改良强制性运动疗法结合针刺在痉挛型偏瘫患儿中的应用  

Application of modified compulsory exercise therapy combined with acupuncture in children with spastic cerebral palsy

作　　者：徐艳 王飞[1] 成逸[1] 孙琦[1] 刘海兵[1] XU Yan;WANG Fei;CHENG Yi;SUN Qi;LIU Haibing(Department of Rehabilitation Medicine,the First People's Hospital of Huzhou in Zhejiang Province,Huzhou 313000,China)

机构地区：[1]浙江省湖州市第一人民医院康复医学科,浙江湖州313000

出　　处：《中国现代医生》2020年第34期14-17,22,共5页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2018KY777);浙江省湖州市科技局资助项目(2018GYB76)。

摘　　要：目的探寻改良强制性运动疗法结合针刺的治疗方案对痉挛型偏瘫患儿上肢功能及功能独立性的影响。方法选取2018年11月~2019年11月来本院接受康复治疗的痉挛型偏瘫患儿50例为研究对象,应用随机数字表法分为两组,观察组与对照组各25例。对照组患儿采用常规运动治疗方案与针刺相结合的治疗方法,观察组在对照组的基础上结合改良强制性运动疗法。治疗周期为8周,在入组前和治疗后分别对两组患儿进行Carroll双上肢功能评定量表(UEFT)、儿童功能独立性量表(WeeFIM)及日常生活活动能力量表(Barthel指数)评估。结果治疗前两组患儿UEFT评分、WeeFIM评分、Barthel指数评分比较,差异无统计学意义(P>0.05)。8周的治疗后两组患儿的UEFT评分、WeeFIM评分均高于治疗前[观察组:UEFT评分(61.84±9.80)分vs(71.72±9.72)分、WeeFIM评分为(85.56±9.36)分vs(95.60±9.01)分;对照组:UEFT评分(60.24±9.66)分vs(65.00±9.57)分、WeeFIM评分(84.56±10.17)分vs(89.76±10.40)分],且观察组患儿较对照组提高更为显著(P<0.05)。治疗后观察组患儿Barthel指数评分较前提高[(60.20±9.52)分vs(69.40±7.54)分],差异有统计学意义(P<0.05),但治疗后对照组患儿Barthel指数评分提高不显著[(61.20±8.93)分vs(65.60±9.28)分],差异无统计学意义(P>0.05)。结论改良强制性运动疗法结合针刺的治疗方案能有效提高偏瘫患儿上肢功能及功能独立性。Objective To explore the effect of modified compulsory exercise therapy combined with acupuncture on upper limb function and functional independence of children with spastic cerebral palsy.Methods A total of 50 children with spastic hemiplegia admitted to our hospital for rehabilitation from November 2018 to November 2019 were selected as the research objects.They were randomly divided into the observation and control groups by the random number table method,with 25 cases in each group.The children in the control group were treated with a combination of conventional exercise therapy and acupuncture.The children in the observation group were treated with modified compulsory exercise therapy based on the control group's treatment.The treatment period was eight weeks.The two groups of children before and after treatment were evaluated by the Carroll Upper Extremities Functional Test(UEFT),the Functional Independence Measure for Children(WeeFIM),and Activity of Daily Living Scale(Barthel Index).Results There was no significant difference in the UEFT score,WeeFIM score,and Barthel index score between the two groups before treatment(P>0.05).After eight weeks of treatment,the UEFT scores and WeeFIM scores of the two groups were higher than those before treatment(the observation group:UEFT score[61.84±9.80]points vs.[71.72±9.72]points,WeeFIM score[85.56±9.36]points vs.[95.60±9.01]points;the control group:UEFT score[60.24±9.66]points vs.[65.00±9.57]points,WeeFIM score was[84.56±10.17]points vs.[89.76±10.40]points).Moreover,the children in the observation group improved more significantly than the control group(P<0.05).The Barthel index score of the observation group after treatment was higher than that before([60.20±9.52]points vs.[69.40±7.54]points),and the difference was statistically significant(P<0.05).Compared with that before,the Barthel index score of the control group did not increase significantly after treatment([61.20±8.93]points vs.[65.60±9.28]points),and the difference was not statistically signif

关 键 词：痉挛型脑性瘫痪 上肢 针刺 改良强制性运动疗法 

分 类 号：R742.3[医药卫生—神经病学与精神病学]