通督针法联合正骨整脊手法治疗青少年特发性脊柱侧弯的临床疗效研究

Study on the clinical effect of Tongdu acupuncture combined with bone-setting and chiropractic manipulation on adolescent idiopathic scoliosis

关键词:  通督针法  正骨整脊手法  青少年特发性脊柱侧弯  临床疗效

Key words:  Tongdu acupuncture method  bone-setting and chiropractic manipulation  adolescent idiopathic scoliosis  clinical effect

摘要:

目的 探讨通督针法联合正骨整脊手法治疗青少年特发性脊柱侧弯（AIS）的临床疗效。方法 前瞻性随机对照研究，共招募96例AIS患者参与研究，按照随机数字表法将其分为两组。对照组（48例）接受通督针法治疗，观察组（48例）接受通督针法联合正骨整脊手法治疗，两组均每日治疗1次，连续治疗5 d后休息2 d，连续治疗6周。比较组间治疗前后Cobb角、脊柱活动度、躯干形态、运动能力和生活质量。结果 治疗6周后，两组Cobb角、椎骨旋转均值、椎骨旋转最大值、脊柱后凸角、脊柱前凸角、骨盆扭转、骨盆斜度，脊柱侧凸研究会-22问卷（SRS-22）评分、意大利脊柱青年生活质量问卷（ISYQOL）评分较治疗前降低（P＜0.05），胸椎屈曲、腰椎屈曲、腰部伸展、腰椎左侧屈曲、腰椎右侧屈曲活动度，功能性运动筛查（FMS）评分较治疗前增高（P＜0.05）。观察组治疗后Cobb角、椎骨旋转均值、椎骨旋转最大值、脊柱后凸角、脊柱前凸角、骨盆扭转、骨盆斜度，SRS-22评分、ISYQOL评分低于对照组（P＜0.05），胸椎屈曲、腰椎屈曲、腰部伸展、腰椎左侧屈曲、腰椎右侧屈曲活动度，FMS评分高于对照组（P＜0.05）。结论 通督针法联合正骨整脊手法能有效缩小AIS患者Cobb角，改善躯干形态、脊柱活动度、运动能力和生活质量。

Abstract:

Objective To investigate the clinical effect of Tongdu acupuncture combined with bone-setting and chiropractic manipulation in the treatment of adolescent idiopathic scoliosis(AIS).Methods A total of 96 AIS patients were recruited to participate in this prospective randomized controlled study, and were divided into two groups by random number table method. The control group(48 cases) received Tongdu acupuncture therapy, and the observation group(48 cases) received Tongdu acupuncture therapy combined with bone-setting manipulation. Both groups were treated once a day for 5 days and then rested for 2 days for 6 weeks. Cobb angle, spinal motion, trunk shape, motor capacity and quality of life were compared between groups before and after treatment.Results After 6 weeks of treatment, Cobb angle, mean vertebra rotation, maximum vertebra rotation, kyphotic angle, lordotic angle, pelvic torsion, pelvic inclination, scoliosis research society-22(SRS-22) score and Italian spine youth quality of life(ISYQOL) score were lower in two groups than before treatment(P < 0.05). Thoracic flexion, lumbar flexion, lumbar extension, left lumbar flexion, right lumbar flexion and functional movement screen(FMS) scores were higher than those before treatment(P < 0.05). After treatment, Cobb angle, mean vertebra rotation, maximum vertebra rotation, kyphotic angle, lordotic angle, pelvic torsion, pelvic inclination, SRS-22 score and ISYQOL score in observation group were lower than those in control group(P < 0.05), thoracic spine flexion, lumbar spine flexion, lumbar extension, left lumbar spine flexion and right lumbar spine flexion motion. FMS score was higher than that of control group(P < 0.05).Conclusion Tongdu acupuncture combined with bone-setting and chiropractic manipulation can effectively reduce Cobb angle and improve trunk shape, spinal motion, motor ability and quality of life in AIS patients.