脊柱平衡疗法对青少年特发性脊柱侧凸患者肺功能及表面平均肌电比值的影响
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作者Author单位AddressE-Mail
杜红根 DU Hong-gen 浙江省中医院推拿科, 浙江 杭州 310006 Department of Massage, Zhejiang Provincial Hospital of TCM, Hangzhou 310006, Zhejiang, China duhonggen1212@163.com 
徐金元 XU Jin-yuan 浙江省中医院推拿科, 浙江 杭州 310006 Department of Massage, Zhejiang Provincial Hospital of TCM, Hangzhou 310006, Zhejiang, China  
蒋忠 JIANG Zhong 浙江省中医院推拿科, 浙江 杭州 310006 Department of Massage, Zhejiang Provincial Hospital of TCM, Hangzhou 310006, Zhejiang, China  
魏晖 WEI Hui 浙江省中医院推拿科, 浙江 杭州 310006 Department of Massage, Zhejiang Provincial Hospital of TCM, Hangzhou 310006, Zhejiang, China  
郁继伟 YU Ji-wei 浙江省中医院推拿科, 浙江 杭州 310006 Department of Massage, Zhejiang Provincial Hospital of TCM, Hangzhou 310006, Zhejiang, China  
叶树良 YE Shu-liang 浙江省中医院推拿科, 浙江 杭州 310006 Department of Massage, Zhejiang Provincial Hospital of TCM, Hangzhou 310006, Zhejiang, China  
宋鸿权 SONG Hong-quan 浙江省中医院推拿科, 浙江 杭州 310006 Department of Massage, Zhejiang Provincial Hospital of TCM, Hangzhou 310006, Zhejiang, China  
宁喜涛 NING Xi-tao 浙江省中医院推拿科, 浙江 杭州 310006 Department of Massage, Zhejiang Provincial Hospital of TCM, Hangzhou 310006, Zhejiang, China  
王焕明 WANG Huan-ming 浙江省中医院推拿科, 浙江 杭州 310006 Department of Massage, Zhejiang Provincial Hospital of TCM, Hangzhou 310006, Zhejiang, China  
期刊信息:《中国骨伤》2016年,第29卷,第4期,第316-319页
DOI:10.3969/j.issn.1003-0034.2016.04.006
基金项目:浙江省中医药科技计划优秀青年人才基金(编号:2012ZQ011)
中文摘要:

目的:评价中医脊柱平衡综合疗法(导引、推拿、小针刀)对青少年特发性脊柱侧凸患者(AIS)肺功能和侧凸两侧表面平均肌电(AEMG)比值的影响.

方法:2008年3月至2014年2月收集的AIS门诊病例140例,男40例,女83例;年龄9~12岁.随机分为中医组(中医综合疗法65例)和对照组(支具法58例).治疗组采用导引2次/d,40 min/次;脊柱平衡推拿正骨2次/周,25 min/次,12个月;脊柱平衡针刀松解1次/周,共10次.对照组应用Milwaukee支具治疗,至少22 h/d,连续佩戴12个月.观察两组患者治疗后第12个月的肺功能,治疗后6、12、18、24个月时的侧凸两侧表面平均肌电(AEMG)比值,其中肺功能的观察指标包括肺活量(VC)、第1秒用力呼气容积占用力肺活量的百分比(FEV1/FVC)、每分钟最大通气量(MVV).

结果:治疗组VC、FEV1/FVC、MVV各指标较治疗前上升(P<0.05),对照组各指标下降(P<0.05);AEMG比值的动态观测,治疗组表现为持续降低并趋向于1,表明侧凸两侧肌张力的不平衡改善;对照组比值增大,表明侧凸两侧肌张力不平衡加剧,侧凸进展.

结论:遵循中医"筋骨并治"动静结合"原则的中医脊柱平衡法能显着改善侧凸脊柱肌力不平衡,阻止侧凸进展,并能提高肺功能;动态观测侧凸脊柱两侧的AEMG比值是评价疗效和评估侧凸进展的有效方法,可替代定期、频繁X线摄片,避免对青少年身体造成潜在危害.
【关键词】青少年  表面肌电图  肺功能  脊柱侧凸  正骨手法  随机对照试验
 
Influences of spine balanced therapies of traditional Chinese medicine in adolescent idiopathic scoliosis in pulmonary function and average ratio of the surface electromyogram
ABSTRACT  

Objective:To evaluate the influences of spine balanced therapies with traditional Chinese medicine on pulmonary function and average electromyogram(AEMG) ratio of the surface electromyogram of adolescent idiopathic scoliosis.

Methods:From March 2008 to Februry 2014,140 outpatients with mild and moderate adolescent idiopathic scoliosis included 40 males and 83 females,ranging in age from 9 to 12 years old were collected. The patients were randomly divided into TCM group (65 cases) and control group (58 cases). In TCM group,the patients underwent Daoyin of the spinal balance (twice a day,40min time); the balance spinal manipulation(twice a week,25 min/time),lasted 12 months;acupotomology therapy (once a week,10 times in total). In control group,the patients were treated with Milwaukee brace(22 hours per day,wearing for 12 months). The pulmonary function was determined after 12 months of treatment,and average electromyogram (AEMG) ratio of the surface electromyogram was measured after 6 months and 12 months of treatment and followed up after 18 and 24 months. Observation indexes of lung function included the forced vital capacity (VC),the percentage of forced expiratory volume in 1 second of forced vital capacity(FEV1/FVC),the chase volume per minute(MVV).

Results:The pulmonary function was significantly improved after 12 months treatment in TCM group(P<0.05) but significantly decreased in control group (P<0.05). The AEMG ratio was significantly reduced(P<0.01) and tended to remain at 1 after stopping treatment in TCM group,showed that the muscle imbalance existed on both sides of the scoliosis tend to balance,but was adverse in control group (P<0.05),showed that the muscle imbalance aggravated.

Conclusion:The spine balanced tharapies followed the principles of TCM "joints and softtissues cured together" "static and dynamic combining" can significantly improve muscle imbalance of the scoliosis,prevented the progression of scoliosis and can improve the lung function. The technique of dynamic observation in AEMG ratio is a new strategy that could replace radiography in evaluation of treatment effect and progression in scoliosis,reduce the potential damage caused by repeated frequent X-ray exposure of the body.
KEY WORDS  Adolescent  Surface electromyography  Pulmonary function  Scoliosis  Bone setting manipulation  Randomized controlled trial
 
引用本文,请按以下格式著录参考文献:
中文格式:杜红根,徐金元,蒋忠,魏晖,郁继伟,叶树良,宋鸿权,宁喜涛,王焕明.脊柱平衡疗法对青少年特发性脊柱侧凸患者肺功能及表面平均肌电比值的影响[J].中国骨伤,2016,29(4):316~319
英文格式:DU Hong-gen,XU Jin-yuan,JIANG Zhong,WEI Hui,YU Ji-wei,YE Shu-liang,SONG Hong-quan,NING Xi-tao,WANG Huan-ming.Influences of spine balanced therapies of traditional Chinese medicine in adolescent idiopathic scoliosis in pulmonary function and average ratio of the surface electromyogram[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(4):316~319
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