不同留针时间对痉挛型脑性瘫痪患儿DTI的影响  

Effect of Different Residence Time for Scalp Acupuncture on DTI of Patients with Spastic Cerebral Palsy

作　　者：易爱文[1] 徐宁[1] 常燕群[1] 黄双苗 李贤英[1] 黄振波[1] 

机构地区：[1]广东省妇幼保健院康复医学科,广东广州511442

出　　处：《新中医》2017年第7期132-135,共4页New Chinese Medicine

摘　　要：目的:通过弥散张量成像技术(DTI)影像评估观察头针治疗痉挛型脑性瘫痪患儿更有效的留针时间。方法:将60例痉挛型脑性瘫痪患儿随机分为A组30例,头针留针时间为30 min;B组30例,头针留针时间为2 h;2组均治疗15次为1疗程,疗程间休息15天,连续治疗3疗程。同时选取正常同龄儿童30例作为对照比较,对正常儿童及治疗前后的患儿进行DTI扫描,并评估A组、B组的康复疗效。结果:治疗后,A组、B组粗大运动功能测试量表-88(GMFM-88)评分均较前提高,组内治疗前后比较,差异均有统计学意义(P<0.05),提示2组治疗均有疗效,而2组组间比较,差异无统计学意义(P>0.05)。治疗前,A组、B组DTI图像各感兴趣区点各向异性性分数值(FA)与正常对照组比较,差异均有统计学意义(P<0.05),提示脑性瘫痪患儿白质纤维束均存在不同程度的损伤。治疗后,A组在扣带束(CG)、内囊前肢(ICAL)上FA与治疗前比较,差异均无统计学意义(P>0.05);在内囊后肢(ICPL)、皮质脊髓束(CST)、胼胝体压部(SCC)、胼胝体膝部(GCC)上,治疗前后比较,差异均有统计学意义(P<0.05),而B组在以上各项感兴趣区点FA治疗前后比较,差异均有统计学意义(P<0.05)。2组组间比较,B组各项FA值均较A组高,且在CST、ICPL、CG、SCC、GCC上,差异均有统计学意义(P<0.05),提示B组疗效优于A组。结论:头针留针2 h的康复疗效要优于留针30 min。Objective：To evaluate and observe the more efficient residence time for scalp acupuncture in treating spastic cerebral palsy with diffusion tensor imaging（DTI）. Methods ：Selected 60 patients with spastic cerebral palsy,and divided them into the group A of 30 cases whose residence time was 30 minutes and the group B of 30 cases whose residence time was two hours randomly. Fifteen times of treatment was regarded as one course, and there was 15 days of rest between different courses of treatment. Treatment for the two groups lasted for three courses. Meanwhile,30 normal children of the same age were selected as the control group. DTI scans were performed in normal children and patients before and after treatment. Evaluated rehabilitation effect of group A and group B. Results ：After treatment,gross motor function measure-88（GMFM-88） of the group A and group B were higher than those before treatment;Comparing effect of the two groups with those before treatment respectively, differences were significant（P〈0.05）,which suggested treatment of the two groups were both effective;Difference between the two groups were not significant（P〉0.05）. Before treatment,compare fractional anisotropy（FA） of the region of interest（ROI） of DTI image of the group A and group B with that of the normal control group,the differences were significant（P〈0.05）,which suggested there were different degrees of damage to the white matter fiber tracts in children with cerebral palsy. After treatment,Compared FA of cingulum（CG） and anterior limb of internal capsule（ICAL） of group A with those before treatment,differences had no significance（P〉0.05）,but the differences of posterior limb of internal capsule（ICPL）,cortical spinal tract（CST）,splenium of corpus callosum（SCC）,genu of corpus callosum（GCC） before and after treatment were significant（P〈0.05）. Compared FA of the above ROI of the group B before and after treatment,differences were significant（P〈0.05）. Every FA sc

关 键 词：痉挛型脑性瘫痪 头针 留针时间 弥散张量成像技术(DTI) 粗大运动功能测试量表-88(GMFM-88) 扣带束(CG) 皮质脊髓束(CST) 

分 类 号：R742.3[医药卫生—神经病学与精神病学]