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Discussing tuina for atlantoaxial subluxation in adults based on the theory of ‘tendon-bone balance’

基于“筋骨平衡”理论探讨成人寰枢关节错位的推拿治疗

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Abstract

According to Chinese medicine, the atlantoaxial joint is a composite joint composed of tendons and bones, and the stability of the joint depends on the ‘tendon-bone balance’ involving tendons, ligaments, atlas and axis. Multiple causes of ‘tendon off-position, joint subluxation’ will lead to joint ‘tendon-bone imbalance’, which will evolve into atlantoaxial subluxation (AAS), endangering human health. Chinese therapeutic massage (tuina) is a very effective treatment for AAS in adults, but conventional manipulations are prone to ineffectiveness or accidents due to neglect of the causal relationship of the ‘tendon-bone imbalance’ and inappropriate manipulations. Compared with conventional manipulations, the rational choice of modified manipulations under the guidance of ‘tendon-bone balance’ theory is more effective and less risky, and more worthy of clinical promotion. From the ‘tendon-bone balance’ theory, we considered the shortcomings of conventional manipulations, and introduced several modified manipulations that have their own strengths in ‘tendon smoothing’ and ‘bone setting’, in order to provide new ideas for treatment of AAS in adults.

摘要

中医认为寰枢关节是一个由“筋”与“骨”构成的复合关节, 关节的稳定有赖于肌腱、 韧带与寰椎、 枢椎的“筋骨平衡”. 多种原因导致的“筋出槽, 骨错缝”会引发关节“筋骨失衡”, 进而演变为寰枢关节错位, 危害人体健康. 推拿治疗成人寰枢关节错位是一种十分有效的手段, 但常规手法由于忽视“筋骨失衡”的因果关系以及手法缺陷问题易导致疗效欠佳和安全事故. 相较于常规手法, 在“筋骨平衡”理论指导下合理选择改良手法疗效好且风险低, 更值得临床推广. 从“筋骨平衡”理论入手, 思考常规手法的不足, 并介绍几种在“理筋”和“正骨”方面各有所长的改良手法, 以期为临床治疗成人寰枢关节错位提供新的思路.

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Acknowledgments

This work was supported by Pilot Project of Clinical Cooperation between Chinese and Western Medicine for Major Difficult Diseases [国家重大疑难疾病中西医临床协作试点建设项目, No. ZY(2018–2020)-FWTX-2005]; Scientific Research Program of Shanghai Science and Technology Commission (上海市科学技术委员会科研计划项目, No. 16401970200); General Project of National Natural Science Foundation of China (国家自然科学基金面上项目, No. 81373763).

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Authors and Affiliations

  1. Department of Tuina, Ningbo Municipal Hospital of Traditional Chinese Medicine, Zhejiang Province, Ningbo, 315010, China

    Jun-da Liu  (刘骏达)

  2. Department of Tuina, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China

    Jian-hua Li  (李建华), Bing-lin Hu  (胡炳麟), Sheng Shao  (邵盛) & Hao Zhang  (张昊)

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  1. Jun-da Liu  (刘骏达)
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  2. Jian-hua Li  (李建华)
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  3. Bing-lin Hu  (胡炳麟)
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  4. Sheng Shao  (邵盛)
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  5. Hao Zhang  (张昊)
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Correspondence to Jian-hua Li  (李建华).

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Author: Liu Jun-da, M.M., resident physician

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Liu, Jd., Li, Jh., Hu, Bl. et al. Discussing tuina for atlantoaxial subluxation in adults based on the theory of ‘tendon-bone balance’. J. Acupunct. Tuina. Sci. 19, 278–283 (2021). https://doi.org/10.1007/s11726-021-1258-4

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  • DOI: https://doi.org/10.1007/s11726-021-1258-4

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