摘要
目的探究理筋正骨手法治疗梨状肌综合征的临床疗效及对患者步态功能的改善作用。方法选取2024年4月至2025年6月在安徽中医药大学第一附属医院筋伤门诊就诊的梨状肌综合征患者64例,随机分为试验组与对照组,2例因接受其他治疗脱落,共纳入62例患者,每组31例。对照组采用神经松动术联合运动疗法,试验组采用理筋正骨手法联合运动疗法,两组患者均每周治疗2次,持续4周。治疗前后评估两组患者的视觉模拟评分法(VAS)评分和日本骨科协会髋关节评估问卷(JHEQ)评分,采用Sensor Medica足底压力测试系统检测两组患者的动态足底压力指标(患侧步速、平均压强、足内侧负荷、后足负荷);使用索诺声超声仪检测梨状肌厚度;比较治疗后两组患者的临床有效率。结果与治疗前比较,治疗后两组患者的VAS评分、梨状肌厚度均降低(P<0.01),且试验组均低于对照组(P<0.05);治疗后两组患者的JHEQ升高(P<0.01),且试验组高于对照组(P<0.05)。与治疗前比较,治疗后两组患者的步速、平均压强、后足负荷均升高(P<0.05,P<0.01),内侧负荷降低(P<0.05);治疗后,与对照组比较,试验组平均压强升高(P<0.05),内侧负荷降低(P<0.01)。治疗后试验组总有效率(93.55%)高于对照组(90.32%)(P<0.05)。结论理筋正骨手法可有效缓解梨状肌综合征患者疼痛,改善髋关节功能,并通过改善足底受力分布及梨状肌形态,促进步态力学的恢复。
Objective To investigate the clinical efficacy of sinew-regulating and bone-aligning manipulation in treating piriformis syndrome(PS)and its ameliorative effects on gait function.Methods A total of 64 PS patients who attended the Tendon Injuries Clinic of the First Affiliated Hospital of Anhui University of Chinese Medicine from April 2024 to June 2025 were enrolled and randomly divided into experimental group and control group.Two patients were excluded due to receiving other treatments,resulting in 62 patients included in the final analysis,with 31 patients in each group.The control group received neural mobilization combined with exercise therapy,while the experimental group received sinew-regulating and bone-aligning manipulation combined with exercise therapy.Both groups underwent treatment twice weekly for four consecutive weeks.The Visual Analogue Scale(VAS)score and Japanese Orthopaedic Association Hip Evaluation Questionnaire(JHEQ)score were assessed before and after treatment.Dynamic plantar pressure parameters(affected-side gait speed,average pressure,medial foot load,and rearfoot load)were assessed using the Sensor Medica plantar pressure analysis system.Piriformis muscle thickness was measured using the SonoSite ultrasound device.The clinical effective rate was compared after treatment.Results Compared with pre-treatment levels,post-treatment VAS scores and piriformis muscle thickness decreased in both groups(P<0.01),with the experimental group consistently lower than the control group(P<0.05).Additionally,post-treatment JHEQ scores increased in both groups(P<0.01),with the experimental group consistently higher than the control group(P<0.05).Compared with pre-treatment,post-treatment gait speed,average pressure,and rearfoot load increased(P<0.05,P<0.01),and medial foot load decreased(P<0.05)in both groups.After treatment,compared with the control group,the experimental group showed a greater increase in average pressure(P<0.05)and a greater decrease in medial foot load(P<0.01).The total effective rate in the experimental group(93.55%)was higher than that in the control group(90.32%)(P<0.05).Conclusion The sinew-regulating and bone-aligning manipulation can effectively alleviate pain,improve hip function,and promote the recovery of gait mechanics by optimizing plantar load distribution and piriformis muscle morphology in PS patients.
作者
胡潇允
江雨
张文娣
程露露
钱群群
李冬静
陈朝晖
HU Xiaoyun;JIANG Yu;ZHANG Wendi;CHENG Lulu;QIAN Qunqun;LI Dongjing;CHEN Zhaohui(The First Clinical Medical College,Anhui University of Chinese Medicine,Hefei,Anhui 230000,China;School of Acupuncture and Tuina,Anhui University of Chinese Medicine,Hefei,Anhui 230000,China;Department of Acupuncture and Rehabilitation,the First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei,Anhui 230000,China)
出处
《湖南中医药大学学报》
2025年第12期2420-2426,共7页
Journal of Hunan University of Chinese Medicine
基金
安徽省高校自然科学重大研究项目(KJ2021ZD0062)
亳州职业技术学院“医疗服务与保障能力提升补助”研究专项课题(YLFW2308)
安徽中医药大学探索性项目(AHUCM2024TS028)。
关键词
梨状肌综合征
理筋正骨手法
动态足底压力
肌骨超声
经筋理论
piriformis syndrome
sinew-regulating and bone-aligning manipulation
dynamic plantar pressure
musculoskeletal ultrasound
meridian-sinew theory
