中西药结合序贯法治疗脑性瘫痪患儿临床疗效观察  

Treatment of Cerebral Palsy Children by Integrative Medical Sequential Method:a Clinical Efficacy Observation

作　　者：王丽芳[1] 张婕[1] 陈小聪[1] 贺莉[1] 赵晓燕[1] 

机构地区：[1]西安市儿童医院康复科西安710002

出　　处：《中国中西医结合杂志》2014年第4期431-434,共4页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：2012年院级课题扶持项目(No.2012B05)

摘　　要：目的观察中西药序贯治疗对脑性瘫痪(cerebral palsy,CP)患儿的智能发育、肌张力及血清白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)的影响。方法将111例CP患儿随机分为对照组(50例)和治疗组(61例),两组均给予综合康复治疗以及静脉滴注单唾液酸四己糖神经节苷脂钠注射液10天后停药,治疗组加用健脑开窍、舒筋活络中药灌肠治疗14天后再停药,然后再开始下一个用药周期,共6个周期。测定治疗前CP患儿血清IL-6和TNF-α含量,评定治疗前后两组患儿的肌张力、盖瑟尔发育评分及血清IL-6和TNF-α含量的变化。结果与本组治疗前比较,两组CP患儿治疗后肌张力、盖瑟尔发育测定各项指标评分均有降低(P<0.05);组间比较,治疗后治疗组显著低于对照组(P<0.05)。治疗后治疗组和对照组肌张力总有效率分别为86.9%、76.0%,治疗组优于对照组(P<0.05)。治疗后治疗组及对照组IL-6、TNF-α含量较治疗前明显下降(P<0.01),且治疗组明显低于对照组(P<0.05)。结论两种方法治疗前后均对CP患儿有效,但治疗组疗效优于对照组,提示中西药结合可发挥协同治疗作用,优化CP治疗方案。Objective To observe the efficacy of integrative medical sequential method in treating cerebral palsy （CP） children＇s intelligence development, muscular tension, serum interleukin 6 （IL- 6）, and tumor necrosis factor α（TNF-α）. Methods Totally 111 CP children were randomly assigned to the control group （50 cases） and the treatment group （61 cases）. All patients received comprehensive rehabilitation training and intravenous dripping of Monosialotetrahexosylganglioside Sodium Injection for 10 days. But those in the treatment group additionally received Chinese medical enema for brain resuscitation, relieving rigidity of muscles and activating collaterals for 14 days. Then they started another medication cycle and lasted for a total of 6 cycles. Serum IL-6 levels and TNF-α contents were determined be- fore treatment. Scoring for muscular tension, Gesell score for intelligence development, contents of serum IL-6 and TNF-α were assessed before and after treatment in the two groups. Results Compared with before treatment in this group, muscular tension, Gesell scores for intelligence development all de- creased in the two groups （P 〈 0.05）. As for inter-group comparison, the decrement was more obvious in the treatment group than in the control group （P 〈 0.05）. The total effective rate was 86.9% in the treatment group and 76.0% in the control group （P 〈0.05）. The contents of IL-6 and TNF-α were obviously reduced in the treatment group and the control group after treatment （P 〈0.01 ）. The decrement was more obvious in the treatment group （P 〈0.05）. Conclusion The two treatment methods were effective for CP children, but the efficacy was superior in the treatment group than in the control group, indicating integrative medical methods could play a synergistic effect and optimize the treatment program for CP.

关 键 词：中药灌肠 脑性瘫痪 肌张力 盖瑟尔发育评分 白介素-6 肿瘤坏死因子-α 

分 类 号：R742.3[医药卫生—神经病学与精神病学]