基于足底静态参数探讨“分节段式”脊柱推拿手法治疗青少年特发性脊柱侧凸的临床疗效  

Outcomes of segmental spinal manipulation for treatment of adolescent idiopathic scoliosis:a static plantar parameters-based clinical study

作　　者：田俊松 吴嘉颖 谢红岩 应晓明[2] 叶鑫[2] TIAN Junsong;WU Jiaying;XIE Hongyan;YING Xiaoming;YE Xin(Yuyao Hospital of TCM,Yuyao 315402,Zhejiang,China;The Third Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310005,Zhejiang,China)

机构地区：[1]余姚市中医医院,浙江余姚315402 [2]浙江中医药大学附属第三医院,浙江杭州310005

出　　处：《中医正骨》2024年第4期15-20,共6页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：宁波市卫生健康科技计划项目(2022Y50);余姚市卫生健康科技计划项目(2022YYB08);浙江中医药大学附属第三医院院级课题(YJKY-2020-01)。

摘　　要：目的:基于足底静态参数探讨“分节段式”脊柱推拿手法治疗青少年特发性脊柱侧凸(adolescent idiopathic scoliosis, AIS)的临床疗效。方法:将60例符合要求的AIS患者随机分为2组,每组30例。常规推拿组采用常规脊柱推拿手法进行治疗,每周2次,共治疗12周;联合推拿组在常规脊柱推拿手法治疗的基础上增加“分节段式”脊柱推拿手法,“分节段式”脊柱推拿手法每周1次,共治疗12周。分别于第1次治疗前和治疗结束后当天,采用USOL三维足底扫描仪采集患者足底静态参数,包括长度参数(足长、足弓长)、宽度参数(前掌宽、后跟宽)、高度参数(足弓内侧高度、外踝高度)及角度参数([足母]趾角度)。结果:(1)长度参数。治疗前及治疗结束后,2组患者双侧足长差值、双侧足弓长差值比较,组间差异均无统计学意义(治疗前:t=1.684,P=0.098;t=0.359,P=0.721;治疗结束后:t=0.263,P=0.081;t=0.240,P=0.811);治疗结束后,2组患者双侧足长差值、双侧足弓长差值均较治疗前减小(双侧足长差值:t=5.079,P=0.000;t=21.891,P=0.000;双侧足弓长差值:t=15.834,P=0.000;t=12.120,P=0.000)。(2)宽度参数。治疗前,2组患者双侧前掌宽差值、双侧后跟宽差值比较,组间差异均无统计学意义(t=-0.748,P=0.457;t=0.372,P=0.711);治疗结束后,2组患者双侧前掌宽差值、双侧后跟宽差值均较治疗前减小(双侧前掌宽差值:t=11.522,P=0.000;t=7.369,P=0.000;双侧后跟宽差值:t=16.745,P=0.000;t=11.486,P=0.000);治疗结束后,联合推拿组患者双侧前掌宽差值、双侧后跟宽差值均小于常规推拿组(t=-2.351,P=0.022;t=-2.699,P=0.009)。(3)高度参数。治疗前,2组患者双侧足弓内侧高度差值、双侧外踝高度差值比较,组间差异均无统计学意义(t=-0.595,P=0.554;t=0.082,P=0.935);治疗结束后,2组患者双侧足弓内侧高度差值、双侧外踝高度差值均较治疗前减小(双侧足弓内侧高度差值:t=9.616,P=0.000;t=10.269,P=0.000;双Objective:To explore the clinical outcomes of segmental spinal manipulation in treatment of adolescent idiopathic scoliosis(AIS)based on the static plantar parameters.Methods:Sixty AIS patients were enrolled in the study and were randomized into conventional manipulation group and combination manipulation group,30 ones in each group.All patients in the 2 groups were treated with conventional spinal manipulation,twice a week for consecutive 12 weeks;moreover,the ones in combination manipulation group were further treated with segmental spinal manipulation,once a week for consecutive 12 weeks.Before the first treatment and after the end of treatment,the static plantar parameters,including length parameters(foot length,foot arch length),width parameters(forefoot width,heel width),height parameters(medial arch height,lateral malleolus height),and angle parameter(big toe angle)were collected,respectively,by using a USOL three-dimensional plantar scanner.Results:①Length parameters.The difference between the bilateral foot length and difference between the bilateral foot arch length were compared between the 2 groups before the treatment and after the end of the treatment,and the results revealed no significant differences(pretreatment:t=1.684,P=0.098;t=0.359,P=0.721;after the end of the treatment:t=0.263,P=0.081;t=0.240,P=0.811);the difference between the bilateral foot length and difference between the bilateral foot arch length decreased in the 2 groups after the end of treatment compared to pretreatment(the difference between the bilateral foot length:t=5.079,P=0.000;t=21.891,P=0.000;the difference between the bilateral foot arch length:t=15.834,P=0.000;t=12.120,P=0.000).②Width parameters.The difference between the bilateral forefoot width and the difference between the bilateral heel width were compared between the 2 groups before the treatment,and the results revealed no significant differences(t=-0.748,P=0.457;t=0.372,P=0.711).The difference between the bilateral forefoot width and the difference between the

关 键 词：脊柱侧凸 青少年 推拿 脊柱 足 参数 

分 类 号：R244.1[医药卫生—针灸推拿学]