以中医辨证理论为指导的津沽小儿推拿治疗脑性瘫痪儿童的临床试验研究  

A clinical trial study on the treatment of children with cerebral palsy by Jingu pediatric tuina guided by the theory of Chinese medicine identification

作　　者：张健[1,2] 赵澎[1] 牛岩[1] 辛庆刚[1] 徐刚 陈淑娟[1] 盛倩倩[1] ZHANG Jian;ZHAO Peng;NIU Yan;XIN Qinggang;XU Gang;CHEN Shujuan;SHENG Qianqian(Department of Rehabilitation,Tianjin Children’s Hospital,Tianjin 300134,China;Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China)

机构地区：[1]天津市儿童医院康复科,天津300134 [2]天津中医药大学,天津301617

出　　处：《天津中医药》2023年第5期569-575,共7页Tianjin Journal of Traditional Chinese Medicine

基　　金：天津市卫健委中医药重点领域课题(20170010)。

摘　　要：[目的]探讨以中医辨证理论为指导的津沽小儿推拿治疗脑性瘫痪的有效性和安全性,并运用现代康复医学手段进行疗效评估,初步制定脑性瘫痪中医推拿治疗规范。[方法]招募天津市儿童医院2019年6月10日—2020年6月10日儿童康复中心的患儿,选择符合脑性瘫痪西医诊断标准、中医疾病分类为“五迟”“五软”“五硬”的患儿60例,随机分为3组,即津沽小儿推拿治疗组、常规推拿对照组及单纯运动治疗组,每组20例,分别予以相应的方法进行干预,4周为1个疗程,共治疗3个疗程。同时进行盲法的实施,采用SAS 9.1统计学软件进行统计学分析。[结果]将数据进行统计学处理,可见津沽小儿推拿治疗组患儿经过治疗后,其中粗大运动功能测试(GMFM)评分卧位、翻身、坐、爬、跪及站立位的得分较其余两组明显提高(P<0.05);在髋、膝、踝关节痉挛状况改善上优于其余两组(P<0.05);从3组脑瘫患儿整体临床疗效来看,津沽小儿推拿组患儿的功能独立状态和日常生活活动能力均较其余两组有明显改善(P<0.05)。[结论]根据中医辨证推拿治疗脑性瘫痪,确立相应治则治法,进行有的放矢的中医推拿治疗,与现代康复医学相接壤,体现中西医结合的优势以及治疗的针对性,为广大脑瘫患儿提供了合理、明确及显效的治疗方案。[Objective]To explore the clinical trial observation of massage therapy for cerebral palsy in children under the guidance of TCM syndrome differentiation theory in Jinggu,and to evaluate the curative effect by modern rehabilitation medical means,and preliminarily establish the standard of TCM massage therapy for cerebral palsy.[Methods]Recruiting children’s hospital of Tianjin on June 10,2019 to 2020,June 10 children rehabilitation center,children choose to accord with cerebral palsy the diagnosis of western medicine,Chinese medicine disease classification for the“five late”“five soft”“five hard”of 60 cases were randomly divided into 3 groups,namely Jingu infantile massage treatment group,treatment group routine massage group and simple movement,20 cases in each group were treated with corresponding intervention methods,4 weeks as a course,a total of 3 courses of treatment.At the same time,the blind method was implemented and SAS 8.3 statistical software was used for statistical analysis.[Results]The data were statistically processed,and it could be seen that after treatment,GMFM scores of decubitus position,turning over,sitting,crawling,kneeling and standing and walking in the treatment group were significantly higher than those in the other two groups(P<0.05).The improvement of hip,knee were better than the other two groups(P<0.05).From the overall clinical effect of the three groups of children with cerebral palsy,the function independence state and the ability of daily living activities of children in the Jingu group were significantly improved compared with the other two groups(P<0.05).[Conclusion]According to the TCM massage treatment of cerebral palsy,the establishment of the corresponding treatment,targeted Chinese massage treatment,and modern rehabilitation medicine border,reflect the advantages of integrated traditional Chinese and western medicine and targeted treatment,for the majority of children with cerebral palsy to provide a reasonable,clear and effective treatment plan.

关 键 词：脑性瘫痪 五迟五软 中医辨证 津沽小儿推拿 

分 类 号：R244.1[医药卫生—针灸推拿学]