1.甘肃省中医院,甘肃省兰州市七里河区瓜州路418号,730050
2.甘肃省第二人民医院
3.甘肃中医药大学
403132880@qq.com
收稿:2021-10-25,
修回:2022-01-29,
纸质出版:2022-05-02
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黄晋,裴生太,李竞等.中医牵引舒筋手法治疗0~6月龄婴儿发育性髋关节发育不良30例临床观察[J].中医杂志,2022,63(09):856-861.
HUANG Jin,PEI Shengtai,LI Jing,et al.Traditional Clinical Observation on Chinese Medicine Traction and Sinews-relaxing Manipulation for 30 Cases of Developmental Dysplasia of the Hip in Infants up to Six Months of Age[J].Journal of Traditional Chinese Medicine,2022,63(09):856-861.
黄晋,裴生太,李竞等.中医牵引舒筋手法治疗0~6月龄婴儿发育性髋关节发育不良30例临床观察[J].中医杂志,2022,63(09):856-861. DOI: 10.13288/j.11-2166/r.2022.09.012.
HUANG Jin,PEI Shengtai,LI Jing,et al.Traditional Clinical Observation on Chinese Medicine Traction and Sinews-relaxing Manipulation for 30 Cases of Developmental Dysplasia of the Hip in Infants up to Six Months of Age[J].Journal of Traditional Chinese Medicine,2022,63(09):856-861. DOI: 10.13288/j.11-2166/r.2022.09.012.
目的
2
观察中医牵引舒筋手法治疗发育性髋关节发育不良(DDH)的临床疗效和安全性。
方法
2
选取0~6月龄DDH患儿60例,按随机数字表法分为治疗组和对照组各30例,其中治疗组患髋数为35个,对照组为36个。治疗组予中医牵引舒筋手法治疗,对照组予Pavlik吊带治疗,两组均每周治疗3天,治疗12周。比较两组患儿治疗4周后Ortolani征及Barlow征,评价患儿髋关节的稳定性;比较两组患儿治疗12周后髋关节超声Graf法检查的α角、β角,并进行临床疗效及安全性评价;同时记录临床治疗费用。
结果
2
治疗4周后,两组患儿Ortolani征、Barlow征阳性者均转为阴性(
P
<0.05)。治疗12周后,两组患儿α角明显增大、β角明显减小(
P
<0.05);治疗组治愈30髋、治愈率85.71%(30/35),对照组治愈32髋、治愈率为88.89%,两组治愈率差异无统计学意义(
P
>0.05)。两组患儿获得随访,治疗组随访时间(12.35±1.82)个月,对照组随访时间(12.78±3.56)个月,除对照组出现2例(2髋)腘窝处皮肤损伤外,两组患儿均无其他并发症和不良反应事件发生,且对照组治疗费用较治疗组明显升高(
P
<0.05)。
结论
2
牵引舒筋手法与Pavlik吊带治疗婴儿DDH,均能使患儿的骨性髋臼和软骨性髋臼得到不同程度的恢复,促使患髋趋于稳定,两种治疗方法疗效相当,但牵引舒筋手法安全性更高、治疗费用更低廉。
Objective
2
To explore the clinical effect and safety of traditional Chinese medicine (TCM) traction and sinews-relaxing manipulation for developmental dysplasia of the hip (DDH).
Methods
2
Sixty infants aged 0-6 months with DDH were divided into treatment group and control group using a random number table, with 30 cases in each group, 35 dysplastic hips in the treatment group and 36 dysplastic hips in the control group. TCM traction and sinews-relaxing manipulation was performed in the treatment group, while Pavlik harness was used in the control group, both at a frequency of 3 days a week for totally 12 weeks. The Ortolani sign and Barlow sign were recorded, and the stability of the hip joint was assessed after 4-week treatment. The α and β angle values of the hip joint by ultrasound Graf method were recorded, and the clinical effect and safety were evaluated after 12-week treatment. The treatment cost was analyzed.
Results
2
After 4-week treatment, the positive results of Ortolani and Barlow sign test were all turned into negative in both groups (
P
<0.05). After 12-week treatment, the α angle increased while the β angle decreased significantly in both groups (
P
<0.05); 30 hips (85.71%,) were cured in the treatment group, while 32 hips (88.89%) were cured in the control group, with no significant difference between groups (
P
>0.05). The duration of the follow-up was 12.35±1.82 months in the treatment group, and was 12.78±3.56 months in the control group. Except for the two cases of skin injury at the popliteal fossa in the control group, there were no other complications and adverse events in both groups. The treatment cost in the control group was significantly higher than that in the treatment group (
P
<0.05).
Conclusion
2
Traction and sinews-relaxing manipulation and Pavlik harness have equivalent effect on restoring the bony acetabulum and cartilaginous acetabulum in different degrees, and promoting the stability of the affected hip in DDH infants. Moreover, Traction and sinews-relaxing manipulation is safer and cheaper.
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