山东医药

目的探讨悬吊运动疗法联合施罗斯疗法治疗青少年特发性脊柱侧凸(AIS)的临床效果。方法选取AIS患儿124例，采用随机数字表法分为观察组和对照组各62例。对照组采用施罗斯疗法，观察组采用施罗斯疗法联合悬吊运动疗法，两组均连续治疗12周。比较两组临床疗效以及治疗前后脊柱矢状位参数矢状位垂直轴距离(SVA)、胸腰段后凸角(TLK)、腰椎前凸角(LL)和胸椎后凸角(TK)，脊柱冠状位参数C₇铅垂线与骶骨中垂线距离(C₇PL-CSVL距离)、顶椎偏距(AVT)，躯干旋转角(ATR)，骨盆参数骨盆倾斜角(PT)、骶骨倾斜角(SS)，血清骨代谢相关指标25羟基维生素D［25(OH)D］、甲状旁腺激素(PTH)、碱性磷酸酶(ALP)，脊柱侧凸研究学会22项问卷(SRS-22)评分。结果 观察组总有效率高于对照组(P<0.05)。治疗后，两组SVA、TLK、C₇PL-CSVL距离、AVT、ATR及PT均较治疗前减小，LL、TK及SS均较治疗前增大；且观察组SVA、TLK、C₇PL-CSVL距离、AVT、ATR及PT均小于对照组，LL、TK及SS均大于对照组(P均<0.05)。两组血清25(OH)D水平均较治疗前升高，PTH及ALP水平均较治疗前降低；且观察组25(OH)D水平高于对照组，PTH、ALP水平均低于对照组(P均<0.05)。两组SRS-22功能活动、疼痛、自我形象及心理健康评分均较治疗前升高，且观察组上述各维度评分及治疗满意度评分均高于对照组(P均<0.05)。结论悬吊运动疗法联合施罗斯疗法可提高AIS患儿的近期临床疗效，改善脊柱-骨盆参数及生活质量，并可能对骨代谢相关指标产生一定影响。

Objective To investigate the clinical efficacy of sling exercise therapy combined with Schroth therapy in the treatment of adolescent idiopathic scoliosis (AIS). Methods A total of 124 children with AIS were selected and randomly divided into an observation group and a control group using a random number table method， with 62 cases in each group. The control group received Schroth therapy， while the observation group received Schroth therapy combined with sling exercise therapy; both groups were treated continuously for 12 weeks. Clinical efficacy was compared between the two groups， as well as pre- and post-treatment spinal sagittal parameters including sagittal vertical axis (SVA)， thoracolumbar kyphosis (TLK)， lumbar lordosis (LL)， and thoracic kyphosis (TK); coronal spinal parameters including the distance from C7 plumb line to center sacral vertical line (C7PL-CSVL distance) and apical vertebral translation (AVT); axial trunk rotation (ATR); pelvic parameters including pelvic tilt (PT) and sacral slope (SS); serum bone metabolism-related indicators including 25-hydroxyvitamin D [25(OH)D]， parathyroid hormone (PTH)， and alkaline phosphatase (ALP); and Scoliosis Research Society-22 (SRS-22) questionnaire scores. Results The total effective rate in the observation group was significantly higher than that in the control group (P<0.05). After treatment， SVA， TLK， C7PL-CSVL distance， AVT， ATR， and PT decreased significantly in both groups compared with baseline， while LL， TK， and SS increased significantly; moreover， the observation group exhibited significantly lower values of SVA， TLK， C7PL-CSVL distance， AVT， ATR， and PT， and significantly higher values of LL， TK， and SS than the control group (all P<0.05). Serum 25(OH)D levels increased significantly in both groups after treatment， while PTH and ALP levels decreased significantly; furthermore， the observation group showed significantly higher 25(OH)D levels and significantly lower PTH and ALP levels than the control group (all P<0.05). SRS-22 scores in the domains of function， pain， self-image， and mental health increased significantly in both groups after treatment， and the observation group demonstrated significantly higher scores in all the aforementioned domains as well as treatment satisfaction than the control group (all P<0.05). Conclusion Sling exercise therapy combined with Schroth therapy can improve the short-term clinical efficacy， spinal-pelvic parameters， and quality of life in children with AIS， and may exert certain effects on bone metabolism-related indicators.