重复经颅磁刺激联合腕踝针对改善脑瘫患儿痉挛及运动功能的影响  

Effect of repetitive transcranial magnetic stimulation combined with wrist ankle acupuncture on improving spasticity and motor function in children with cerebral palsy

作　　者：史燕[1] 张依群 张孝静[3] 冯子娅 陈嫣红 SHI Yan;ZHANG Yi-qun;ZHANG Xiao-jing;FENG Zi-ya;CHEN Yan-hong(Department of Child Rehabilitation,Third Afiliated Hospital of Zhejiang University of Traditional Chinese Medicine,Hangzhou,Zhejiang 310000,China;不详)

机构地区：[1]浙江中医药大学附属第三医院儿童康复科,浙江杭州310000 [2]杭州市上城区采荷街道社区卫生服务中心护理部 [3]浙江中医药大学附属第三医院护理部 [4]浙江康复医疗中心儿童康复科 [5]浙江康复医疗中心门诊

出　　处：《中国妇幼保健》2023年第10期1917-1921,共5页Maternal and Child Health Care of China

基　　金：浙江省中医药科技项目(2022ZB182)。

摘　　要：目的探讨重复经颅磁刺激联合腕踝针对改善脑瘫患儿痉挛和运动功能的影响。方法选取浙江中医药大学附属第三医院2020年2月—2023年2月108例脑瘫患儿为研究对象。54例患儿接受重复经颅磁刺激治疗为对照组,54例患儿接受重复经颅磁刺激治疗联合腕踝针治疗为观察组。观察两组患儿治疗前后粗大运动功能恢复情况、精细运动功能恢复情况、双侧腓肠肌痉挛的情况、双侧踝关节主动背屈活动度情况及满意度情况。结果治疗前,两组患儿A区、B区及C区GMFM评分差异均无统计学意义(均P>0.05)。治疗后,观察组A区、B区及C区GMFM评分均明显优于对照组(对照组:34.67±1.21分、27.19±3.67分、11.39±0.56分;观察组:45.76±7.15分、34.46±1.75分、16.21±1.85分),差异均有统计学意义(t=-11.247,-13.173,-18.324,均P<0.05)。治疗前,两组患儿A区、B区及C区FMFM评分差异均无统计学意义(t=1.573,-0.267,-0.321,均P>0.05)。治疗后,观察组A区、B区及C区FMFM评分均明显优于对照组(对照组:13.76±7.15分、11.19±3.66分、12.17±0.55分;观察组:16.67±1.21分、15.46±1.75分、13.81±0.78分),差异均有统计学意义(t=-2.947,-7.752,-12.773,均P<0.05)。治疗前,两组患儿左腓肠肌肌张力、右腓肠肌肌张力评分差异均无统计学意义(t=0.516,-0.605,均P>0.05)。治疗后,观察组左腓肠肌肌张力、右腓肠肌肌张力评分均明显优于对照组(对照组vs.观察组:3.26±1.15分vs.1.67±0.80分,t=8.340,P<0.05;3.19±1.64分vs.1.46±0.79分,t=6.953,P<0.05)。治疗后,观察组左右足背屈角度明显优于对照组(对照组:12.26±2.16度、12.19±3.63度;观察组:17.67±1.27度、17.46±1.71度),差异均有统计学意义(t=-15.820,-9.664,均P<0.05)。对照组患儿家长总满意度为83.33%,观察组患儿总满意度为98.15%,观察组患儿家长的满意度高于对照组,差异有统计学意义(χ^(2)=7.053,P<0.05)。结论重复经颅磁刺激联合腕踝针可明显提高脑Objective To explore the effects of repetitive transcranial magnetic stimulation combined with wrist-ankle acupuncture on improving spasticity and motor function in children with cerebral palsy.Methods The subjects of this study were 108 children with cerebral palsy treated at the Third Affiliated Hospital of Zhejang Chinese Medical University from February 2020 to February 2023,for a total of 3 years.The control group of 54 children received repetitive transcranial magnetic stimulation treatment,and the observation group of 54 children received repetitive transcranial magnetic stimulation combined with wrist-ankle acupuncture treatment.The recovery of gross motor function,fine motor function,spasticity of bilateral gastrocnemius muscles,active dorsiflexion range of motion of bilateral ankle joints,and satisfaction were observed in both groups before and after treatment.Results Before treatment,there were no statistically significant differences in GMFM scores of areas A,B,and C between the two groups(P>0.05).After treatment,the GMFM scores of areas A,B,and C in the observation group were significantly better than those in the control group(control group:34.67±1.21 points,27.19±3.67 points,11.39±0.56 points;observation group:45.76±7.15 points,34.46±1.75 points,16.21±1.85 points),with statistically significant differences(t=-11.247,-13.173,-18.324,P<0.05).Before treatment,there were no statistically significant differences in FMFM scores of areas A,B,and C between the two groups(t=1.573,-0.267,-0.321,P>0.05).After treatment,the FMFM scores of areas A,B,and C in the observation group were significantly better than those in the control group(control group:13.76±7.15 points,11.19±3.66 points,12.17±0.55 points;observation group:16.67±1.21 points,15.46±1.75 points,13.81±0.78 points),with statistically significant differences(t=-2.947,-7.752,-12.773,P<0.05).Before treatment,there were no statistically significant differences in the muscle tone scores of left and right gastrocnemius muscles between the two gr

关 键 词：重复经颅磁刺激 腕踝针 脑瘫患儿 痉挛 运动功能 

分 类 号：R742.3[医药卫生—神经病学与精神病学]