保守治疗对青少年特发性脊柱侧凸患者Cobb角干预效果的Meta分析

Meta-analysis of the intervention effectiveness on Cobb angle of conservative treatment in patients with adolescent idiopathic scoliosis

中文关键词:  保守治疗  Cobb角  Schroth  肌筋膜链康复技术  核心稳定训练

英文关键词:Conservative treatment  Cobb angle  Schroth  Myofascial chain rehabilitation technique  Core stability training

中文摘要:

  【摘要】 目的：系统评价仅观察、支具、特定运动疗法（Schroth、SEAS等）、中医疗法、康复技术、一般运动疗法对青少年轻、中度特发性脊柱侧凸（adolescent idiopathic scoliosis，AIS）患者Cobb角的治疗效果。方法：系统检索Pubmed、The Cochrane Library、Embase、Web of Science、知网、万方、维普数据库，搜索青少年脊柱侧凸患者保守治疗方法的相关研究，检索时间自建库至2023年10月。由2位研究人员独立筛选文献、提取资料并评价纳入研究的偏倚风险后，采用Stata 14.0软件进行网状Meta分析。结果：共纳入16项研究，包括923例患者。Meta分析结果显示，AIS保守治疗对患者Cobb角累积排序曲线下面积从高到低依次为：Schroth+肌筋膜链康复技术>Schroth+色努支具>核心稳定训练+电针与整脊>Schroth+肌筋膜链推拿手法>Schroth+不同坐姿骑马训练>Schroth+“分节段式”脊柱推拿手法>Schroth+“通督五线”针法>Schroth+平乐正骨手法>Schroth+悬吊训练>核心稳定训练>“三步七法”推拿>“通督五线”针法>Schroth>自我矫正>仅观察>Schroth家庭疗法+推拿三维平面手法>本体感觉神经肌肉促进法>Schroth家庭疗法。结论：青少年轻、中度特发性脊柱侧凸的保守治疗中，Schroth结合肌筋膜链康复技术疗效较好。

英文摘要:

  【Abstract】 Objectives: To evaluate the treatment effectiveness on Cobb angle systematically of observation, bracing, specific exercise therapy(Schroth, SEAS, etc), traditional Chinese medicine therapy, rehabilitation techniques, and general exercise therapy in patients with mild to moderate adolescent idiopathic scoliosis(AIS). Methods: A systematic search of Pubmed, The Cochrane Library, Embase, Web of Science, CNKI, WanFang, and VIP databases was performed for studies related to conservative treatment methods for adolescent scoliosis patients from the time of their inceptions to October 2023. After 2 investigators independently screened the literature, extracted the information, and evaluated the risk of bias in the included studies, reticulated meta-analysis was performed using Stata 14.0 software. Results: A total of 16 studies, including 923 patients, were included. Meta-analysis showed that the surface under the cumulative ranking curve of AIS conservative treatment on patients′ Cobb angle was, in descending order, as follows: Schroth+Myofascial chain rehabilitation technique>Schroth+Cheneau brace>Core stability training+Electro-acupuncture and chiropractic>Schroth+Myofascial chain manipulation> Schroth+Different sitting position horse riding training>Schroth+"Segmental" spinal manipulation>Schroth+"Five-line Du-unblocking" acupuncture>Schroth+Pingle bone-setting manipulation>Schroth+Suspension training> Core stability training>"Three-step Seven-method" massage>"Five-line Du-unblocking" acupuncture>Schroth>Active self-correction>Observation only>Schroth home therapy+Three-dimensional plane massage>Proprioceptive neuromuscular facilitation>Schroth home therapy. Conclusions: Schroth combined with myofascial chain rehabilitation technique is the most effective in the conservative treatment modalities of mild to moderate AIS.