两种不同手法治疗小儿肌性斜颈的临床对比观察

Clinical research on standardized tuina treatment for congenital muscular torticollis

目的:探讨优化组合的固定推拿手法流程(以下简称"优化手法")对小儿肌性斜颈的治疗作用,为今后确定规范手法操作规程及临床推广提供依据。方法:随机选择小儿肌性斜颈患者52例,治疗组27例,以优化手法治疗;对照组25例,以传统按揉法治疗。均每日1次,每周5次,20次为1疗程,3个疗程后评定疗效。疗效评价结合患儿症状及体征,并以患侧胸锁乳突肌肿块的彩色超声波影像变化参数作为主要评判标准之一。结果:优化手法治疗26例,总有效率92.3%;对照组治疗23例,总有效率69.6%。两组疗效有明显差异(P<0.05)。患侧肿块彩色超声波影像显示,治疗组肿块厚度治疗后显著减小(P<0.05)。对照组肿块厚度治疗前后无显著性差异(P>0.05)。结论:优化组合的固定推拿手法流程治疗小儿肌性斜颈临床总有效率明显优于传统按揉法。

Objective：To discuss the efficacy of standardized tuina treatment on congenital muscular torticollis（CMT） so as to provide support for the establishment of standard operation rule and clinical promotion.Method：Fifty-two infants of CMT were randomly assigned to the treatment group（27 infants） and the control group（25 infants）.The treatment group was treated with standardized tuina treatment,and the control group was treated with traditional tuina treatment.Both groups had treatment once daily and five times each week,20 times as one course.The effect was compared after 3 courses.Efficacy assessment was based on the infants＇ symptoms and physical signs and the changes of thickness of the lump on the sternocleidomastoid muscle showed by coloured ultrasonic image.Result：The total effective rate of 26 infants treated with standardized tuina was 92.3% and that of 23 infants treated with traditional tuina was 69.6%.The efficacy of the two groups was significantly different（P0.05）.The ultrasonic image showed thickness of lumps were obviously reduced in treatment group（P0.05）,the changes in control group was not significantly（P0.05）.Conclusion：The total effective rate of standardized tuina treatment in treating CMT is obviously higher than that of traditional tuina treatment.