从生物力学角度分析八段锦前四式防治神经根型颈椎病*
作者：彭丽媛1，高 靖1，龚思浩1，花迎雪1，李 红1，彭红艳1，蔡 娲2，沈卫东2
单位：1.上海市浦东新区新场社区卫生服务中心，上海 201314； 2.上海中医药大学附属曙光医院，上海 201203
引用：引用：彭丽媛，高靖，龚思浩，花迎雪，李红，彭红艳，蔡娲，沈卫东.从生物力学角度分析八段锦前四式防治神经根型颈椎病[J].中医药导报,2025,31(12):163-167,173.
DOI：10.13862/j.cn43-1446/r.2025.12.026
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摘要：目的：从有限元角度模拟神经根型颈椎病（CSR）患者在做八段锦前四式时颈椎的生物力学改变，为临床指导八段锦防治神经根型颈椎病提供理论依据。方法：收集1例CSR患者的颈椎CT数据，运用软件构建C1~C7颈椎椎体、椎间盘的有限元模型，模拟患者做八段锦前四式时，身体中正位，颈部后伸60°、旋转45°，观察颈椎各个椎体和椎间盘的应力、形变的生物力学变化。结果：椎体最大应力均在与椎间盘接触处，且各节椎体在旋转45°时的应力均比后伸60°时大。后伸时椎间盘最大应力在其前侧，旋转时椎间盘最大应力在其左右侧。各椎间盘在旋转45°时的应力明显比后伸60°时的大，固定C7椎体，各椎体、椎间盘形变从上到下逐渐减小，且椎体形变大于椎间盘。结论：八段锦前四式中的颈部后伸、旋转能通过调整椎体、椎间盘的应力分布，减轻对颈神经根的压迫。椎体、椎间盘的形变可以调整颈椎椎体之间的位置关系，纠正可能存在的微小错位，减少椎间盘对神经根的刺激，减轻神经根受压引起的一系列症状。
关键词：神经根型颈椎病；八段锦；生物力学；有限元
Abstract：
Objective: To simulate biomechanical changes in the cervical spine of patients with cervical spondylotic radiculopathy (CSR) performing the first four movements of Baduanjin from a finite element perspective, providing a theoretical basis for clinical guidance. Methods: Cervical CT data from one CSR patient were used to construct finite element models of C1-C7 vertebrae and intervertebral discs. Simulations were performed with the body upright, neck extended 60°, and rotated 45°. Stress and deformation of vertebrae and discs were observed. Results: Maximum vertebral stress occurred at disc contact points, with greater stress at 45° rotation than at 60° extension. Maximum disc stress during extension was anterior; during rotation, it was lateral. Disc stress was significantly greater during rotation. With C7 fixed, deformation decreased from superior to inferior, and vertebral deformation exceeded disc deformation. Conclusion: Neck extension and rotation in the first four movements of Baduanjin can adjust stress distribution in vertebrae and discs, relieving nerve root compression. Deformation adjusts vertebral positional relationships, corrects minor misalignments, reduces disc irritation to nerve roots, and alleviates associated symptoms, providing a theoretical basis for using Baduanjin in CSR prevention and treatment.
Key words：cervical spondylotic radiculopathy; Baduanjin; biomechanics; finite element
发布时间：2026-01-30
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