“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

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。

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.

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

Key words

Muscular torticollis / Shanghai-style pediatric massage / SWE / Meridian unblocking and neck regulation / Child

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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)