不同非手术治疗对儿童青少年特发性脊柱侧弯效果的对比研究

目的 探讨医疗体操、手法治疗、矫形支具治疗对儿童青少年特发性脊柱侧弯的临床效果。方法 选择2008年11月～2013年9月通过特发性脊柱侧弯普查发现及在自贡市第一人民医院就诊的特发性脊柱侧弯患者80例，分为医疗体操组（30例）、手法治疗组（25例）及矫形支具组（25例），医疗体操组采用自编医疗体操进行干预，手法治疗组根据解剖学特点采用综合性手法进行操作；矫形支具组应用矫形支具进行干预；疗程9～12月。观察并比较三组Cobb角变化情况。结果 治疗后三组Cobb角分别为：医疗体操组（17．00±8．00）°，手法治疗组（20．15±7．75）°,矫形支具组（11．86±5．07）°。医疗体操组治疗前后Cobb角比较差异有统计学意义（P=0．031）；矫形支具组治疗前后Cobb角比较差异有高度统计学意义（P=0．000）；而手法治疗组治疗前后比较差异无统计学意义（P=0．325）。治疗后医疗体操组与手法治疗组间Cobb角比较差异有统计学意义（P〈0．05）；治疗后矫形支具组与手法治疗组之Cobb角比较差异有高度统计学意义（P〈0．01）；治疗后医疗体操组与矫形支具组间Cobb角比较差异有高度统计学意义（P〈0．01）。结论 自编医疗体操、矫形支具对儿童青少年特发性脊柱侧弯疗效显著。

Comparative study of effect of different non-operative treatments on patients with AIS

Objective To investigate the effects of different non-operative treatments such as therapeutic exercise, manipulation therapy, orthopedic brace therapy on patients with AIS. Methods 80 patientswith AIS in the First People＇s Hospital of Zigong City or general investigation from November 2008 to September 2013 were selected and divided into therapeutic exercise group with 30 cases, manipulation group with 25 cases, orthopedic brace group with 25 cases. Patients in therapeutic exercise group were treated with therapeutic exercise; patients in manipulation group were treated with manipulation therapy and patients in orthopedic brace group were treated with brace therapy. Each group was treated for about 9-12 months. The Cobb＇s angle among the 3 groups were observed and compared. Results The Cobb＇s angles in each group after treatments in therapeutic exercise group, manipulation group, orthopedic brace group were （17.00±8.00）°, （20.15±7.75）°, （11.86±5.07）° respectively. The difference of Cobb＇s angle in therapeutic exercise group before and after treatment was statistically significant （P = 0.031）; the difference of Cobb＇s angle in orthopedic brace group before and af- ter treatment was statistically significant （P = 0.000）; the difference of Cobb＇s angle in manipulation group before and after treatment was not statistically significant （P = 0.325）. The difference of Cobb＇s angle after the treatment between therapeutic exercise group and manipulation group was statistically significant （P 〈 0.05）; the difference of Cobb＇s angle after the treatment between orthopedic brace group and manipulation group was statistically significant （P 〈 0.01）; the difference of Cobb＇s angle after the treatment between therapeutic exercise group and orthopedic brace group was statistically significant （P 〈 0.01）. Conclusion Therapeutic exercise and brace are very effective for AIS patients.