头后小直肌与颈性眩晕关系探讨及从筋论治颈性眩晕
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摘要
颈性眩晕为临床常见疾病,颈性眩晕的发病和转归与局部肌肉等软组织密不可分。作为脊旁深层肌肉的头后小直肌对头颈的稳定性起到重要作用,其功能的异常可导致颈椎寰枢关节的稳定性降低,是造成颈性眩晕发生、加重及复发的重要因素。临床治疗颈性眩晕可"从筋论治",通过推拿、针刺、导引功法等来改善头后小直肌,从而治疗颈性眩晕。通过有针对性的肌肉锻炼并发挥传统中医的导引功法作用,将为防治颈性眩晕提供新的方向。
Cervical vertigo is a commonly-seen disease,and its pathogenesis and prognosis are closely related with focal soft tissues such as muscles. As the deep muscle beside the spine,rectus capitis posterior minor muscles play an important role in maintaining the stability of the neck and head. The dysfunction of rectus capitis posterior minor muscles results into the decrease of the stability of atlantoaxial joint,and becomes an important factor for the development,deterioration and recurrence of cervical vertigo. The treatment of cervical vertigo can be focused on regulating the tendon for the improvement of rectus capitis posterior minor muscles through massage,acupuncture,and Daoyin(physical-breathing exercise). Performing Daoyin by targeted muscle training will be a new approach to the prevention and treatment of cervical vertigo.
Cervical vertigo is a commonly-seen disease,and its pathogenesis and prognosis are closely related with focal soft tissues such as muscles. As the deep muscle beside the spine,rectus capitis posterior minor muscles play an important role in maintaining the stability of the neck and head. The dysfunction of rectus capitis posterior minor muscles results into the decrease of the stability of atlantoaxial joint,and becomes an important factor for the development,deterioration and recurrence of cervical vertigo. The treatment of cervical vertigo can be focused on regulating the tendon for the improvement of rectus capitis posterior minor muscles through massage,acupuncture,and Daoyin(physical-breathing exercise). Performing Daoyin by targeted muscle training will be a new approach to the prevention and treatment of cervical vertigo.
引文
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[14]宋坤锋,高延征,高坤,等.颈性眩晕的发病机制及其研究进展[J].中国医药指南,2013,11(15):74.
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[19]Fernández-de-Las-Pe?as C,Cuadrado M L,Arendt-Nielsen L,et al.Association of cross-sectional area of the rectus capitis posterior minor muscle with active trigger points in chronic tension-type headache:a pilot study[J].Am J Phys Med Rehabil,2008,87(3):197.
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[23]Kendall F P,McCreary E K.Muscles:testing and function[M].3rd Ed.Baltimore:Williams&Wilkins,1983.
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[26]Mitchell B S,Humphreys B K,O'Sullivan E.Attachments of the ligamentum nuchae to cervical posterior spinal dura and the lateral part of the occipital bone[J].J Mani Physiol Ther,1998,21(3):145.
[27]Dean N A,Mitchell B S.Anatomic relation between the nuchal ligament(ligamentum nuchae)and the spinal dura mater in the craniocervical region[J].Clin Anat,2002,15(3):182.
[28]Humphreys B K,Kenin S,Hubbrard B B,et al.Investigation of connective tissue attachments to the cervical spinal dura mater[J].Clin Anat,2003,16(2):152.
[29]Rutten H P,Szpak K,van Mameren H,et al.Anatomic relation between the rectus capitis posterior minor muscle and the dura mater[J].Spine(Phila Pa 1976),1997,22(8):924.
[30]Lang J.The craniocervical junction-anatomy.In:Voth D,Glees P.Diseases in the craniocervical junction[M].Berlin,New York:Walter de Gruyter,1987,27-61.
[31]Yuan X Y,Yu S B,Li Y F,et al.Patterns of attachment of the myodural bridge by the rectus capitis posterior minor muscle[J].Anat Sci Int,2016,91(2):175.
[32]Hides J A,Richardson C A,Jull G A.Multifidus muscle recovery is not automatic after resolution of acute,first-episode low back pain[J].Spine(Phila Pa 1976),1996,21(23):2763.
[33]Hallgren R C.Modeling length-tension properties of RCPm muscles during voluntary retraction of the head[J].Manual Therapy,2014,19(4):319.
[34]曾智本.颈部肌群牵伸疗法联合推拿手法对颈性眩晕患者的疗效分析[J].中医临床研究,2018,16(10):21.
[2]薛爽,王国相.什么是颈性眩晕[J].中国脊柱脊髓杂志,1999,9(5):297.
[3]苑晓鹰.枕下肌群的临床解剖学研究及其与慢性头痛的关系[D].大连:大连医科大学,2017.
[4]Panjabi M M.The stabilizing system of the spine,part I:function,dysfunction,adaptation,and enhancement[J].J Spinal Disord,1992,5(4):383.
[5]PeckD,BuxtonDF,NitzA.Acomparisonofspindle concentrations in large and small muscles acting in parallel combinations[J].JMorphol,1984,180(3):243.
[6]Freeman M D,Woodham M A,Woodham A W.The role of the lumbar multifidus in chronic low back pain:a review[J].PM R,2010,2(2):142.
