针刺联合康复训练治疗小儿脑性瘫痪临床研究  

Effect of traditional Chinese medicine acupuncture combined with rehabilitation training on children with cerebral palsy

作　　者：丁小芹 汪秋春 曾火明 何爱军 Ding Xiaoqin;Wang Qiuchun;Zeng Huoming;He Aijun(Department of Paediatrics, Xiaogan Traditional Chinese Medicine Hospital Pediatrics, Xiaogan 432000, China)

机构地区：[1]湖北省孝感市中医医院儿科,432000

出　　处：《国际中医中药杂志》2019年第7期711-714,共4页International Journal of Traditional Chinese Medicine

基　　金：湖北省科学技术研究项目(WJ2015A112).

摘　　要：目的评价针刺联合康复训练治疗小儿脑性瘫痪的疗效。方法将符合入选标准的68例脑瘫患儿采用随机数字表法分为2组,每组34例。对照组采用Bobath疗法联合Vojta疗法进行康复训练,观察组在对照组基础上联合针刺治疗。2组均治疗12周。采用改良Ashworth法进行双下肢肌张力评估,采用粗大运动功能量表(Gross Motor Function Measure Scale, GMFM)进行粗大运动功能评估,采用Fugl-Meyer运动功能评定法评估患儿肢体运动功能,采用ELISA法检测血清VEGF及肌酸激酶脑型同工酶(Creatine kinase Brain Band Isoenzyme, CK-BB)水平,评价临床疗效。结果治疗后,观察组肌张力评分[(1.3±0.3)分比(1.7±0.4)分,t=4.108]低于对照组,GMFM评分[(55.7±13.7)分比(37.8±11.4)分,t=5.881]高于对照组(P<0.01);血清VEGF[(145.67±19.78)ng/L比(171.35±22.54)ng/L,t=4.993]、CK-BB[(71.46±17.62)U/L比(95.76±19.65)U/L,t=5.368]水平低于对照组(P<0.01)。观察组总有效率为94.1%(32/34)、对照组为73.5%(25/34),2组比较差异有统计学意义(χ2=5.314,P=0.021)。结论针刺联合康复训练可明显改善脑瘫患儿肌张力及粗大运动功能,降低患儿血清VEGE及CK-BB水平,提高临床疗效。Objective To evaluate the therapeutic effect of acupuncture combined with rehabilitation training on children with cerebral palsy. Methods A total of 68 children with cerebral palsy who met the inclusion criteria were randomly divided into two groups, 34 in each group. The control group was treated with Bobath therapy combined with Vojta therapy for rehabilitation training, while the observation group was treated with acupuncture on the basis of the control group. Both groups were treated for 12 weeks. Modified Ashworth method was used to assess the muscular tension of lower limbs, the gross motor function scale was used to assess the gross motor function, and the Fugl-Meyer motor function evaluation method was used to evaluate the limb motor function of children. And the serum levels of vascular endothelial growth factor and creatine kinase brain isoenzyme (CK-BB) were detected by ELISA. Results After treatment, the muscle tension score (1.3 ± 0.3 vs. 1.7 ± 0.4, t=4.108) in the observation group was significantly lower than that in the control group, while the GMFM score (55.7 ± 13.7 vs. 37.8±11.4, t=5.881) significantly higher than that in the control group (P<0.01). The serum VEGF (145.67 ± 19.78 ng/L vs. 171.35 ± 22.54 ng/L, t=4.993) in the observation group were significantly lower than those of the control group (P<0.01). The levels of CK-BB (71.46 ± 17.62 U/L vs. 95.76 ± 19.65 U/L, t=5.368) in the observation group were significantly lower than those of the control group (P<0.01). The total effective rate was 94.1%(32/34) in the observation group and 73.5%(25/34) in the control group. There were significant differences between the two groups (χ2=5.314, P=0.021). Conclusions Acupuncture combined with rehabilitation training can improve the muscle tension and gross motor function of children with cerebral palsy, reduce the levels of VEGF and CK-BB in serum of children with cerebral palsy, and improve the clinical effect.

关 键 词：脑性瘫痪 儿童 体针疗法 穴位 头针刺激区 康复训练 肢体功能 

分 类 号：R246.6[医药卫生—针灸推拿学]