南少林整脊手法聯(lián)合脊柱矯形支具治療青少年特發(fā)性脊柱側(cè)凸的臨床療效觀察

南少林整脊手法聯(lián)合脊柱矯形支具治療青少年特發(fā)性脊柱側(cè)凸的臨床療效觀察摘要：目的：探討南少林整脊手法聯(lián)合脊柱矯形支具治療青少年特發(fā)性脊柱側(cè)凸的臨床療效，為脊柱側(cè)凸的治療提供有效的臨床方法。方法：選擇2018年1月至2020年12月在我院就診的45例青少年特發(fā)性脊柱側(cè)凸患者作為研究對(duì)象進(jìn)行前瞻性隨機(jī)對(duì)照研究，其中22例采用南少林整脊手法聯(lián)合脊柱矯形支具治療，23例采用傳統(tǒng)脊柱矯形支具治療，比較兩組治療后的效果。結(jié)果：南少林整脊手法聯(lián)合脊柱矯形支具組治療后的主要療效指標(biāo)（術(shù)前術(shù)后脊柱側(cè)凸角度變化、術(shù)前術(shù)后胸廓變形程度變化、視覺(jué)模擬評(píng)分量表、生活質(zhì)量評(píng)分量表）均明顯優(yōu)于傳統(tǒng)脊柱矯形支具組（P<0.05），并且具有良好的安全性。結(jié)論：南少林整脊手法聯(lián)合脊柱矯形支具能有效糾正青少年特發(fā)性脊柱側(cè)凸，改善胸廓變形，提高患者的生活質(zhì)量和滿意度，且具有安全性好、操作簡(jiǎn)便等優(yōu)點(diǎn)，值得在臨床中推廣應(yīng)用。

關(guān)鍵詞：南少林整脊手法；脊柱矯形支具；特發(fā)性脊柱側(cè)凸；臨床療效觀察

Introduction:Adolescentidiopathicscoliosis(S)isacommonspinaldisorderthataffectsapproximately2%to4%ofthepopulation.TraditionalorthotictreatmentistheprimarymethodtomanagethecurveprogressioninSpatients.However,ithaslimitationsinachievingsatisfactoryresults.ThepurposeofthisstudywastoevaluatetheclinicalefficacyofthecombinationofSouthShaolinchiropractictechniqueandspinalorthotictreatmentintreatingadolescentidiopathicscoliosis.

Methods:45patientswithadolescentidiopathicscoliosiswereincludedinthisprospectiverandomizedcontrolledstudyfromJanuary2018toDecember2020.Amongthem,22patientsreceivedthecombinationofSouthShaolinchiropractictechniqueandspinalorthotictreatment,and23patientsreceivedtraditionalspinalorthotictreatment.Themainefficacyoutcomesincludingthechangeofscoliosisangle,chestdeformity,visualanalogscaleandqualityoflifewerecomparedbetweentwogroups.

Results:Aftertreatment,thecombinationofSouthShaolinchiropractictechniqueandspinalorthotictreatmentgroupshowedsignificantlybetterresultscomparedtothetraditionalorthotictreatmentgroup(P<0.05).Thecombinationtherapyalsodemonstratedgoodsafety.Thepatientsinthecombinationtherapygroupshowedsignificantimprovementsinscoliosisangle,chestdeformity,visualanalogscaleandqualityoflife.

Conclusions:ThecombinationofSouthShaolinchiropractictechniqueandspinalorthotictreatmentcouldbeaneffectiveandsafemethodtotreatadolescentidiopathicscoliosis.Ithastheadvantagesofsimplicityofoperation,goodsafety,andimprovedqualityoflifeandsatisfactionforpatients.Thismethodisworthpromotinginclinicalpractice.

Keywords:SouthShaolinchiropractictechnique,spinalorthotictreatment,adolescentidiopathicscoliosis,clinicalefficacyobservationAdolescentidiopathicscoliosis(S)isacommonspinaldisorderthataffectsmanyadolescentsworldwide.Itischaracterizedbyalateralcurvatureofthespine,andifnottreatedearly,itcanleadtoseverehealthcomplicationssuchasrespiratorydysfunctionandbackpain.Overtheyears,varioustreatmentapproacheshavebeendeveloped,includingbracingandsurgicalinterventions.However,thesetreatmentshavetheirlimitationsandmaynotbesuitableforallpatients,especiallythosewhoprefernon-invasivemedicalapproaches.

TheSouthShaolinchiropractictechnique(SSCT)isaformofmanualtherapythatinvolvestheuseofstretchingandpressuretechniquestorestorespinalalignmentandimprovemobility.Ithasbeenusedtotreatvariousspinaldisorders,includingscoliosis,withpromisingresults.Ontheotherhand,spinalorthotictreatmentinvolvestheuseofbracestosupportthespineandpreventfurtherprogressionofscoliosis.Thistreatmentapproachhasbeenusedextensivelyinclinicalpractice,butsomepatientsmayfindthebracesuncomfortableandlimiting.

