通督醒神法配合康复训练治疗脑性瘫痪300例  

Analysis on acupuncture and rehabilitation training for treatment of cerebral palsy in 300 patients

作　　者：李诺[1] 刘振寰[1] 钱旭光[1] 符文杰[1] 张勇[1] 罗冠君[1] 招文健[1] 

机构地区：[1]广州中医药大学附属南海妇幼保健院儿康科,佛山市528200

出　　处：《中华针灸电子杂志》2014年第3期1-4,共4页Chinese Journal of Acupuncture and Moxibustion（Electronic Edition）

摘　　要：目的探讨通督醒神针刺法对脑瘫患儿运动、智力及脑神经功能恢复的作用。方法对参与研究的1~5岁300例脑瘫患儿采用通督醒神针刺法,并配合物理治疗、作业治疗、语言治疗等疗法,于治疗前及治疗后3个月,使用北京盖什尔（Gesell）神经发育评定量表及美国粗大运动功能量表（GMFM）评定患儿在智力及运动方面的变化情况,并应用头颅CT/MRI评估患儿治疗前后脑神经修复情况。采用SPSS 13.0统计软件进行资料处理,治疗前后Gesell各能区评分及GMFM（A、B、C）行正态检验,符合正态分布用x±s表示,GMFM（D,E）不符合正态分布,采用中位数±四分位数（M±Q）进行统计描述,以P〈0.05为差异有统计学意义。结果临床康复疗效方面,显效42例（14%）,有效148例（49.3%）,无效110例（36.7%）,总有效率63.3%（190/300）。治疗后Gesell治疗前后神经发育评定量表中社会适应发育商（DQ）、大运动DQ、语言DQ、精细动作DQ、个人社交DQ的评分比较差异均有显著性统计学意义（t=11.53、6.73、9.69、9.43,均P〈0.05）。治疗后GMFM评定量表中A、B、C、D四个能区评分较前均有显著提高（t=17.09、12.73、5.20,Z=4.50,均P〈0.05）,E能区评分较前无统计学意义（Z=1.81,P〉0.05）。治疗前后头颅影像学检查比较,治疗后头颅CT/MRI病变恢复至正常者22例（8.2%）,好转159例（59.1%）,无明显变化者88例（32.7%）,有效率达67.2%（181/269）。结论通督醒神针刺疗法能促进脑瘫患儿运动、智力的发育,且可促进患儿脑神经修复。Objective The aim of this study was to discuss effects of acupuncture on movement, intelligence and cranial nerve functional recovery in children with cerebral palsy. Methods A total of 300 cases of children （aged 1-5 years） with cerebral palsy were treated using acupuncture,and with physical therapy,occupational therapy,speech therapy and other therapies. Gesell＇s Developmental Scale and the Gross Motor Function Measure （GMFM） were used to assess mental and physical activities in patients before and 3-month after treatment. The situation of children with brain repair was detected by cranial CT/MRI before and after treatment. SPSS 13.0 statistical software was used for data processing. Scores of Gesell and GMFM line（A,B,C） before and after the treatment were analyzed by normality test. The normal distribution was represented by x±s. The median plus or minus quartile statistical description of（M±Q） was used for GMFM （D,E）. P〈0.05 was considered statistically significant. Results The curative effect of clinical rehabilitation,42 cases were markedly improved （14%）,148 cases （49.3%） improved,110 cases （36.7%） invalid,and the total effective rate was 63.3%（190/300）. There were significant differences in the scores of Gesell including Developmental Quotient（DQ）,gross motor DQ,language DQ,fine motor DQ and personal social DQ,before and after treatment in patients （t=11.53,6.73 and 9.69,9.43,P〈0.05）. After treatment GMFM rating scales of A,B,C and D were significantly increased compared with the previous （t=17.09,12.73 and 5.2,Z=4.50,P〈0.05）. There was no significant difference in E score before and after treatment （Z=1.81,P〉0.05）. Results of cranial CT/MRI showed that lesions returned to normal in 22 cases （8.2%）,improvement in 159 cases （59.1%） and no obvious changes in 88 cases （32.7%）. The effective rate was 67.2%（181/269）. Conclusion Acupuncture can promote movement and intellectual development of cerebral palsy,and can help cranial nerv

关 键 词：针刺疗法 脑性瘫痪 康复 

分 类 号：R246.6[医药卫生—针灸推拿学]