理学疗法与传统推拿治疗小儿先天性肌性斜颈的疗效对比  

Comparative Observation on Therapeutic Effect of Physical Therapy and Traditional Massage on Congenital Muscular Torticollis in Children

作　　者：王丽娜 蔡民 贾丽君 侯梅 WANG Li-na;CAI Min;JIA Li-jun;HOU Mei(Medical College of Qingdao University,Qingdao,Shandong 266021;The First People's Hospital of Pingvuan County,Dezhou,Shandong 253100;Qingdao Woman and Children's Hospital,Qingdao,Shandong 266034)

机构地区：[1]青岛大学医学部,山东青岛266021 [2]平原县第一人民医院,山东德州253100 [3]青岛市妇女儿童医院,山东青岛266034

出　　处：《按摩与康复医学》2021年第20期48-51,共4页Chinese Manipulation and Rehabilitation Medicine

摘　　要：目的:探讨早期理学疗法(physical therapy,PT)与传统推拿两种不同治疗方法对小儿先天性肌性斜颈的疗效。方法:选择2016年1月~2019年2月于平原县第一人民医院康复门诊就诊的74例先天性肌性斜颈患儿,年龄20~90天,随机分为观察组39例和对照组35例。观察组采用牵伸、姿势控制和运动学习等方法,通过视觉、听觉、触觉的刺激,诱发患儿主动运动,扩大颈部活动范围,锻炼颈部周围肌群力量;对照组采用传统中医按揉和牵伸被动手法,软化结节,改善颈部活动范围;两组均同时给予环境适应性策略家庭指导。治疗方案为一对一医院治疗,每日1次、每次30min、每周连续治疗5日,总疗程12周;采用香港中文大学制定的先天性肌性斜颈疗效评分标准对比两组临床疗效。结果:两组患儿治疗后颈部旋转及侧屈活动度、胸锁乳突肌肿块及肌肉紧张度均显著改善;观察组疗效优良者为94.87%,高于对照组的74.29%(P<0.05)。结论:理学疗法与传统推拿治疗小儿先天性肌性斜颈均有效;传统推拿以被动方法为主,而理学疗法内容符合ICF框架下活动和参与、个人和环境及运动学习原理,疗效更优,值得临床推广使用。Objective:To explore the curative effect of early physical therapy(PT)and traditional massage on congenital muscular torticollis(CMT)in children.Methods:from January 2016 to February 2019.74 children with CMT were selected from the rehabilitation clinic of the first people's hos-pital of Pingyuan county as the study object,aged 20〜90 days.They were randomly divided into observation group(n=39)and control group(n=35).The observation group used the methods of drawing,posture control and motor learning to stimulate the children's vision,hearing and touch,to induce the children's active movement,expand the range of neck activity,and exercise the strength of the muscles around the neck.In control group,the passive manipulation of traditional medicine massage and draft was used to soften the nodule and improve the range of neck movement.Both groups were given family guidance on environmental adaptation strategy at the same time.The treatment plan is one-to-one hospital treatment,once a day,30 minutes each time,5 consecutive days per week,the total course of treatment is 12 weeks.The clinical effects of the two groups were compared by using the score standard of CMT developed by the Chinese University of Hong Kong.Results:After treatment,the neck rotation,lateral flexion,sternocleidomastoid mass and muscle tension of the two groups were significantly improved;94.87%of the patients in observation group had good curative effect;74.28%of the patients in group 2 had good curative effect,and the curative effect in observation group was significantly better than that in control(P<0.05).Conclusion:Both physical therapy and traditional massage are effective in the treatment of CMT in children.Traditional massage is mainly passive,and the content of physical therapy is in line with the principles of activity and participation,individual and environment,and sports learning under the framework of ICF,which is more effective and worthy of clinical application.

关 键 词：先天性肌性斜颈 理学疗法 推拿 疗效 

分 类 号：R726.8[医药卫生—儿科]