%0 Journal Article
%T 脊柱推拿对腰椎间盘突出症患者脑功能活动的影响
%A 元唯安
%A 沈知彼
%A 薛利
%A 谭文莉
%A 程英武
%A 詹松华
%A 詹红生
%J 浙江大学学报(医学版)
%D 2015
%R 10.3785/j.issn.1008-9292.2015.03.002
%X 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。</br>Abstract: 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. Key words: Manipulation, spinal Lumbar vertebrae Intervertebral disk displacement/AN MO LIAO FA Magnetic resonance imaging Brain Pain Treatment outcome
%K Manipulation
%K spinal Lumbar vertebrae Intervertebral disk displacement/AN MO LIAO FA Magnetic resonance imaging Brain Pain Treatment outcome
%U http://www.zjujournals.com/med/CN/10.3785/j.issn.1008-9292.2015.03.002