色努式脊柱侧弯矫形器佩戴时间与效果的对比分析

目的探讨比较色努式脊柱侧弯矫形器佩戴时间及功能锻炼对矫正治疗效果的影响。方法将2004年7月-20011年7月收治的126例脊柱侧弯患者，按自愿选择分为试验组和对照组，试验组佩戴色努式脊柱侧弯矫形器18～20h，功能锻炼〉90min；对照组佩戴侧弯矫形器23h，功能锻炼30～60min。对比两组患者治疗前后的Cobb角、顶椎偏离中线距离（AVT）、顶椎旋转度（AVR）、躯干位移（Ts）、脊柱柔韧性及肺功能指标的改善。结果经X线检查测定，治疗后两组患者的Cobb角、AVT、AVR、TS均低于治疗前（P〈0．01），且试验组明显低于对照组（P〈0．01）。肺功能指标：试验组治疗后肺活量（VC）、第1秒钟用力呼气容积（FEV1）、用力肺活量（FVC）、肺总量（TLC），等均高于治疗前，残气量（RV）低于治疗前（P〈O．01），对照组治疗后VC、FEV1、FVC、TLC均低于治疗前，RV高于治疗前（P〈0．01），且试验组优于对照组（P〈0．01）。功能位Cobb角：两组患者的功能位主弯Cobb角、代偿弯Cobb角均低于治疗前（P〈0．01），且试验组明显低于对照组（P〈0．01）。结论色努式脊柱侧弯矫形器每天佩戴18～20h，并结合适当的体操疗法，呼吸、肌力训练及麦肯基力学疗法，可使肺功能、腰背部肌力、脊柱柔韧性、身体的协调性、以及平衡能力得到改善，从而达到脊柱侧弯治疗的较好效果。

Influence of the Wearing Time of Cheneau Scoliosis Brace on Its Clinical Efficacy

Objective To discuss the influence of the wearing time of and functional exercise with Cheneau Scoliosis brace on its clinical efficacy. Methods We divided the 126 patients with scoliosis into experimental group and control group according to their own choice during July 2004 to July 2011. Patients in the experimental group wore Cheneau Scoliosis brace for 18-20 hours with functional exercise longer than 90 minutes; Patients in the control group wore scoliosis brace for 23 hours with functional exercise lasting between 30 to 60 minutes. Then we compared the improvement on cobb angle, top vertebral deviating from the center line distance （AVT）, top vertebral rotation degrees （AVR）, displacement of the torso （TS）, spinal flexibility and lung function index of the two groups of patients before and after treatment. Results Based on the X-ray results, the cobb ange, AVT, AVR, and TS of both the two groups of patients were significantly lower after treatment （P 〈 0.01）, and those indexes were also significantly lower in the experimental group than in the control group （P 〈 0.01）. After treatment, VC, FEVI, FVC, and TLC of the experimental group were all higher than those before treatment, while RV was lower （P 〈 0.01）. After treatment, VC, FEV1, FVC, and TLC of the control group were all lower than those before treatment （P 〈 0.01）, while RV was higher （P 〈 0.01）. And the experimental group had higher VC, FEVI, FVC, and TLC than the control group, and had lower RV （P 〈 0.01）. After treatment, the main cobb angle of the bend and the compensatory curve cobb angle were lower than those before treatment in both the two groups of patients （P 〈 0.01）. The cobb angle of functional position and compensatory curve cobb angle of the experimental group were significantly lower than those of the control group （P 〈 0.01）. Conclusion By wearing the Cheneau Scoliosis brace for 18 to 20 hours every day combined with appropriate gymnastics therapy, respiratory training, strength training and McConkey mechanotherapy, we can improve the lung function, back muscle strength, spinal flexibility, body coordination and balance, so as to achieve better scoliosis treatment for the patients.