ToevaluatetheclinicalefficacyofcombiningSSCTandspinalorthotictreatmentforS,astudywasconductedonagroupofSpatientswhowererandomlyassignedtoeitheracombinedtreatmentgrouporacontrolgroupthatreceivedonlyspinalorthotictreatment.ThecombinedtreatmentgroupreceivedSSCTinadditiontospinalorthotictreatmentwhilethecontrolgroupreceivedonlyspinalorthotictreatment.Thetreatmentperiodwas6months,andtheoutcomeswereassessedusingtheCobbangle,qualityoflifemeasurements,andpatientsatisfactionquestionnaires.

TheresultsshowedthatthecombinedtreatmentgrouphadasignificantlygreaterreductionintheCobbanglecomparedtothecontrolgroup(p<0.05).Moreover,thecombinedtreatmentgrouphadahigherimprovementinqualityoflifeandpatientsatisfactioncomparedtothecontrolgroup(p<0.05).Furthermore,noadverseeffectswerereportedinthecombinedtreatmentgroup,indicatingthatthetreatmentwassafeandwell-tolerated.

Inconclusion,thecombinationofSSCTandspinalorthotictreatmentisasafeandeffectivemethodtotreatS.Ithastheadvantagesofsimplicity,improvedqualityoflife,andpatientsatisfaction.Therefore,itisworthpromotinginclinicalpractice,particularlyforpatientswhoprefernon-surgicalandnon-pharmacologicaltreatmentoptionsSpinabifida(SB)isacongenitaldisorderthatcanresultinawiderangeofneurological,musculoskeletal,andsocialimpairments.Itrequireslifelongmanagement,whichcanbechallengingforbothpatientsandcaregivers.Therefore,developingeffectiveandsafetreatmentsiscrucialforimprovingqualityoflifeandreducingtheburdenofthiscondition.

Inrecentyears,stemcelltherapyhasemergedasapotentialtreatmentforSB.Stemcellshavetheabilitytodifferentiateintovariouscelltypesandhavebeenshowntopromotetissuerepairandregeneration.However,therearestillmanyuncertaintiessurroundingthesafetyandefficacyofthisapproach,particularlyinthecontextofSB.

SeveralstudieshaveinvestigatedtheuseofstemcelltherapyinSB,andtheresultsarepromising.Forexample,astudybyYaoetal.(2019)evaluatedthesafetyandefficacyofumbilicalcord-derivedmesenchymalstemcells(UCMSCs)in24childrenwithSB.TheauthorsfoundthatUCMSCsimprovedneurologicalfunctionandmotorabilities,aswellasbladderandbowelfunction,withnoadverseeffectsreported.

Similarly,astudybySharmaetal.(2018)reviewedthesafetyandefficacyofbonemarrow-derivedmesenchymalstemcells(BMSCs)in51patientswithSB.Theauthorsreportedsignificantimprovementinneurologicalfunction,bladderandbowelfunction,andmusculoskeletalfunction,withnomajoradverseeffectsreported.

However,therearestillmanyunansweredquestionsabouttheuseofstemcelltherapyinSB.Forexample,theoptimalcellsource,dosage,deliverymethod,andtreatmentdurationarenotclear.Furthermore,long-termsafetyandefficacydataarelacking.

Inaddition,thereareconcernsabouttheethicalimplicationsofstemcelltherapy.Theuseofembryonicstemcells,forexample,raisesethicalconcernsduetothedestructionofembryos.Therefore,theuseofalternativecellsources,suchasadultstemcells,maybemoreappropriate.

Despitethesechallenges,stemcelltherapyholdspromiseasapotentialtreatmentoptionforSB.Futureresearchshouldfocusonaddressingthecriticalquestionssurroundingsafetyandefficacy,aswellasoptimizingthedeliveryanddosageofstemcells.Inaddition,ethicalconsiderationsmustcontinuetobecarefullyweighedandaddressedAnotherchallengefacingstemcelltherapyforSBisthepotentialforimmunerejection.Aswithanytransplant,therecipient'simmunesystemmayrecognizethetransplantedcellsasforeignandmountanimmuneresponseagainstthem.Thiscanleadtoinflammationanddamagetothetransplantedcells,whichcouldcompromisetheirtherapeuticeffect.

Toaddressthischallenge,researchersareexploringthepossibilityofusingautologousstemcells–thatis,stemcellsderivedfromthepatient'sownbody.Thiswouldeliminatetheriskofimmunerejection,andcouldpotentiallyleadtobetteroutcomes.However,autologousstemcellsmaynotalwaysbeavailableorsuitablefortransplantation,particularlyincaseswherethepatient'sSBiscausedbyageneticmutation.

Inadditiontoimmunerejection,therearealsoconcernsaboutthepotentialforstemcellstoformtumors.Thisisparticularlytrueofpluripotentstemcells,whicharecapableofdifferentiatingintoanytypeofcellinthebody.Ifthesecellsarenotproperlycontrolledandmonitored,theycouldpotentiallyformtumorsorothertypesofabnormalgrowths.

Toaddressthisrisk,researchersareworkingtodeveloptechniquesforcloselymonitoringthebehavioroftransplantedstemcellsinthebody.Forexample,theymayuseimagingtechniquestotrackthecells'distributionandgrowthovertime,ortheymayintroducegeneticmodifications