两种推拿手法治疗非肿块型肌性斜颈疗效比较

目的 观察君、臣、佐、使配伍推拿方法即揉推"颈部五线"联合抻颈肌、轻点穴治疗非肿块型肌性斜颈的临床疗效.方法 将71例非肿块型肌性斜颈患儿随机分为对照组(35例)和治疗组(36例),对照组采取传统推拿治疗,治疗组在此基础上结合原治疗经验增减,即以揉推"颈部五线"为君,以增加抻颈肌时间为臣,以轻点体穴为佐使.在治疗前,治疗3、6周后评定患儿颈部歪斜角度和颈部被动关节活动度,比较两组疗效.结果 与治疗前比较,两组治疗3、6周患侧旋转角度和健侧侧屈角度均显著增加(P<0.05),颈部歪斜角度均显著减小(P<0.05);治疗组侧旋转角度和健侧侧屈角度均显著大于对照组(P<0.05),颈部歪斜角度显著小于对照组(P<0.05).治疗组疗效优于对照组(P<0.05).结论 运用君、臣、佐、使配伍推拿方法治疗非肿块型肌性斜颈,对改善患儿颈部歪斜角度、颈部被动关节活动度效果确切,整体疗效优于传统推拿手法.

Clinical Effect of Two Massage Manipulation Techniques in Treatment of Non-mass Muscular Torticollis: A Comparative Analysis

Objective To investigate the clinical effect of the massage method based on the principles of monarch, minister, assistant, and guide, i.e., five-line neck movement combined with cervical muscle stretching and gentle acupuncture, in the treatment of non-mass muscular torticollis. Methods A total of 71 children with non-mass muscular torticollis were randomly divided into control group with 35 children and treatment group with 36 children. The children in the control group were given conventional massage, and those in the treatment group were given modified massage based on previous treatment experience, with five-line neck movement as monarch, increased duration of cervical muscle stretching as minister, and gentle acupuncture as assistant and guide. The skew angle of the neck and passive range of motion of the neck were evaluated before treatment and at 3 and 6 weeks of treatment, and clinical outcome was compared between the two groups. Results At 3 and 6 weeks of treatment, both groups had significant increases in the rotation angle of the ipsilateral side and the flexion angle of the contralateral side (P<0.05) and a significant reduction in the skew angle of the neck (P<0.05), and compared with the control group, the treatment group had significantly larger rotation angle of the ipsilateral side and flexion angle of the contralateral side (P<0.05) and a significantly smaller skew angle of the neck (P<0.05). The treatment group had a significantly better clinical outcome than the control group (P<0.05). Conclusion In the treatment of non-mass muscular torticollis, the massage method based on the principles of monarch, minister, assistant, and guide has a marked clinical effect in improving the skew angle of the neck and passive range of motion of the neck, with a better clinical effect than conventional massage.