[7]Moseley G L,Hodges P W,Gandevia S C.Deep and superficial fibers of the lumbar multifidus muscle are differentially active during voluntary arm movements[J].Spine(Phila Pa 1976),2002,27(2):E29.
[8]Hallgren R C,Pierce S J,Prokop L L,et al.Electromyographic activity of rectus capitis posterior minor muscles associated withvoluntary retraction of the head[J].Spine J,2014,14(1):104.
[9]连树林,丁庆刚,旋静,等.颈性眩晕的发病机制研究[J].长春中医药大学学报,2012,28(3):432.
[10]Kahrstrom J,Hardebo J E,Owman C,et al.Neonatal chronic sympathectomy in normotensive rats affects pial arteries:enhanced stiffness and reduced capacity to dilate[J].Acta Physiol Scand,1996,157(20):217.
[11]Jordan W,Decker M,Kamrowski H,et al.Effects of cerebrovascular challenges on plasma endothelin[J].Neurosci Res,2002,43(2):127.
[12]Ziv I,Fleminger G,Djalaetti R,et al.Increased plasma endothelin-1 in acute ischemic stroke[J].Stroke,1992,23(7):1014.
[13]森园彻志.颈部震动刺激对身体平衡的影响[J].国外医学:耳鼻咽喉科学分册,1993,17(4):238.
[14]宋坤锋,高延征,高坤,等.颈性眩晕的发病机制及其研究进展[J].中国医药指南,2013,11(15):74.
[15]Glasgow E F,Twomey L T,Scull E R,et al.Aspects of manipulative therapy[M].Edinburgh:Churchill Livingstone,1985:72-77.
[16]Wall P D,Melzack R.The dorsal horn.Textbook of pain[M].2nd Ed.Edinburgh:Churchill Livingstone,1995:102-111.
[17]Hu J W,Vernon H,Tatourian I.Changes in neck electromyography associated with meningeal noxious stimulation[J].J Mani Physiol Ther,1995,18(9):577.
[18]Azarbal B,Tobis J,Suh W,et al.Association of interatrial shunts and migraine headaches:impact of transcatheter closure[J].J Am Coll Cardiol,2005,45(4):489.
[19]Fernández-de-Las-Pe?as C,Cuadrado M L,Arendt-Nielsen L,et al.Association of cross-sectional area of the rectus capitis posterior minor muscle with active trigger points in chronic tension-type headache:a pilot study[J].Am J Phys Med Rehabil,2008,87(3):197.
[20]Elliott J,Galloway G J,Jull G A,et al.Magnetic resonance imaging analysis of the upper cervical spine extensor musculature in an asymptomatic cohort:an index of fat within muscle[J].Clin Radiol,2005,60(3):355.
[21]Elliott J,Jull G,Noteboom J T,et al.Fatty infiltration in the cervical extensor muscles in persistent whiplash-associated disorders:a magnetic resonance imaging analysis[J].Spine(Phila Pa 1976),2006,31(22):E847.
[22]Elliott J,Sterling M,Noteboom J T,et al.Fatty infiltrate in the cervical extensor muscles is not a feature of chronic,insidiousonset neck pain[J].Cli Radiol,2008,63(6):681.
[23]Kendall F P,McCreary E K.Muscles:testing and function[M].3rd Ed.Baltimore:Williams&Wilkins,1983.
[24]White A A,Punjabi M M.Clinical biomechanics of the spine[M].2nd ed.Philadelphia:J B Lippincott,1990.
[25]Penning P.Functional anatomy of joints and discs.In:Sherk HH.The cervical spine[M].2nd ed.Philadelphia:J B Lippincott,1989:33-56.
[26]Mitchell B S,Humphreys B K,O'Sullivan E.Attachments of the ligamentum nuchae to cervical posterior spinal dura and the lateral part of the occipital bone[J].J Mani Physiol Ther,1998,21(3):145.
[27]Dean N A,Mitchell B S.Anatomic relation between the nuchal ligament(ligamentum nuchae)and the spinal dura mater in the craniocervical region[J].Clin Anat,2002,15(3):182.
[28]Humphreys B K,Kenin S,Hubbrard B B,et al.Investigation of connective tissue attachments to the cervical spinal dura mater[J].Clin Anat,2003,16(2):152.
[29]Rutten H P,Szpak K,van Mameren H,et al.Anatomic relation between the rectus capitis posterior minor muscle and the dura mater[J].Spine(Phila Pa 1976),1997,22(8):924.
[30]Lang J.The craniocervical junction-anatomy.In:Voth D,Glees P.Diseases in the craniocervical junction[M].Berlin,New York:Walter de Gruyter,1987,27-61.
[31]Yuan X Y,Yu S B,Li Y F,et al.Patterns of attachment of the myodural bridge by the rectus capitis posterior minor muscle[J].Anat Sci Int,2016,91(2):175.
[32]Hides J A,Richardson C A,Jull G A.Multifidus muscle recovery is not automatic after resolution of acute,first-episode low back pain[J].Spine(Phila Pa 1976),1996,21(23):2763.
[33]Hallgren R C.Modeling length-tension properties of RCPm muscles during voluntary retraction of the head[J].Manual Therapy,2014,19(4):319.
[34]曾智本.颈部肌群牵伸疗法联合推拿手法对颈性眩晕患者的疗效分析[J].中医临床研究,2018,16(10):21.
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