中华中医药杂志2025，Vol.40Issue(2)：524-529,6.
基于LASSO-偏相关分析探讨解结除痹中医外治法对腰椎间盘突出症患者步行生物力学特征的影响
Exploration on the effects of traditional Chinese medicine external treatment of resolving tendon nodules and arthralgia on walking biomechanical characteristics in patients with lumbar disc herniation based on LASSO-partial correlation analysis
摘要
Abstract
Objective:To analyze the effects of traditional Chinese medicine external treatment of resolving tendon nodules and arthralgia(RTNA)on the clinical efficacy and walking biomechanical characteristics in patients with lumbar disc herniation(LDH).Methods:From January 1,2020 to December 31,2023,70 patients with LDH who were treated with external treatment of RTNA in the Department of Tuina,The Affiliated Hospital of Changchun University of Chinese Medicine were enrolled.Baseline data,biomechanical characteristic parameters of walking before and after treatment,visual analogue scale(VAS)for pain,Japanese Orthopaedic Association(JOA)low back pain score,and Oswestry disability index(ODI)were analyzed.LASSO regression and partial correlation analysis were used to screen the key biomechanical factors related to the treatment.Results:Compared with before treatment,the VAS score and ODI of the patients significantly decreased after treatment(P＜0.01),the JOA score significantly increased(P＜0.01),and the total effective rate was 87.14％(61/70).In the walking state,part of the plantar pressure was significantly changed(P＜0.01,P＜0.05),part of the joint range of motion(ROM)was significantly decreased(P＜0.01),and the symmetry index was increased(P＜0.01,P＜0.05).LASSO regression analysis showed that the ratio of forefoot and hindfoot load was correlated with the ROM of the pelvis,hip,knee,and ankle[λ=0.3793,log(λ)=-0.9694],and the load ratio of the big toe was correlated with the ROM of the hip[λ=0.6143,log(λ)=-0.4873].The load ratio of toes at T2-T5 was correlated with the ROM of pelvis and knee[λ=0.1943,log(λ)=-1.6384],and the load ratio of metatarsal head Ⅰ was correlated with the ROM of knee[λ=0.4464,log( )=-0.8065].In the partial correlation analysis,the ratio of forefoot and hindfoot load was significantly correlated with hip rotation,knee varus and valgus,and ankle flexion and extension angles(P＜0.05,P＜0.01).The load ratio of T2-T5 toes was significantly positively correlated with the ankle rotation angle(P＜0.01),and the load ratio of metatarsal headⅠ was significantly negatively correlated with the ankle rotation angle(P＜0.01).Conclusion:The external treatment of RTNA can effectively relieve pain and dysfunction of patients with LDH.Its mechanism may be related to improving joint function and ROM,optimizing plantar pressure distribution and its negative feedback regulation.关键词
椎间盘突出/生物力学/足底压力/LASSO回归/中医外治法/解结除痹Key words
Intervertebral disc herniation(LDH)/Biomechanics/Plantar pressure/LASSO regression/External treatment of traditional Chinese medicine/Resolving tendon nodules and arthralgia引用本文复制引用
姚俊杰,孙明,商强强,常天瀛,孙雅蕙,江晶蕾,吴兴全,丛德毓..基于LASSO-偏相关分析探讨解结除痹中医外治法对腰椎间盘突出症患者步行生物力学特征的影响[J].中华中医药杂志,2025,40(2):524-529,6.基金项目
国家重点研发计划项目(No.2018YFC1706000),长春中医药大学附属医院基本中医药循证能力建设项目(2024),吉林省中医药科技项目(No.2024038) （No.2018YFC1706000）
