脊柱整体手法结合小儿推拿、颈椎牵引治疗短暂性儿童抽动障碍合并寰枢椎失稳30例

Thirty Cases of Transient Tic Disorder in Children Combined with Atlantoaxial Instability Treated with Integral Manipulation of Spine in Combination with Pediatric Massage and Cervical Traction

目的:观察脊柱整体手法结合小儿推拿疗法、颈椎牵引治疗短暂性儿童抽动障碍合并寰枢椎失稳的临床疗效。方法:选择短暂性儿童抽动障碍合并寰枢椎失稳患儿60例,按照随机数字表法分为治疗组和对照组,每组30例。治疗组患儿采用脊柱整体手法、小儿推拿疗法、颈椎牵引治疗,对照组患儿口服盐酸硫必利。观察所有患儿治疗前后耶鲁综合抽动严重程度量表(ygtss yale global tic severity scale,YGTSS)及颈部寰枢椎影像变化情况。结果:治疗组有效率为90.00%,对照组有效率为43.33%,治疗组有效率高于对照组,差异有统计学意义(P<0.05);治疗组治疗后YGTSS评分低于对照组,差异有统计学意义(P<0.05);治疗组颈部寰枢椎影像学变化情况优于对照组,差异有统计学意义(P<0.05)。结论:脊柱整体手法结合小儿推拿疗法、颈椎牵引治疗短暂性儿童抽动障碍合并寰枢椎失稳,能改善患儿抽动严重程度及寰枢椎关节失稳。

Objective:To observe the clinical curative effect of integral manipulation of spine in combination with pediatric massage and cervical traction on transient tic disorder in children combined with atlantoaxial instability.Methods:A total of 60 patients with transient tic disorder complicated with atlantoaxial instability were randomly divided into the treatment group and the control group,with 30 cases in each group.The children in the treatment group were treated with integral spinal manipulation,pediatric massage and cervical traction,while the children in the control group were treated with tiapride hydrochloride for oral administration.The changes of Yale Global Tic Severity Scale(YGTSS)and cervical atlantoaxial images were observed before and after treatment.Results:The effective rate was 90.00%in the treatment group,which was higher than that in the control group:43.33%.The difference was statistically significant(P<0.05).The YGTSS score of the treatment group was lower than that of the control group.The difference was statistically significant(P<0.05).The image change of cervical atlantoaxial in the treatment group was better than that in the control group.The difference was statistically significant(P<0.05).Conclusion:Integral manipulation of spine in combination with pediatric massage and cervical traction in the treatment of transient tic disorder in children combined with atlantoaxial instability can improve the severity of tic and atlantoaxial joint instability in children.