侧倾指数、骨盆侧斜指数、髋关节内收外展指数、髋关节屈伸指数、髋关节旋转指数、膝关节旋转指数、踝关节内外翻指数、踝关节屈伸指数、踝关节旋转指数升高(P<0.05)。40例LDH患者经中医综合治疗后,未出现不良反应及毒副作用,在随访过程中有5例患者症状反复或再次入院治疗。 结论 中医综合疗法可明显改善气滞血瘀型LDH患者的疼痛、功能障碍,增加步行状态中的动态稳定性,是安全有效的保守治疗方案。

关键词: 椎间盘移位, 椎间盘突出, 步态分析, 中医药疗法, 推拿,脊柱, 针灸疗法, 治疗结果

Abstract:

Background

Conservative traditional Chinese medicine (TCM) treatment has clinically proven to have a clear curative effect on lumbar disc herniation (LDH) , and its mechanism of action and biomechanical effects are the hot spots in current research.

Objective

To perform a wearable inertial sensors-based gait analysis in LDH patients with qi-stagnation and blood-stasis before and after treatment, and to verify the advantages of comprehensive TCM therapy by biomechanical methods.

Methods

This study selected 40 inpatients with an admission diagnosis of LDH treated with comprehensive TCM therapy from Tuina Department, the Affiliated Hospital of Changchun University of Chinese Medicine from June 2020 to December 2021. The patients' age, gender, the lower limb with pain, baseline body mass index, hospitalization time and pre- and post-treatment scale scores for low back pain were collected. Gait parameters were collected by wearable inertial sensors at pre- and post-treatment.

Results

Among the 40 patients, 18 were males and 12 were females. Eighteen patients had pain in the left lower limb, 8 had pain in the right lower limb, and the other 14 had pain in both lower limbs. Patients had a mean age of (52.3±15.2) years, a mean body mass index of (25.2±4.2) kg/m2, and a mean length of hospitalization of (17.5±6.2) days. The treatment was effective or marketed effective in 35 cases, ineffective in 5 cases, achieving an overall response rate of 87.5%. The Visual Analogue Scale score and Oswestry Disability Index decreased, and the Japanese Orthopaedic Association Score increased after treatment compared with the baseline levels (P<0.05) . After treatment, the patient's cadence, speed, stride length, gait cycle, swing phase percentage, shank and foot shock impact increased, and the stance phase percentage decreased (P<0.05) . The range of motion of hip abduction and adduction, hip rotation, knee varus and valgus, knee rotation and ankle rotation decreased (P<0.05) . Increased pelvic obliquity index, pelvic tilt index, hip abduction and adduction degrees, hip flexion and extension degrees, hip rotation index, knee rotation index, ankle inversion and eversion degrees, ankle flexion and extension index, and ankle rotation index were also found after treatment (P<0.05) . No toxic or adverse events occurred during the treatment. Five cases had repeated symptoms or were rehospitalized during the follow-up.

Conclusion

Comprehensive TCM therapy can obviously relieve the pain, improve functional disorders and increase the gait dynamic stability in patients with LDH due to qi-stagnation and blood-stasis, which is a safe and effective conservative treatment option.

Key words: Intervertebral disc displacement, Intervertebral disk displacement, Gait analysis, Traditional Chinese medicine therapy, Manipulation, spinal, Acupuncture moxibustion therapy, Treatment outcome