常规理疗联合针刺对重症手足口病中枢神经系统受损致神经肌肉系统功能异常患儿运动功能障碍的干预效果  

Intervention Effects of Routine Physiotherapy Combined with Acupuncture on Motor Dysfunction in Children with Neuromuscular System Dysfunction Caused by Central Nervous System Damage of Severe Hand-foot-mouth Disease

作　　者：陈芳[1] 周崇臣 宋春兰 成怡冰 耿香菊 高国财 崔亚杰 CHEN Fang;ZHOU Chongchen;SONG Chunlan;CHENG Yibing;GENG Xiangju;GAO Guocai;CUI Yajie(Pediatric Intensive Care Unit,Children's Hospital Affiliated of Zhengzhou University /Henan Children's Hospital/Zhengzhou Children's Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属儿童医院河南省儿童医院郑州儿童医院重症监护室,河南省郑州市450000

出　　处：《中国全科医学》2019年第6期643-647,共5页Chinese General Practice

基　　金：河南省2014年度医学科技攻关计划重点项目(201402040);河南省自然科学基金资助项目(152300410002);河南省医学科技攻关计划项目(201504068)

摘　　要：背景手足口病(HFMD)是一种好发于5岁以下婴幼儿的急性发疹性传染病,可由20多种肠道病毒感染引起,以发热及手、足、口腔、臀部等部位出现疱疹、斑丘疹或溃疡为主要临床症状,大多经治疗后可缓解,不留后遗症,但重症HFMD可造成周围神经麻痹、中枢神经系统损伤,甚至危及患儿的生命,因此,采取有效的干预措施是非常必要的。目的研究常规理疗联合针刺对重症HFMD中枢神经系统受损致神经肌肉系统功能异常患儿运动功能障碍的干预效果。方法选取2014年6月—2017年12月在郑州大学附属儿童医院就诊的重症HFMD中枢神经系统受损致神经肌肉系统功能异常患儿88例。将患儿随机分为对照组和观察组,每组44例。两组患儿均给予常规西医治疗(包括抗病毒、抗感染、促受损神经恢复及维持水、电解质和酸碱平衡),对照组加用常规理疗,观察组加用常规理疗联合针刺治疗,两组治疗周期均为1个月。比较两组临床疗效,治疗前后粗大运动功能量表(GMFM)、Berg平衡量表(BBS)评分,中枢神经系统受损的相关症状(包括呕吐、易惊、肢体抖动、肌无力、嗜睡)消失时间,治疗前后生化指标[白介素6(IL-6)、超敏C反应蛋白(hs-CRP)、白细胞计数(WBC)、肌酸激酶(CK)水平]及不良反应发生情况。结果观察组临床疗效优于对照组(P<0.05)。治疗后,观察组GMFM、BBS评分高于对照组(P<0.05);治疗后两组GMFM、BBS评分高于本组治疗前(P<0.05)。观察组呕吐、易惊、肢体抖动、肌无力、嗜睡消失时间短于对照组(P<0.05)。治疗后,观察组IL-6、hs-CRP、WBC、CK水平低于对照组(P<0.05);治疗后两组IL-6、hs-CRP、WBC、CK水平低于本组治疗前(P<0.05)。两组治疗期间未出现明显的不良反应。结论常规理疗联合针刺治疗重症HFMD中枢神经系统受损致神经肌肉系统功能异常患儿,可显著改善患儿运动功能,缩短病程,减轻炎性反应,且无�Background Hand-foot-mouth disease(HFMD)is an acute eruptive infectious disease that occurs in infants and young children under 5 years old.It can be caused by more than 20 kinds of enterovirus infections,and its main clinical symptoms are fever and herpes,maculopapule or ulcer in hands,feet,mouth and buttocks,and most can be relieved after treatment without sequelae,but severe HFMD can cause peripheral nerve palsy,central nervous system damage,and even endanger the lives of children patients.Therefore,effective intervention is necessary.Objective To explore the intervention effects of routine physiotherapy combined with acupuncture on motor dysfunction in children with neuromuscular system dysfunction caused by central nervous system damage of severe HFMD.Methods A total of 88 children with neuromuscular system dysfunction caused by central nervous system damage of severe HFMD in Children's Hospital Affiliated of Zhengzhou University from June 2014 to December 2017 were selected and randomly divided into control group and observation group,each with 44 subjects.Both groups were given conventional western medicine(including antiviral,anti-infection and promotion of damaged nerve recovery,maintenance of water,electrolytes and acid-base balance),the control group was additionally given routine physiotherapy,and the observation group given routine physiotherapy and acupuncture.The two groups were treated for 1 months.The clinical efficacy,scores of gross motor function measure(GMFM)and Berg balance scale(BBS)before and after treatment,disappearance time of related symptoms(including vomiting,frightening,limb shaking,muscle weakness,somnolence)of central nervous system damage,levels of biochemical indexes〔interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP),white blood cell count(WBC)and creatine kinase(CK)〕before and after treatment,occurrence of adverse reactions were compared between the two groups.Results The clinical efficacy in observation group was significantly higher than that in control group

关 键 词：手足口病 中枢神经系统 针刺疗法 运动障碍 

分 类 号：R512.5[医药卫生—内科学]