不同牵拉时间对小儿肌性斜颈干预的临床疗效观察

发布时间：2018-01-31 21:49

本文关键词： 不同牵拉时间小儿肌性斜颈临床疗效　出处：《福建中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过观察不同牵拉时间治疗小儿肌性斜颈的临床疗效,初步探讨不同牵拉时间对CMT临床疗效的影响,为临床上提高推拿治疗小儿肌性斜颈临床疗效提供一种简便可行、确实有效的方法。方法:按照本课题中诊断、纳入和排除标准选择福建中医药大学附属康复医院儿童康复科及推拿科2015年8月-2016年10月间小儿肌性斜颈患儿60例,按照随机分组的方法分为治疗组和对照组,每组各30例。两组均采用"按揉法、弹拨法、拿捏法及被动牵拉法"治疗,其中被动牵拉法治疗组予"每次牵拉30s,牵拉10次",对照组予"每次牵拉10s,牵拉10次",两组均每日1次,每周5次,20次为1个疗程,治疗3个疗程。治疗前后分别对两组患儿进行彩色多普勒超声检查及小儿斜颈病疗效评价量表评分。将两组收集的数据,应用SPSS21.0统计分析软件进行统计学处理。根据分析结果,比较两组的临床疗效。结果:研究结束后,治疗组完成研究28例,对照组完成研究29例。统计分析结果如下:1.临床疗效:治疗组治愈7例,显效8例,有效9例,无效4例,总有效率85.7%;对照组治愈2例,显效4例,有效13例,无效10例,总有效率65.5%。两组疗效经统计学处理,具有显著性差异(P0.01)。说明治疗组疗效优于对照组。2.治疗后,记录两组彩色多普勒超声检查指标,两组进行治疗前后组内比较,均有显著性差异(P0.01),说明两组在改善肿块大小方面都有显著疗效。治疗后,对小儿斜颈病疗效评价量表评分,两组进行治疗前后组内比较,两组"颈斜程度"、"胸锁乳突肌变化"、"肿块硬度"、"颈椎旋转情况"、"颈椎侧弯情况"及"总分"比较均有显著性差异(P0.01),两组"肿块大小"比较,差异有统计学意义(P0.05),说明两组在改善小儿肌性斜颈症状与体征方面都有显著疗效,尤其在改善"颈斜程度"、"胸锁乳突肌变化"、"肿块硬度"、"颈椎旋转情况"及"颈椎侧弯情况"方面疗效更明显。3.治疗后,两组彩色多普勒超声检查指标进行组间比较,差异无统计学意义(P0.05)。说明两组在改善肿块大小方面疗效相当。治疗后,对小儿斜颈病疗效评价量表评分,两组进行组间比较,两组"颈斜程度"、"胸锁乳突肌变化"、"肿块硬度"、"颈椎旋转情况"、"颈椎侧弯情况"及"总分"比较,差异有统计学意义(P0.05),两组"肿块大小"比较,差异无统计学意义(P0.05)。说明治疗组在改善CMT患儿症状和体征,尤其是"颈斜程度"、"胸锁乳突肌变化"、"肿块硬度"、"颈椎旋转情况"及"颈椎侧弯情况"方面更有效;而在改善"肿块大小"方面,两者疗效相当。结论:不同牵拉时间对CMT的临床疗效有影响,"每次牵拉30s,牵拉10次"能更明显改善CMT患儿的临床症状及体征,能有效提高推拿治疗CMT的临床疗效。
[Abstract]:Objective: to observe the clinical effect of different stretch time on children muscular torticollis and to explore the effect of different stretch time on the clinical effect of CMT. To provide a simple and effective method for improving the clinical efficacy of massage in treating children with muscular torticollis. Methods: according to the diagnosis of this subject. From August 2015 to October 2016, 60 cases of children with muscular torticollis were selected from the Department of Child Rehabilitation and the Department of Massage in the Rehabilitation Hospital affiliated to Fujian University of traditional Chinese Medicine. According to the method of random grouping, each group was divided into treatment group (30 cases) and control group (30 cases). The two groups were treated with "pressing kneading method, spring plucking method, kneading method and passive pulling method". The passive traction treatment group was given "30 s each time, 10 times", while the control group was given "10 times each time, 10 times a time". The two groups were treated once a day, 5 times a week for 20 times as a course of treatment. Three courses of treatment. Before and after the treatment of the two groups of children were examined by color Doppler ultrasound and children with torticollis evaluation scale score. The data collected by the two groups. According to the analysis results, the clinical efficacy of the two groups was compared. Results: after the end of the study, the treatment group completed the study of 28 cases. The results of statistical analysis were as follows: 1. Clinical efficacy: 7 cases were cured, 8 cases were markedly effective, 9 cases were effective, 4 cases were ineffective in the treatment group, the total effective rate was 85.7%. In the control group, 2 cases were cured, 4 cases were markedly effective, 13 cases were effective, 10 cases were ineffective, and the total effective rate was 65.5%. The results showed that the therapeutic effect of the treatment group was better than that of the control group. 2. After treatment, the indexes of color Doppler ultrasound were recorded and compared between the two groups before and after treatment. There was significant difference between the two groups in improving the size of the tumor. After treatment, the evaluation scale of children's torticollis was evaluated, and the comparison between the two groups before and after treatment was made. There were significant differences in "cervical oblique degree", "changes of sternocleidomastoid muscle", "hardness of mass", "rotation of cervical spine", "lateral curvature of cervical spine" and "total score" between the two groups (P 0.01). The difference of "mass size" between the two groups was statistically significant (P 0.05), which indicated that the two groups had significant effects in improving the symptoms and signs of muscular torticollis in children, especially in improving the "degree of cervical oblique". "changes of sternocleidomastoid muscle", "hardness of mass", "rotation of cervical spine" and "lateral curvature of cervical vertebra" were more obvious. 3. After treatment, the indexes of color Doppler ultrasound were compared between the two groups. There was no significant difference between the two groups in improving the size of the tumor. After treatment, the evaluation scale for the efficacy of children with torticollis was scored and compared between the two groups. The degree of cervical oblique, the change of sternocleidomastoid muscle, the hardness of mass, the rotation of cervical vertebra, the degree of lateral curvature of cervical spine and the total score were significantly different between the two groups (P 0.05). There was no significant difference in the size of mass between the two groups (P 0.05). It indicated that the treatment group was improving the symptoms and signs of CMT, especially the degree of cervical oblique and the change of sternocleidomastoid muscle. "Mass hardness", "cervical spine rotation" and "cervical scoliosis" are more effective; But in the aspect of improving the "tumor size", the curative effect is equal. Conclusion: different traction time has influence on the clinical curative effect of CMT, "30 s each time." Pulling 10 times can significantly improve the clinical symptoms and signs of children with CMT, can effectively improve the clinical efficacy of massage in the treatment of CMT.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R244.1

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