“通络调颈法”配合高频超声联合剪切波弹性成像技术治疗小儿肌性斜颈的疗效观察

doi:10.20274/j.cnki.issn.1674-3865.2026.04.014

中国中西医结合儿科学 ›› 2026, Vol. 18 ›› Issue (4): 344-347.doi: 10.20274/j.cnki.issn.1674-3865.2026.04.014

• 临床研究 • 上一篇

“通络调颈法”配合高频超声联合剪切波弹性成像技术治疗小儿肌性斜颈的疗效观察

王雪娇¹, 王茜², 郭巍娜¹, 李娜¹, 武子英¹, 施颖¹, 宋勤丽¹, 韩海琼¹()

201803 上海，上海市嘉定区江桥镇社区卫生服务中心康复医学科（王雪娇，李娜，武子英，施颖，宋勤丽，韩海琼），医务部（郭巍娜）
201800 上海，上海市嘉定区中医医院推拿科（王茜）

收稿日期:2025-10-24 修回日期:2026-04-29 出版日期:2026-08-25 上线日期:2026-08-31
通讯作者: 韩海琼 E-mail:771918223@qq.com
作者简介:王雪娇（1991-），女，医学硕士，主治医师。研究方向：推拿治疗厌食症、便秘、咳嗽、脊柱侧弯等小儿疾病
基金资助:
上海市市级名中医工作室基层工作站建设项目(JCGZZ-2025056);嘉定区公立医院改革与高质量发展示范项目“疁城杏林”人才培养计划(JDLCXLXZ-12);上海市卫生健康委员会中医药科研项目(2024QN068)

Clinical efficacy observation of "meridian unblocking and neck regulation method" combined with high-frequency ultrasound and SWE technology in the treatment of pediatric muscular torticollis

Xuejiao WANG¹, Qian WANG², Weina GUO¹, Na LI¹, Ziying WU¹, Ying SHI¹, Qinli SONG¹, Haiqiong HAN¹()

^1.Jiangqiao Town Community Health Service Center of Jiading District，Shanghai 201803，China
^2.Jiading District Hospital of Traditional Chinese Medicine，Shanghai 201800，China

Received:2025-10-24 Revised:2026-04-29 Published:2026-08-25 Online:2026-08-31
Contact: Haiqiong HAN E-mail:771918223@qq.com
Supported by:
Shanghai Municipal Health Commission Traditional Chinese Medicine Research Projects(2024QN068)

摘要/Abstract

摘要：

目的探讨海派儿科推拿“通络调颈法”治疗小儿肌性斜颈的临床疗效，并通过高频超声联合剪切波弹性成像技术定量评估治疗前后胸锁乳突肌杨氏模量值、剪切波速度及厚度的变化。方法选取2022年12月至2025年8月在上海市嘉定区江桥镇社区卫生服务中心康复医学科门诊就诊的肌性斜颈患儿32例作为研究对象，给予海派儿科推拿“通络调颈法”治疗，每日1次，每周5次，持续6个月。分别于治疗前和治疗6个月后采用高频超声联合剪切波弹性成像技术测量患侧胸锁乳突肌的杨氏模量值、剪切波速度及厚度，并评估临床疗效。结果治疗后，32例患儿中痊愈25例(78.1%)，好转6例(18.7%)，无效1例(3.2%)，总有效率为96.8%。治疗后患侧胸锁乳突肌杨氏模量值、剪切波速度、厚度均低于治疗前，差异有统计学意义（P<0.05）。结论海派儿科推拿“通络调颈法”治疗小儿肌性斜颈疗效确切，能显著改善胸锁乳突肌的硬度和厚度，改善患儿症状，方法值得推广。

关键词: 肌性斜颈, 海派儿科推拿, 剪切波弹性成像, 通络调颈, 儿童

Abstract:

Objective To investigate the clinical efficacy of the Shanghai-style pediatric massage technique "meridian unblocking and neck regulation method" in the treatment of pediatric muscular torticollis, and to quantitatively assess the changes in the Young's modulus， shear wave velocity and thickness of the sternocleidomastoid muscle before and after treatment using high-frequency ultrasound combined with shear wave elastography (SWE). Methods A total of 32 pediatric patients with muscular torticollis were selected as research subjects, who visited Jiangqiao Town Community Health Service Center of Jiading District in Shanghai between Dec. 2022 and Aug. 2025, and they were treated with the Shanghai-style pediatric massage technique "meridian unblocking and neck regulation method", once a day for five days per week over a period of six months. Before treatment and after six months of treatment， the Young's modulus， shear wave velocity and thickness of the sternocleidomastoid muscle in the affected side were measured using high-frequency ultrasound combined with SWE technology, and clinical efficacy was evaluated. Results After treatment， 25 (78.1%) of the 32 pediatric patients achieved complete recovery， 6 (18.7%) showed improvement， and 1 (3.2%) had no response， resulting in a total effective rate of 96.8%. The Young's modulus， shear wave velocity and thickness of the sternocleidomastoid muscle in the affected side exhibited significant reductions after treatment， with marked differences observed between pre- and post-treatment values (P<0.05). Conclusion The Shanghai-style pediatric massage technique "meridian unblocking and neck regulation method" demonstrates definitive efficacy in the treatment of pediatric muscular torticollis. It significantly improves the stiffness and thickness of the sternocleidomastoid muscle and alleviates the symptoms， making this approach worthy of promotion.

Key words: Muscular torticollis, Shanghai-style pediatric massage, SWE, Meridian unblocking and neck regulation, Child

中图分类号:

R726.8

王雪娇, 王茜, 郭巍娜, 李娜, 武子英, 施颖, 宋勤丽, 韩海琼. “通络调颈法”配合高频超声联合剪切波弹性成像技术治疗小儿肌性斜颈的疗效观察[J]. 中国中西医结合儿科学, 2026, 18(4): 344-347.

Xuejiao WANG, Qian WANG, Weina GUO, Na LI, Ziying WU, Ying SHI, Qinli SONG, Haiqiong HAN. Clinical efficacy observation of "meridian unblocking and neck regulation method" combined with high-frequency ultrasound and SWE technology in the treatment of pediatric muscular torticollis[J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2026, 18(4): 344-347.

