青少年特发性脊柱侧凸保守治疗及中西医结合治疗的研究进展

doi:10.20274/j.cnki.issn.1674-3865.2025.05.006

Abstract

Abstract:

Adolescent idiopathic scoliosis(AIS)， a complex three-dimensional spinal deformity， represents the most prevalent spinal disorder among adolescents， significantly compromising the physical, physiological and psychological well-being of adolescents. This article systematically reviews the intervention strategy of assessment-treatment-reassessment for AIS through a rehabilitation perspective, which breaks through the barrier of assessment and traditional Chinese and western medicine treatment under the existing mode. A multi-dimensional framework is proposed by integrating multidisciplinary technologies with treatment modalities. The paper discusses the comprehensive assessment of AIS, as well as the scoliosis-specific exercise therapy， brace therapy, traditional Chinese rehabilitation techniques and the current status of integrated Chinese and western medicine treatment. The aim is to provide rational theoretical support and practical references for AIS treatment.

Key words: Adolescent idiopathic scoliosis, Scoliosis-specific exercise therapy, Brace therapy, Traditional Chinese medicine therapy, Chinese and western medicine treatment

CLC Number:

R682.1+3

Hui LIANG, Xifan MEI. Research progress on conservative treatment and integrated traditional Chinese and western medicine treatment for adolescent idiopathic scoliosis[J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2025, 17(5): 392-396.

Figures/Tables 2

Table 1

Comparison between mainstream schools of PSSE"

疗法名称	国家	目标	主要内容	适用条件
脊柱侧凸三维矫正疗法（Schroth）	德国	防止生长期曲线进展^[15]	身体轴向拉伸；根据模块分型反向矫正及旋转；易化、稳定矫正姿势训练；特殊的呼吸训练技术^[11]	适用于Cobb角<50°的患者，尤其适用于Cobb角10°～30°的患者^[9,15]
Lyon疗法（需要与Lyon支具结合应用）	法国	提高对自身姿势缺陷认识，改善运动功能使其符合人体工程学^[15]	呼吸训练、脊柱三维矫正、关节松动、患儿教育、坐姿控制^[11]	一般用于轻中度侧弯，用于对儿童进行促进局部塑形和扭转矫力的前期准备^[15]
脊柱侧凸科学训练方法（SEAS）	意大利	提高主动自我矫正中脊柱的稳定性与姿势控制^[15]	三维主动自我矫正；矫正姿势下肌力训练；自我矫正姿势和运动日常模式化；心肺有氧训练；支具佩戴下针对训练^[11]	Cobb角<25°，强调动态稳定性训练，适用于低进展风险的轻度侧弯，可与矫正支具配合使用^[15]
巴塞罗那脊柱侧弯物理治疗学校（BSPTS）	西班牙	纠正姿势，改善体态；阻止侧弯进展；改善呼吸功能；增加活动；减少疼痛^[15]	模块理论分类；外部辅助3D自我矫正；等长肌肉收缩稳定姿势；输入本体感觉纠正身体结构；呼吸力学重塑躯干^[3,16]	多种类型脊柱侧弯，主要用于特发性脊柱侧凸，可用于早发性脊柱侧凸^[15]
Dobomed疗法	波兰	稳定和纠正脊柱畸形，减少侧弯进展，改善患者整体功能状态^[15]	“阶段性锁定”呼吸；低位闭链运动锻炼；高体位主动3D自动矫正躯干抗重力^[15]	轻度脊柱侧弯，一般Cobb角<30°^[17]
脊柱侧凸功能性个体化疗法（FITS）	波兰	提高患者意识，改善肩和骨盆位置，3D呼吸改善功能教育等^[15]	认知教育；放松肌筋膜；改善矢状面生理弧度；改善足部和骨盆负重线；提高腰和骨盆的稳定性；促进三维方向矫正的呼吸训练；平衡功能训练；矫正步态和日常异常姿势^[11]	诊断和治疗特发性脊柱侧凸的方法，可作运动、支具治疗的辅助治疗、手术治疗前或者手术后骨盆和肩带的矫正方法^[11]
侧移疗法（side shift）	英国	主动矫正针对脊柱侧弯顶点的脊柱曲线，躯干向凹陷的侧移运动^[15]	向弯曲凹侧移动躯干、针对侧弯特定运动训练、疼痛管理技术^[11,15]	适用于发生在任何节段的单弯或双弯^[11]

Table 1

Table 2

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名称	类型	适用范围
Milwaukee支具	颈胸腰骶支具	曲线顶点在T8以上的患者，特别是胸廓尚未发育良好的患儿^[11]
Boston支具	胸腰骶支具	常用于单或双弯患儿，对顶椎位于T7及以下者有效，但是建议用于T6和L2之间，并每天佩戴至少18 h^[11,18]
Wilmington支具	定制化躯干矫形器	曲线顶锥在T8以下，20°～39°特发性曲线^[18]
Lyon支具	模块化三维矫正支具	该支具的使用指征与其他支具相同，但是不建议用于非青春期发育青少年和婴儿脊柱侧弯^[18]
Cheneau支具	三维非对称矫正支具	顶锥在T8以下，用矫枉过正来实现对脊柱侧弯的牵引作用^[19]
Charleston支具	夜间侧屈支具	顶锥在T8以下，对AIS主曲线的支具内矫正效果良好，但不适用于不成熟患者和具有大曲线、高主曲线尖、双主曲线和单胸曲线的患者^[18,20]

Research progress on conservative treatment and integrated traditional Chinese and western medicine treatment for adolescent idiopathic scoliosis

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