摘要
目的:探讨“分节段式”脊柱推拿手法对青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患者脊柱三维结构的影响。方法:将符合要求的90例AIS患者随机分为2组,每组45例。常规推拿组采用《推拿治疗学》中的脊柱病证推拿手法治疗,每周治疗2次,共治疗24周;联合推拿组在常规推拿基础上联合“分节段式”脊柱推拿手法治疗,每周治疗1次,共治疗24周。分别于治疗前及治疗结束时记录并比较2组患者的脊柱矢状位垂直轴(sagittal vertical axis,SVA)距离、胸椎后凸角(thoracic kyphosis,TK)、胸腰段后凸角(thoracolumbar kyphosis,TLK)、腰椎前凸角(lumbar lordosis,LL)、C_(7)铅垂线(C_(7) plumb line,C_(7)PL)与骶骨中垂线(center sacral vertical line,CSVL)的距离、顶椎偏距(apical vertebral translation,AVT)、骨盆入射角(pelvicinc idence,PI)、骶骨倾斜角(sacral slope,SS)及骨盆倾斜角(pelvic tilt,PT)。结果:①脊柱矢状位参数。治疗前,2组患者的脊柱SVA距离、TK、TLK、LL比较,组间差异均无统计学意义[(5.100±1.125)cm,(5.250±0.920)cm,t=-0.326,P=0.748;20.900°±3.143°,20.400°±2.674°,t=0.383,P=0.706;5.300°±1.767°,4.900°±1.523°,t=0.542,P=0.594;32.800°±3.393°,32.900°±2.378°,t=-0.076,P=0.940];治疗结束后,联合推拿组的脊柱SVA距离、TLK均小于常规推拿组[(2.400±0.843)cm,(3.900±0.614)cm,t=-4.546,P=0.000;2.100°±0.994°,3.200°±1.033°,t=-2.426,P=0.026],联合推拿组的TK、LL均大于常规推拿组(28.500°±3.472°,25.100°±3.281°,t=2.251,P=0.037;41.300°±3.301°,37.700°±2.584°,t=2.715,P=0.014),2组患者的脊柱SVA距离、TLK均小于治疗前(t=5.939,P=0.000;t=6.384,P=0.000;t=5.400,P=0.000;t=5.075,P=0.000),2组患者的TK、LL均大于治疗前(t=-5.919,P=0.000;t=-8.728,P=0.000;t=-15.105,P=0.000;t=-10.854,P=0.000)。②脊柱冠状位参数。治疗前,2组患者的C_(7)PL与CSVL的距离、AVT比较,组间差异均无统计学意义[(3.350±0.668)cm,(3.100±0.843)cm,t=0.735,P=0.472;(5.
Objective:To explore the effects of segmental spinal manipulation on three-dimensional(3 D)spinal structure in patients with adolescent idiopathic scoliosis(AIS).Methods:Ninety AIS patients were enrolled in the study and were randomly divided into conventional manipulation group and combination manipulation group, 45 cases in each group.All patients in the 2 groups were treated with manipulation for spinal diseases which was extracted from Manipulation Acology,twice a week for consecutive 24 weeks.Moreover, the patients in combination manipulation group were further treated with segmental spinal manipulation, once a week for consecutive 24 weeks.The parameters including sagittal vertical axis(SVA)distance, thoracic kyphosis(TK),thoracolumbar kyphosis(TLK),lumbar lordosis(LL),distance between Cplumb line(CPL)and center sacral vertical line(CSVL),apical vertebral translation(AVT),pelvic incidence(PI),sacral slope(SS)and pelvic tilt(PT)were recorded and compared between the 2 groups before the treatment and at the end of treatment.Results:(1)There was no statistical difference in SVA distance, TK, TLK and LL between the 2 groups before the treatment(5.100±1.125 vs 5.250±0.920 cm, t=-0.326,P=0.748;20.900±3.143 vs 20.400±2.674 degrees, t=0.383,P=0.706;5.300±1.767 vs 4.900±1.523 degrees, t=0.542,P=0.594;32.800±3.393 vs 32.900±2.378 degrees, t=-0.076,P=0.940).The SVA distance was shorter, the TLK was smaller, whereas the TK and LL were greater in combination manipulation group compared to conventional manipulation group after the end of the treatment(2.400±0.843 vs 3.900±0.614 cm, t=-4.546,P=0.000;2.100±0.994 vs 3.200±1.033 degrees, t=-2.426,P=0.026;28.500±3.472 vs 25.100±3.281 degrees, t=2.251,P=0.037;41.300±3.301 vs 37.700±2.584 degrees, t=2.715,P=0.014).The SVA distance and TLK decreased, whereas the TK and LL increased after the end of the treatment compared to pretreatment in the 2 groups(t=5.939,P=0.000;t=6.384,P=0.000;t=5.400,P=0.000;t=5.075,P=0.000;t=-5.919,P=0.000;t=-8.728,P=0.000;t=-15.105,P=0.
作者
田俊松
应晓明
李晓
叶鑫
李帅林
周建忠
杨志峰
李立柯
TIAN Junsong;YING Xiaoming;LI Xiao;YE Xin;LI Shuailin;ZHOU Jianzhong;YANG Zhifeng;LI Like(Yuyao Hospital of TCM,Yuyao 315499,Zhejiang,China;The Third Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310005,Zhejiang,China)
出处
《中医正骨》
2022年第7期15-21,共7页
The Journal of Traditional Chinese Orthopedics and Traumatology
基金
浙江省中青年临床名中医项目(sjzqn202106)
浙江中医药适宜技术培育项目(2018ZT003)。
关键词
脊柱侧凸
推拿
脊柱
青少年
临床试验
scoliosis
manipulation,spinal
adolescent
clinical trial