图/表 1

参考文献 31

[1]	袁凤明,宋维铭.先天性肌性斜颈的研究进展[J].中国医疗美容,2022,12(12):44-49.
[2]	Joyce MB, de Chalain TM. Treatment of recalcitrant idiopathic muscular torticollis in infants with botulinum toxin type A[J]. J Craniofac Surg， 2005，16(2):321-327.
[3]	王红桢,于娟,张璇.推拿治疗先天性肌性斜颈的研究进展[J].中国民间疗法,2025,33(10):112-115.
[4]	王林林.推拿结合针刺治疗小儿包块型肌性斜颈临床观察[J].内蒙古中医药,2023,42(4):129-130.
[5]	许丽,魏理珍,陈远青.小儿肌性斜颈的鉴别与中医治疗[J].中国中西医结合儿科学,2011,3(4):295-296.
[6]	李茂林,杜君威.基于理筋理论四步法推拿治疗先天性肌性斜颈[J].光明中医,2025,40(13):2706-2709.
[7]	Kaplan SL, Coulter C, Sargent B. Physical therapy management of congenital muscular torticollis: a 2018 evidence-based clinical practice guideline from the APTA academy of pediatric physical therapy[J]. Pediatr Phys Ther， 2018，30(4):240-290.
[8]	阮雯聪,金慧英,杨屏日,等.先天性肌性斜颈严重程度评分表对小儿先天性肌性斜颈诊断及预后的评估价值[J].中华物理医学与康复杂志,2021,43(9):821-825.
[9]	Tien YC, Su JY, Lin GT, et al. Ultrasonographic study of the coexistence of muscular torticollis and dysplasia of the hip[J]. J Pediatr Orthop， 2001，21(3):343-347.
[10]	邱鑫,熊竹,曾帅丹,等. 腔镜治疗儿童先天性肌性斜颈的系统评价和Meta分析[J]. 中华小儿外科杂志,2021,42(5):392-402.
[11]	Pan P. The Transaxillary subcutaneous endoscopic sternocleido⁃mastoid muscle division as an approach for the surgical treatment of congenital muscular torticollis in children[J]. Indian J Otolaryngol Head Neck Surg， 2020，72(1):123-127.
[12]	王珂.推拿联合穴位热敷治疗小儿先天性肌性斜颈临床观察[J].中国中西医结合儿科学,2019,11(1):88-90.
[13]	方芳,胡恩庆,王佳佳,等.推拿联合中药外用治疗肿块型先天性肌性斜颈28例[J].安徽中医药大学学报,2025,44(1):76-79.
[14]	谭龙泽,刘春雷,王跑球,等.以“补脾强肾”为主的特定穴推拿对脑性瘫痪患儿脑血流状态的影响[J].中国中西医结合儿科学,2022,14(6):473-476.
[15]	梁梦,陈晶晶,左金兰,等.推拿治疗小儿厌食症经验撷菁[J].中国中西医结合儿科学,2024,16(1):58-62.
[16]	留碧丽,李敏,夏文霞,等.常规超声联合SWE在婴幼儿先天性肌性斜颈早期诊治中的应用价值[J].现代实用医学,2021,33(1):52-53.
[17]	许娜,夏焙,唐宁宁,等.胸锁乳突肌剪切波弹性成像影响因素在先天性肌性斜颈早期诊断中的应用[J].中华医学超声杂志(电子版),2018,15(2):111-118.
[18]	Kaplan SL, Coulter C, Fetters L. Physical therapy management of congenital muscular torticollis: an evidence-based clinical practice guideline: from the Section on Pediatrics of the American Physical Therapy Association[J]. Pediatr Phys Ther， 2013，25(4):348-394.
[19]	郝惠秋.捏脊推拿对严重功能性消化不良伴厌食症的疗效观察[J].四川中医,2016,34(1):194-196.
[20]	何玉华,康静.手法推拿配合中药外敷治疗小儿先天性肌性斜颈28例[J].中医外治杂志,2011,20(6):11-12.
[21]	俞其囡,张玮涛,傅建明.姿势矫正联合推拿治疗小儿先天性肌性斜颈效果观察[J].中国乡村医药,2025,32(7):16-18.
[22]	林依玮,陈思龙,许丽.许丽治疗小儿先天性肌性斜颈失治经验介绍[J].新中医,2024,56(8):208-212.
[23]	何敏,汪建军,汪顺富.推拿弹拨手法结合家庭康复护理治疗小儿先天性肌性斜颈的临床观察[J].中医药临床杂志,2024,36(8):1595-1599.
[24]	赵江波,任小英.中医推拿治疗小儿肌性斜颈的研究进展[J].中医临床研究,2020,12(28):146-148.
[25]	Li S, Zhao W, Sun X. Comment on "Traditional Chinese medicine (TCM) massage for the treatment of congenital muscular torticollis (CMT) in infants and children: A systematic review and meta-analysis"[J]. Complement Ther Clin Pract， 2022，46:101537.
[26]	金义成. 海派儿科推拿手法说[C]//中华中医药学会少儿推拿传承发展共同体成立大会暨第一届少儿推拿传承发展学术交流会论文集， 2018:1-3.
[27]	许丽. 海派儿科推拿之--小儿推拿特色十法[C]//浙江省中医药学会2017年推拿分会学术年会论文集， 2017:19-21.
[28]	何丽兰.高频超声联合SWE对小儿先天性肌性斜颈推拿疗效评价的临床研究[D].杭州：浙江中医药大学,2024.
[29]	王雁丽,赖梅平,周江鑫,等.高频彩超联合声触弹性成像在评价小儿先天性肌性斜颈推拿疗效中的临床价值探讨[J].影像研究与医学应用,2023,7(8):62-65.
[30]	付嘉好,陈超,付卓,等.超声量化评估先天性肌性斜颈患儿胸锁乳突肌回声强度的信度研究[J].中国中西医结合影像学杂志,2025,23(3):352-357.
[31]	毛嘉雯,王慧娟,杨秋萍,等.推康融合治疗小儿先天性肌性斜颈的临床诊疗思路[J].湖南中医药大学学报,2025,45(1):95-99.

项目	n	健侧			患侧
项目	n	杨氏模量值(kPa)	剪切波速度(m/s)	厚度(mm)	杨氏模量值(kPa)	剪切波速度(m/s)	厚度(mm)
治疗前	32	18.95±2.63	1.96±0.25	6.58±0.87	35.62±4.85	3.85±0.31	12.34±1.15
治疗后	32	19.12±2.54	1.99±0.23	6.61±0.82	21.41±3.72	2.08±0.38	7.52±0.89
t值		0.275	0.521	0.149	15.837	12.154	19.463
P值		0.785	0.606	0.882	<0.001	<0.001	<0.001

“通络调颈法”配合高频超声联合剪切波弹性成像技术治疗小儿肌性斜颈的疗效观察

Clinical efficacy observation of "meridian unblocking and neck regulation method" combined with high-frequency ultrasound and SWE technology in the treatment of pediatric muscular torticollis

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