快针结合作业疗法治疗痉挛型脑瘫患儿手功能障碍:随机对照试验  

Fast needling combined with occupational therapy for hand dysfunction of spastic cerebral palsy: a randomized controlled trial

作　　者：吴娟妹 尹林林 黄信萍 陈方川 吴莹莹 孟蕊 谢鸿翔 WU Juanmei;YIN Linlin;HUANG Xinping;CHEN Fangchuan;WU Yingying;MENG Rui;XIE Hongxiang(Children's Rehabilitation Center,Ningbo Rehabilitation Hospital,Ningbo 315000,Zhejiang Province,China;Children's Rehabilitation and Sports Medicine Research Branch,Rehabilitation&Sports Medicine Research Institute of Zhejiang Province,Ningbo315000)

机构地区：[1]宁波市康复医院儿童康复中心,浙江宁波315000 [2]浙江省康复与运动医学研究所儿童康复与运动医学研究分所,宁波315000

出　　处：《中国针灸》2024年第2期149-152,共4页Chinese Acupuncture & Moxibustion

基　　金：浙江省中医药科技计划项目:2022ZB333;宁波市康复医院院内孵化项目:2020FH17。

摘　　要：目的:比较快针、留针结合作业疗法与单纯作业疗法治疗痉挛型脑瘫患儿手功能障碍的临床疗效。方法:将75例痉挛型脑瘫患儿随机分为快针组(25例,脱落1例)、留针组(25例,脱落1例)和作业疗法组(25例)。作业疗法组只进行作业疗法治疗,每次20 min。快针组予针刺(不留针)结合作业疗法,留针组予针刺(留针)结合作业疗法,针刺取双侧合谷、后溪、鱼际、外关、肩髃等,留针组留针30 min。以上治疗均每日1次,每周5次,共治疗12周。观察各组患儿治疗前后精细运动评定量表(FMFM)评分、Peabody运动发育量表(第2版)(PDMS-2)评分,比较快针组与留针组针刺安全性。结果:治疗后,各组患儿FMFM、PDMS-2评分较治疗前升高(P<0.01),快针组和留针组FMFM、PDMS-2评分均高于作业疗法组(P<0.05,P<0.01)。快针组针刺异常情况发生率为0.3%(5/1 440),低于留针组的1.4%(20/1 440,P<0.05)。结论:针刺结合作业疗法改善痉挛型脑瘫患儿手功能障碍的临床疗效优于单纯作业疗法,且快针与留针疗效无差异,但快针的安全性较留针更好。Objective To compare the clinical effect of fast needling(without needle retaining), needle retaining acupuncture combined with occupational therapy and simple occupational therapy for hand dysfunction of spastic cerebral palsy in children. Methods A total of 75 children with spastic cerebral palsy were randomly divided into an occupational therapy group(25 cases), a fast needling group(25 cases, 1 case dropped out) and a needle retaining group(25 cases, 1 case dropped out). The patients in the occupational therapy group were only treated with occupational therapy for 20 min each time. The patients in the fast needling group were treated with acupuncture(without needle retaining) combined with occupational therapy, and the needle retaining group was treated with acupuncture(needle retaining) combined with occupational therapy, and acupuncture was taken at Hegu(LI 4), Houxi(SI 3), Yuji(LU 10), Waiguan(SJ 5), Jianyu(LI 15)and so on. The needles were retained for 30 min in patients of the needle retaining group. All the above treatments were performed once a day, 5 times a week for 12 weeks. The scores of fine motor function measure(FMFM) and Peabody developmental motor scale 2(PDMS-2) were observed in patients of the three groups before and after treatment, and the safety of the fast needling group and the needle retaining group was compared. