葛根汤并枕颌带牵引治疗风寒束表型儿童寰枢关节半脱位  

Gegen Decoction in Treatment of Non-traumatic Atlanto-axial Subluxation of Children

作　　者：洪嘉志 黄炎强 蓝蔚娴 吕辰玮[1] HONG Jiazhi;HUANG Yanqiang;LAN Weixian;LYU Chenwei(The Orthopedics Department,Zhangzhou Hospital of Traditional Chinese Medicine Affiliated to Fujian University of Traditional Chinese Medicine,Zhangzhou Fujian 363000,China)

机构地区：[1]福建中医药大学附属漳州市中医院骨伤科,福建漳州363000

出　　处：《中国卫生标准管理》2021年第12期122-125,共4页China Health Standard Management

基　　金：2019年漳州市自然科学基金项目(ZZ2019J30)。

摘　　要：目的探讨葛根汤联合枕颌带牵引治疗风寒阻络型儿童寰枢关节半脱位的临床疗效。方法对感受风寒之邪所致的59例小儿寰枢关节半脱位进行随机分组,两组均采用持续枕颌带牵引法治疗的基础治疗,治疗组加用葛根汤中药内服。通过收集患儿治疗前及治疗3天、1周及2周后的Wong-Baker疼痛面部评分、寰枢椎旋转活动角度(range of motion,ROM),寰齿间距(atlantodental interva,ADI)及两侧寰椎侧块与齿状突间隙的差值(varianee of bilateral lateral atlanto-dental space,VBLADS)并对上述数据进行分析处理。结果两组患儿在经治疗后,疼痛明显减轻,治疗后各时间段WongBaker疼痛评分治疗组均低于对照组(P <0.05)。颈椎活动均明显改善,各时间点ROM对比,治疗组均优于对照组(P <0.01)。治疗后两组ADI及VBLADS均较前减小(P <0.05),但两组在治疗后的ADI对比显示不具有统计学差异(P=0.136> 0.05),在治疗后的VBLADS对比中,治疗组低于对照组,差异具有统计学意义(P<0.05)。在临床疗效的对比中,对照组总有效率为66.66%,治疗组总有效率为93.10%,认为差异具有统计学意义(χ^(2)=6.36,P <0.05)。结论葛根汤联合持续枕颌带牵引能较快地改善患儿的颈项疼痛及颈椎活动度,帮助患儿尽早恢复生活及学习。Objective To explore the clinical efficacy of Gegen Decoction in treatment of non-traumatic atlanto-axial subluxation of children.Methods A total of 59 children with non-traumatic atlantoaxial subluxation were randomly divided into the treatment group and the control group.Both groups were treated with basic treatment of continuous occipito-jaw traction while the treatment group took Gegen Decoction orally.The children’s Wong-Baker pain score,cervical spine ROM,varianee of bilateral lateral atlanto-dental space and atlantodental interva were recorded.Results After treatment,the pain of the treatment group was significantly reduced,and the Wong-Baker pain score of the treatment group was lower than that of the control group(P<0.05).ROM comparison at each time point showed that the treatment group was superior to the control group(P<0.01).ADI and VBLADS of the two groups decreased after treatment(P<0.05),but there was no statistical difference between the two groups of the ADI after treatment(P=0.136>0.05),and the comparison of VBLADS of the treatment group was lower than that of the control group,with statistically significant difference(P<0.05).In the comparison of clinical efficacy,the total effective rate was 66.66%in the control group and 93.10%in the treatment group,suggesting that the difference was statistically significant(χ^(2)=6.36,P<0.05).Conclusion Combined with continuous occipito-jaw traction,Gegen Decoction orally can quickly remove the neck pain and improve the cervical spine ROM,helping children to resume life and learning as soon as possible.

关 键 词：儿童寰枢关节半脱位 风寒阻络 葛根汤 枕颌带牵引 寰枢椎旋转活动角度 寰齿间距 

分 类 号：R274.2[医药卫生—中医骨伤科学]