疏通正脊术治疗青少年特发性脊柱侧弯25例临床观察

Clinical study of straightening the spine technique in the treatment of adolescent idiopathic scoliosis

目的观察疏通正脊术治疗青少年特发性脊柱侧弯(AIS)的临床疗效。方法选取2019年12月至2021年1月河南中医药大学第一附属医院儿科就诊的AIS患儿52例,采用随机数字表法分为对照组和治疗组,各26例。治疗过程中有3例因依从性不佳脱落,最终治疗组25例,对照组24例。治疗组予疏通正脊术治疗,对照组予正骨调曲法治疗,2组均每周3次,4周为1个疗程,治疗3个疗程后统计临床疗效,并分别于治疗前、后比较脊柱侧弯角度(Cobb角)和脊柱侧凸研究学会22项病人调查问卷(SRS-22)评分的变化。结果对照组总有效率为83.33%(20/24),治疗组为96.00%(24/25),2组比较,差异无统计学意义(P>0.05)。治疗前2组Cobb角数值比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组Cobb角数值均显著降低,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组降低更显著(P<0.05)。治疗组SRS-22问卷在疼痛、自我形象/外观、精神健康、治疗满意度和总评分方面显著高于对照组,2组比较,差异有统计学意义(P<0.05),功能/活动度方面比较,差异无统计学意义(P>0.05)。治疗期间2组均未出现头晕、恶心、呕吐、组织损伤及骨折等不良反应,提示治疗安全性良好。结论疏通正脊术治疗AIS疗效满意,能显著改善Cobb角度,减轻脊柱侧弯,提升AIS患儿生活质量,且安全性良好,值得临床推广应用。

Objective To observe the clinical efficacy of straightening the spine technique in the treatment of adolescent idiopathic scoliosis(AIS).Methods Fifty-two cases of children with AIS attending the Department of Paediatrics of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine from December 2019 to January 2021 were selected and divided into a control group and a treatment group,each with 26 cases,using the random number table method.In the treatment process,3 cases were discharged due to poor compliance,and finally 25 cases were in the treatment group and 24 cases in the control group.The treatment group was treated with the sparing and orthopedic technique,and the control group was treated with the orthopedic method,both groups were treated 3 times a week,4 weeks for a course of treatment,and the treatment was carried out for 3 courses of treatment.The clinical efficacy of the control group was calculated,and the scoliosis angle(Cobb angle),the scoliosis research society 22-item patient questionnaire(SRS-22)scores were compared before and after the treatment,respectively.Results The total effective rate was 83.33%(20/24)in the control group and 96.00%(24/25)in the treatment group,and the difference between the 2 groups was not statistically significant(P>0.05).For details,see Table 2.The comparison of Cobb angle values between the 2 groups before treatment,the difference was not statistically significant(P>0.05),and was comparable.After treatment,the Cobb angle values of the 2 groups were significantly reduced,and the difference was statistically significant when compared with the same group before treatment(P<0.05),and the reduction was more significant in the treatment group(P<0.05).After treatment,the SRS-22 questionnaire of the treatment group was significantly higher than that of the control group in terms of pain,self-image,mental health and total score,and there was a statistically significant difference when comparing the 2 groups(P<0.05),and there was no statistically significant difference when comparing them in terms of function(P>0.05).During the treatment period,no adverse reactions such as dizziness,nausea,vomiting,low back pain,tissue damage and fracture occurred in both groups,suggesting that the safety of the treatment was good.Conclusion The efficacy of straightening the spine technique for AIS is satisfactory,which can significantly improve the Cobb angle,reduce scoliosis,improve the quality of life of children with AIS,and the safety is good,which is worthy of clinical promotion.