脊柱平衡法治疗青少年特发性脊柱侧凸症的随机对照研究  

Randomized Control Study of Spinal Balance Method of TCM in Treatment of Adolescent Idiopathic Scoliosis

作　　者：魏晖[1] 杜红根[1] 叶树良[1] 徐金元[1] 蒋忠[1] 郁继伟[1] 

机构地区：[1]浙江省中医院推拿科,浙江杭州310006

出　　处：《中华中医药学刊》2014年第5期1070-1073,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：浙江省中医药科技计划优秀青年人才基金项目(2012ZQ011)

摘　　要：目的:评价脊柱平衡法综合治疗青少年特发性脊柱侧凸症的有效性、安全性及优势。方法:收集2008年5月—2012年6月间确诊为AIS门诊病例90例,随机分为治疗组(脊柱平衡法)55例和对照组(支具法)35例,两组性别、年龄、Cobb角差异无显著性,所有患者均对治疗知情同意。治疗组采用①脊柱平衡导引:2次/d,40 min/次,每天坚持,12个月;②平衡手法:2次/周,25 min/次,12个月;③针刀整体松解:1次/周,10次。对照组应用Milwaukee支具治疗,22h/天,12个月。观察指标为12个月治疗前后的Cobb角改善情况、sEMG的AEMG比值变化、对肺功能指标的影响及安全性,并进行两组的比较。结果:两组治疗后Cobb角均有显著减小,矫正率分别为52%、47%,组间比较无显著差异(P>0.05);治疗组治疗后AEMG比值明显减小(P<0.01),表明侧凸两侧的肌张力趋于平衡,对照组治疗后AEMG比值增大(P<0.05),表明侧凸两侧的肌张力不平衡加剧;治疗组治疗后各项肺功能均有明显改善(P<0.05),对照组的各项指标均有下降(P<0.05)。治疗中未发现所采用治疗方法对生命体征如血压、心率、心律、呼吸频率等产生不良影响;也未出现骨折、脱位、晕针、出血、病情加重的病例。结论:基于中医理论的脊柱平衡综合疗法安全、有效,且能显著改善侧凸两侧肌力的不平衡,阻止侧凸进展,提高肺功能,并有较好依从性。Objective：To evaluate the efficacy and safety and adavantage of spinal blance method of TCM for treating AIS. Methods ：90 outpatients diagnosed as AIS were randomly divided into treatment group （spinal balance method） in 55 cases and the control group （35 cases, bracing method） between May 2008--June 2012. No significant difference was found in sex and age, Cobb angle as well. All patients signed the informed consent. The treatment group adopted three methods： （1）Daoyin of the spinal balance （twice a day,40 rain/time）, lasted 12 months; （2）the balance manipulation （twice a week,25 rain/time） ,lasted 12 months;（3）small needle - knife therapy （once a week, 10 times）. The control group adopted Milwaukee brace （22 h/day）,lasted 12 months. The curative effect and safety were observed before and after treatment, including amelioration of Cobb angle, the change of AEMG ratio of sEMG,influence of lung function index and safety. The curative effect was compared between two groups. Results ： After treatment, the two groups Cobb angle were both significantly reduced, and the correction rates were separately 52% and 47%, and there was no significant difference between two groups （P 〉 0.05 ）. AEMG ratio was significantly reduced （ P 〈 0.01 ） in treatment group, and it showed that the muscle imbalance existed on both sides of the scoliosis tend while the control group increased （ P 〈 0.05 ）, and it showed that the muscle imbalance aggravated. The lung function was significantly improved （ P 〈 0.05 ） in treatment group, while decreased （ P 〈 0.05 ） in control group. No side effect of blood pressure, pulse, cardiac rhythm, breathing frequency was fonnd and no fracture, dislocation, syncope, hemorrhage, sicker patient as well. Conclusion：The spinal bal- ance therapy based on traditional Chinese medicine theory has excellent curative effect and safety, and can significantly a- meliorates the imbalance existed on both sides of the scoliosis and improve lung

关 键 词：脊柱侧凸 青少年 导引 手法 针刀 肌电图 肺功能 

分 类 号：R244.1[医药卫生—针灸推拿学]