穴位注射神经节苷脂钠联用小牛血清治疗小儿脑性瘫痪的临床分析  

Clinical analysis of acupoint injection of ganglioside sodium combined with calf serum in the treatment of pediatric cerebral palsy

作　　者：杨凤翔[1] 谢瑾[1] 郭俐宏[1] 李海峰[1] 王俊华[1] 

机构地区：[1]湖北省十堰市太和医院湖北医药学院附属医院康复中心,湖北十堰442000

出　　处：《中国医药导报》2017年第8期143-146,151,共5页China Medical Herald

基　　金：湖北省卫生厅中医药中西医结合科研项目(2013Z-B13)

摘　　要：目的比较单用神经节苷脂钠穴位注射和小牛血清去蛋白注射液静脉滴注及两药联用治疗小儿脑性瘫痪(CP)的效果。方法将2015年2月~2016年7月湖北省十堰市太和医院康复科收治的183例CP患儿随机分为神经节苷脂钠组(A组)、小牛血清组(B组)和联合治疗组(C组)。三组均给予常规康复训练和针灸等基础治疗,A组加穴位注射神经节苷脂钠,B组加用小牛血清去蛋白注射液静脉滴注,C组为两组治疗方法并用,均治疗21 d。检测CP患儿治疗前及第1、2、3个疗程时静脉血乙酰胆碱(Ach)、乙酰胆碱脂酶(Ach E)、血浆去甲肾上腺素(NE)及脑源性神经生长因子(BDNF)活性,记录局部脑血流(RCBF)、脑电图(EEG)病理性棘波出现次数和振幅,并采用儿童粗大运动功能测试量表-88(GMFM-88)评估疗效。结果治疗第3个疗程时,C组CP患儿静脉血Ach及NE含量降低,Ach E及BDNF活性增强,与同组治疗前及B组比较,差异有统计学意义(P<0.05);RCBF增高,与A组比较,差异有统计学意义(P<0.05);EEG病理性棘波出现次数和波幅明显降低,与B组比较,差异有统计学意义(P<0.05);第2、3个疗程时GMFM-88评分明显提高,临床总有效率为90.16%,与B组和A组比较,差异有统计学意义(P<0.05)。结论采用头针和体针针刺治疗CP可疏通患儿经络,松弛脑血管平滑肌,小牛血清去蛋白注射液静脉滴注可增加RCBF,改善微循环,神经节苷脂钠穴位注射吸收后可提高Ach E和BDNF活性,抑制交感和副交感神经突触释放神经递质NE和Ach。综合治疗可提高CP临床疗效。Objective To compare the therapeutic effects of acupoint injection of ganglioside sodium alone and Deproteinised Calf Blood Serum Injection alone and combined usage of two drugs in the treatment of children with cerebral palsy（CP）. Methods One hundred and eighty-three cases of children with CP admitted to Taihe Hospital of Shiyan City from February 2015 to July 2016 were randomly divided into ganglion sodium group（group A）, calf serum group（group B） and combined group（group C）. All 3 groups were received routine rehabilitation training and acupuncture therapy;group A was added with acupoint injection of sodium ganglion, group B was added with Deproteinised Calf Blood Serum Injection, intravenous drip, group C was given the two drugs above, all 3 groups were treated for 21 days. The activities of venous blood acetylcholine（Ach）, acetylcholinesterase（Ach E）, plasma norepinephrine（NE） and brain derived neurotrophic factor（BDNF） of children with CP before treatment and after treatment for 1, 2, 3 courses were detected. The local cerebral blood flow（RCBF）, the occurrence times of pathological spike wave and amplitude of electroencephalogram（EEG） were recorded, and the efficacy was evaluated by gross motor function measurement scale-88（GMFM-88）. Results At the third course of treatment, the contents of venous blood Ach and NE in CP group were decreased, and the activities of ACh E and BDNF were enhanced, which had statistically significant differences comparedwith those before treatment and those of group B（P 〈 0.05）; the RCBF was increased, which had statistically significant difference compared with that of group A（P 〈 0.05）; the occurrence times of pathological spike wave and amplitude of EEG were reduced, which had statistically significant differences compared with that of group B（P 〈0.05）; the scores of GMFM-88 at the second and third courses were improved, and the total effective rate was 90.16%,which had statistically significant differences compared

关 键 词：小儿脑性瘫痪 针刺 穴位注射 神经节苷脂钠 小牛血清 

分 类 号：R748[医药卫生—神经病学与精神病学]