靳三针联合行为干预法治疗学龄前轻中度孤独症谱系障碍  

Effect of Jin’s Three-Needle Therapy Combined with Behavioral Intervention on Preschool Children with Mild-to-Moderate Autism Spectrum Disorder

作　　者：洪钰[1] 康洁 郭敬民[1] 刘桂华[1] 欧萍[1] 陈晓芳 黄龙生[1] HONG Yu;KANG Jie;GUO Jingmin;LIU Guihua;OU Ping;CHEN Xiaofang;HUANG Longsheng(Fujian Maternity and Child Health Hospital,Fuzhou,Fujian 350001,China;College of Traditional Chinese Medicine,Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian 350122,China;Jinjiang Maternity and Child Health Hospital,Quanzhou,Fujian 362299,China)

机构地区：[1]福建省妇幼保健院,福建福州350001 [2]福建中医药大学中医学院,福建福州350122 [3]晋江市妇幼保健院,福建泉州362299

出　　处：《康复学报》2022年第6期539-544,共6页Rehabilitation Medicine

基　　金：国家自然科学基金项目(81804173);福建省医学创新项目(2020CXA016);福建省中医药科研项目(2021zyjc26)。

摘　　要：目的:观察靳三针联合行为干预法对学龄前轻中度孤独症谱系障碍(ASD)患儿核心症状及焦虑障碍的临床疗效。方法:选择2018年1—12月在福建省妇幼保健儿童保健中心就诊的轻中度学龄前ASD患儿109例,采用Excel软件Rand函数分为对照组和观察组,分别54例和55例。对照组采取应用行为分析疗法结合结构化教育方式治疗,2~4 h/d,持续治疗3个月;观察组在对照组基础上接受“靳三针”针刺疗法,主穴选择四神针、智三针、颞三针、定神针,并根据ASD中医辨证分型进行配穴加减,5 d/周,1个月/疗程,共持续治疗3个月。分别于治疗前和治疗3个月后,采用孤独症行为评定量表(ABC)评估患儿孤独症行为;采用儿童孤独症评定量表(CARS)评估ASD患儿严重程度;采用社会反应量表(SRS)评估ASD患儿的社会交往能力;采用《学前儿童焦虑量表(中文版)》评估ASD患儿焦虑状况。结果:(1)ABC、CARS评分:与治疗前比较,2组治疗后ABC总分及各因子得分和CARS总分均明显降低(P<0.05)。与对照组比较,观察组治疗后ABC总分、社会交往因子得分和语言因子得分均明显更低(P<0.05)。(2)SRS评分:与治疗前比较,2组治疗后SRS总分及各因子得分均明显降低(P<0.05)。与对照组比较,观察组治疗后社交认知得分、社交沟通得分、社交动机得分、孤独症行为方式得分及SRS总分均明显更低(P<0.05)。(3)焦虑障碍评分:与治疗前比较,对照组治疗后躯体伤害恐惧得分、社交恐惧得分和广泛性焦虑得分均明显降低(P<0.05),观察组治疗后焦虑总分及各因子得分均明显降低(P<0.05)。与对照组比较,观察治疗后组焦虑总分及各因子(除分离焦虑外)得分均明显更低(P<0.05)。结论:靳三针联合行为干预法可以减轻学龄前轻中度ASD患儿核心症状,提高其社会交往能力,改善其焦虑障碍,值得临床推广应用。Objective:To explore the clinical efficacy of Jin’s three-needle therapy combined with behavioral intervention on core symptoms and anxiety disorder of preschool children with mild-to-moderate autism spectrum disorder(ASD).Methods:A total of 109 preschool children with mild-to-moderate ASD who were treated in the Child Health Center of Fujian Maternity and Child Health Hospital from January 2018 to December 2018,were divided randomly into control group and observation group by the rand function of Excel software,with 55 cases and 54 cases respectively.The control group received behavior analysis therapy combined with structured education,two to four hours a day,lasting for three months;the observation group received Jin’s three-needle therapy in addition to the interventions of the control group,in which the acupoints were mainly selected as Sishen needle,mental three-needle,temporal three-needle,Dingshen needle,and the addition and subtraction of acupoints were according to the TCM syndrome differentiation and classification of ASD.The treatment was five days a week,one month a course,and lasted for three months.Before and three months after treatment,autism behavior checklist(ABC) was used to evaluate the autism behavior of children with ASD;children autism rating scale(CARS) was used to evaluate the severity of children with ASD;social responsiveness scale(SRS) was used to evaluate social interaction skills of children with ASD;spence children’s anxiety scale(SCAS) was used to evaluate anxiety disorder of children with ASD.Results:(1) ABC,CARS scores:compared with that before treatment,the total ABC score,the scores of each factor of ABC and the total score of CARS of both groups decreased significantly after treatment(P<0.05).Compared with the control group,the ABC score,the social interaction factor score and the language factor score of the observation group decreased significantly after treatment(P<0.05).(2) SRS score:compared with that before treatment,the total score of SRS and the scores of each f

关 键 词：孤独症谱系障碍 靳三针 社会交往 焦虑障碍 学龄前儿童 

分 类 号：R749.94[医药卫生—神经病学与精神病学]