理筋正骨手法联合动态神经肌肉稳定技术治疗慢性非特异性腰痛的临床疗效及神经机制初探:一项随机对照研究OA

Background Chronic non-specific low back pain(CNLBP)is a highly prevalent musculoskeletal disease worldwide,which severely impairs patients'quality of life.Most existing studies primarily focus on biomechanical improvements while neglecting the modulatory role of the central nervous system in pain perception.From three perspectives-neurophysiology,biomechanics,and integrated traditional Chinese and Western medicine-this study aims to explore novel strategies for the prevention and treatment of CNLBP.Objective To compare the clinical efficacy of manual therapy(tendon-regulating and bone-setting)combined with dynamic neuromuscular stabilization(DNS)for patients with chronic non-specific low back pain.Methods A total of 72 chronic non-specific low back pain(CNLBP)patients admitted to the Tendon Injury Outpatient Department of the First Clinical Medical College,Anhui University of Chinese Medicine from August 2024 to August 2025 were randomly divided into two groups(1:1)via a computer-generated random number table,with 36 cases each.Three patients withdrew due to personal reasons(1 in the experimental group,2 in the control group).The control group received sham manipulation plus DNS training(3 times/week for 4 weeks),while the experimental group received tendon-regulating and bone-setting manipulation plus DNS training(2 times/week for 4 weeks).Visual Analogue Scale(VAS),Roland-Morris Disability Questionnaire(RMQ),Pain Catastrophizing Scale(PCS)scores,and surface electromyography(sEMG)co-contraction ratio(CCR)of lumbar and abdominal muscles were compared before and after treatment,with adverse events monitored.Results Before treatment,there were no significant differences in the baseline data between the two groups(P>0.05).After treatment,the VAS score,RMQ score,PCS and its subscale scores,as well as the surface electromyography CCR of the lumbocrural and abdominal muscles in both groups were significantly improved compared with those before treatment(P<0.05);moreover,the degree of improvement in the experimental group was significantly superior to that in the control group(P<0.05).Conclusion Tendon-regulating and bone-setting manipulation combined with DNS can effectively alleviate pain,improve functional impairment and pain catastrophizing thinking,enhance muscle co-contraction function,and show good safety.Its clinical efficacy is superior to that of DNS monotherapy.