揿针按压疗法对脑瘫患儿核心肌群稳定性影响的临床对比研究  

Effects of intradermal needling on core muscle stability in children with cerebral palsy: a clinical comparative study

作　　者：齐腾澈[1] 王春南[1] QI Tengche;WANG Chunnan(the Third Branch of Neurological Rehabilitation Department, Shenyang Children Hospital, Shenyang 110032, Liaoning Province, China)

机构地区：[1]沈阳市儿童医院神经康复三科,辽宁沈阳110032

出　　处：《中国针灸》2018年第6期597-601,共5页Chinese Acupuncture & Moxibustion

基　　金：辽宁省自然科学基金项目:2014020185

摘　　要：目的:观察康复训练配合揿针按压、康复训练配合针刺与单纯康复训练对脑瘫患儿核心肌群稳定性的影响,探寻改善脑瘫患儿核心肌群稳定性的较佳疗法。方法:选取2~4岁脑瘫患儿120例随机分为揿针康复组、针刺康复组与康复组,每组40例。康复组予运动疗法以及核心肌群稳定性训练,每日1次;在与康复组相同康复训练基础上,针刺康复组配合针刺疗法(每天1次),揿针康复组配合揿针按压(每天更换1次),取穴均为腰阳关、命门、L2~L5夹脊穴,治疗4周为一疗程。于治疗前及治疗3个疗程后,对比患儿竖脊肌表面肌电积分值(i EMG)、均方根值(RMS)和平均功率频率(MPF),Berg平衡量表以及粗大运动功能量表(GFMF)中B区(坐位能区)、C区(爬与跪能区)、D区(站立位能区)和E区(行走与跑跳能区)分值的变化。结果:(1)与治疗前比较,揿针康复组及针刺康复组治疗后竖脊肌i EMG值、RMS值,以及揿针康复组MPF值均显著增高(均P<0.05);治疗后揿针康复组竖脊肌表面肌电图各项指标均高于其他两组(均P<0.05),针刺康复组RMS值高于康复组(P<0.05)。(2)3组患儿治疗后Berg平衡量表评分均较治疗前显著增高(均P<0.05),且揿针康复组高于其他两组(均P<0.05)。(3)3组患儿治疗后B区和C区,以及揿针康复组和针刺康复组D区分值均较治疗前显著提高(均P<0.05),且揿针康复组和针刺康复组的B区、C区及D区分值均高于康复组(均P<0.05),揿针康复组B区及C区分值亦高于针刺康复组(均P<0.05)。结论:在康复训练基础上,揿针按压疗法可更好地改善患儿核心肌群稳定性,提高患儿平衡及运动能力,疗效优于常规针刺与单纯康复训练。Objective To observe the effects of rehabilitation training（RT） combined with intradermal needling, RT combined with acupuncture and RT alone on core muscle stability in children with cerebral palsy, and to explore the superior therapy to improve core muscle stability in children with cerebral palsy. Methods A total of 120 children with cerebral palsy aged from 2 to4 years old were randomly divided into a RT and intradermal needling group（group A）, a RT and acupuncture group（group B） and a RT group（group C）, 40 cases in each one. The patients in the group C were treated with kinesitherapy and core muscle stability training, once a day. Along with identical RT of group C, the patients in the group B were treated with acupuncture（once a day）,while the patients in the group A were treated with intradermal needling at Yaoyangguan（GV 3）, Mingmen（GV 4）, Jiaji（EX-B 2,L2-L5）, and 4-week treatment was taken as one course. The integrated electromyography（i EMG） of surface electromyography, root mean square（RMS） and mean power frequency（MPF） of erector spinae muscles, Berg balance scale as well as B area（siting）, C area（climbing and kneeling）, D area（standing） and E area（walking, running and jumping） of gross motor function measure（GMFM）were compared before and after 3-course treatment. Results（1） Compared before treatment, the i EMG and RMS of erector spinae muscles in the group A and group B as well as MPF in the group A were all increased after treatment（all P〈0.05）; after treatment, all the electromyography indexes in the group A were higher than those in the group B and group C（all P〈0.05）; the RMS in the group B was higher than that in the group C（P〈0.05）.（2） Compared before treatment, the Berg balance scale was all increased after treatment in the three groups（all P〈0.05）, and the scale in the group A was higher those that in the group B and group C（both P〈0.05）.（3）Compared before treatment, the B area and C area

关 键 词：脑性瘫痪 核心肌群稳定性 揿针按压 针刺疗法 康复训练 表面肌电 

分 类 号：R246.4[医药卫生—针灸推拿学]