三步三位三法治疗儿童寰枢关节半脱位的临床研究

Clinical Study of Three Steps,Three Positions and Three Methods in Treatment of Atlantoaxial Joint Subluxation in Children

目的:观察“三步三位三法”手法在“柔筋正骨”理论指导下治疗儿童寰枢关节半脱位的临床疗效。方法:选取寰枢关节半脱位患者75例,脱落4例,随机分为观察组36例与对照组35例。对照组采用常规仰卧位颈椎牵引、肌肉放松手法治疗。观察组采用常规仰卧位颈椎牵引、三步三位三法手法治疗。对两组患者治疗前后的临床疗效、寰齿侧间隙测量值差值、颈痛量表(NPQ)得分进行记录。结果:观察组治疗后的临床疗效、寰齿侧间隙测量值差值、颈痛量表(NPQ)得分均优于对照组,差异有统计学意义(P<0.05)。结论:柔筋正骨理论指导下三步三位三法手法优于常规仰卧位颈椎牵引、肌肉放松手法治疗儿童寰枢关节半脱位,值得推广运用。

Objectives:To observe the clinical efficacy of‘three steps,three positions and three methods’therapy in the treatment of atlantoaxial joint subluxation in children based on the theory of‘softening tendons and setting bones’.Methods:75 children with atlantoaxial joint subluxation were randomly divided into the observation group(n=36)and the control group(n=35),4 cases were missed out in the study.The control group was treated with routine supine cervical traction and muscle relaxation manipulation;whereas the observation group was treated with conventional supine cervical traction and three step,three position and three method manipulation.Clinical efficacy,the difference between the measured values of atlanto odontoid space and the score of neck pain scale(NPQ)were recorded before and after the treatment in the two groups.Results:The clinical efficacy,the difference of measured values of atlanto odontoid space and the score of NPQ were significantly better in the observation group than those in the control group after the treatment(P<0.05).Conclusion:Guided by the theory of softening tendons and setting bone,the three-step,three position and three method manipulation is superior to the conventional cervical traction and muscle relaxation manipulation in the treatment of atlantoaxial joint subluxation in children.The therapy is worth popularizing.