目的 探讨矫形器和运动训练治疗青少年特发性脊柱侧凸(AIS)的疗效以及两种治疗方法对患者心理状况和生活质量的影响。 方法 2017年7月至2018年2月，选取10~16岁、Cobb角25°~40°的特发性脊柱侧凸患者55例，分为运动训练组(n = 25)和矫形器组(n = 30)，并进行对应治疗。分别记录患者治疗前、治疗3个月、治疗6个月后的Cobb角、躯干位移(TS)、顶椎旋转度(AVR)和顶椎偏离中线距离(AVT)，并于治疗前和治疗6个月后采用国际脊柱侧凸研究学会22项问卷(SRS-22)对生活质量和心理状态进行评定。 结果 治疗后，运动训练组SRS-22中功能/活动度、疼痛、自我形象/外观和治疗满意度评分均优于矫形器组(t > 2.137, P < 0.05)。治疗3个月及治疗6个月后，两组Cobb角均显著小于治疗前(t > 4.461, P < 0.001)；治疗6个月后，矫形器组Cobb角小于运动训练组(t = 2.548, P < 0.05)。治疗3个月后及治疗6个月后，两组TS、AVR和AVT均优于治疗前(t > 2.338, P < 0.05)；治疗6个月后，矫形器组TS、AVR、AVT均优于运动训练组(t > 2.259, P < 0.05)。 结论 单独的运动训练对Cobb角为25°~40°的AIS患者有较好的疗效，且在心理状况和生活质量方面的改善优于矫形器治疗，但是在脊柱侧凸畸形的改善方面不如矫形器治疗。
Objective To compare the effects of spinal orthosis and exercise training on psychological status and quality of life in patients with adolescent idiopathic scoliosis (AIS). Methods From July, 2017 to Febrary, 2018, 55 AIS patients aged ten to 16 years were enrolled. According to the individual's choice, they were divided into exercise group (n = 25) and orthosis group (n = 30). The Cobb's angle, apex vertebral rotation (AVR), trunk shift (TS) and apex vertebral translocation (AVT) were measured before, three months and six months after intervention. They were also evaluated with Scoliosis Research Society Patient Questionnaire-22 (SRS-22) before and six months after intervention. Results Six months after intervention, the scores of function/activity level, pain, self-image/appearance and treatment satisfaction were better in the exercise group than in the orthosis group (t > 2.137, P < 0.05). Three months and six months after intervention, the Cobb's angles reduced significantly in both groups (t > 4.461, P < 0.001); six months after intervention, the Cobb's angle was smaller in the orthosis group than in the exercise group (t = 2.548, P < 0.05). Three months and six months after intervention, TS, AVR and AVT improved in both groups (t > 2.338, P < 0.05); six months after intervention, they were better in the orthosis group than in the exercise group (t > 2.259, P < 0.05). Conclusion Single exercise training is effective on AIS patients with Cobb's angle between 25° to 40°, especially for psychological status and the quality of life, however, it isn't as better as orthotics treatment for deformity correction.
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