中医正骨推拿、火龙罐联合施罗特疗法治疗青少年特发性脊柱侧弯的临床研究

Efficacy of Chinese medicine orthopedic massage and fire dragon pot combined with Schroth therapy on adolescent idiopathic scoliosis

目的 观察中医正骨推拿、火龙罐联合施罗特疗法治疗青少年特发性脊柱侧弯的临床疗效。方法 选取2021年10月—2023年1月青岛市妇女儿童医院诊治的青少年特发性脊柱侧弯患者90例进行前瞻性研究,采用随机数字表法将患者分为传统疗法组、运动疗法组和联合组,每组30例。传统疗法组采用中医正骨推拿和火龙罐疗法治疗,运动疗法组采用施罗特疗法治疗,联合组采用中医正骨推拿、火龙罐联合施罗特疗法治疗,3组均连续治疗16周。比较3组治疗前后脊柱侧弯角度(Cobb角和背部倾斜角)、CSVL-C7PL间距、Nash-Moe椎体旋转度分级、顶椎凸侧和凹侧的表面肌电信号均方根值,统计3组治疗总有效率。结果 3组治疗后Cobb角、背部倾斜角以及CSVL-C7PL间距均明显小于治疗前(P均<0.05),且联合组上述指标均明显小于传统疗法组和运动疗法组(P均<0.05)。3组治疗后Nash-Moe椎体旋转度分级均较治疗前明显降低(P均<0.05),且联合组Nash-Moe椎体旋转度分级明显低于传统疗法组和运动疗法组(P均<0.05)。3组治疗前后顶椎凸侧表面肌电信号均方根值组内和组间比较差异均无统计学意义(P均>0.05);3组治疗后的顶椎凹侧表面肌电信号均方根值均较治疗前明显升高(P均<0.05),且联合组顶椎凹侧的表面肌电信号均方根值明显高于传统疗法组和运动疗法组(P均<0.05);传统疗法组和运动疗法组治疗后的顶椎凸侧表面肌电信号均方根值均明显高于同组的顶椎凹侧(P均<0.05),而联合组治疗后的顶椎凸侧和凹侧表面肌电信号均方根值比较差异无统计学意义(P>0.05)。联合组的治疗总有效率明显高于传统疗法组和运动疗法组[96.67%(29/30)比76.67%(23/30)、80.00%(24/30),P均<0.05]。结论 中医正骨推拿和火龙罐疗法、施罗特疗法以及中医正骨推拿、火龙罐联合施罗特疗法均可有效缩小脊柱侧弯角度,恢复脊柱平衡,改善背部不对称形态,而中医正骨推拿、火龙罐联合施罗特疗法矫正效果更佳。

Objective It is to observe the clinical efficacy of traditional Chinese medicine orthopedic massage and fire dragon pot combined with Schroth therapy in the treatment of adolescent idiopathic scoliosis.Methods Ninety patients with adolescent idiopathic scoliosis treated in Qingdao Women and Children’s Hospital from October 2021 to January 2023 were selected for prospective study,and the patients were divided into traditional therapy group,exercise therapy group and combination group by random number table,with 30 cases in each group.The traditional therapy group was treated with traditional Chinese medicine orthopedic massage and fire dragon pot,the exercise therapy group was treated with Schroth therapy,and the combination group was treated with traditional Chinese medicine orthopedic massage and fire dragon pot combined with Schroth therapy,all the three groups were treated continuously for 16 weeks.The scoliosis angles(Cobb angle and back tilt angle),CSVL-C7PL spacing,Nash-Moe vertebral rotation classification,and the root mean square value of the surface electromyographic signals of parietal vertebrae convex and concave sides of the three groups were compared before and after the treatment,and the total effective rate of the treatment of the three groups was calculated.Results The Cobb angle,back tilt angle,and CSVL-C7PL spacing of the three groups were significantly smaller than those before treatment(all P<0.05),and the above indexes of the combination group were significantly smaller than those of the traditional therapy group and exercise therapy group(all P<0.05).The Nash-Moe vertebral body rotation classification of the three groups was significantly lower than that before treatment(P<0.05),and the classification of the combination group was significantly lower than that the traditional therapy group and exercise therapy group(P<0.05).There was no statistically significant difference in the root mean square value of the surface electromyographic signals of parietal vertebrae convex side of the three groups before and after the treatment when compared in each group and among the three groups(all P>0.05);the root mean square value of the surface electromyographic signals of parietal vertebrae concave side of the three groups after the treatment were significantly higher than those before treatment(all P<0.05),and the combination group were significantly higher than those of the traditional therapy group and exercise therapy group(both P<0.05).The root mean square values of the surface electromyographic signals of parietal vertebrae convex side of the traditional therapy group and exercise therapy group after treatment were higher than that of concave side in the same group(both P<0.05);whereas,there was no statistical significance in the values between the convex side and concave side in the combination group after treatments(P>0.05).The total effective rate of treatment in the combination group was significantly higher than that in the traditional therapy group and exercise therapy group[96.67%(29/30)VS.76.67%(23/30)and VS.80.00%(24/30),all (P<0.05)].Conclusion Traditional Chinese medicine orthopedic massage,fire dragon pot and Schroth therapy alone or their combination therapy can effectively reduce the angle of scoliosis,restore the balance of spine,improve the asymmetric shape of back in the treatment of adolescent idiopathic scoliosis,and the effect of correction of combination therapy is better.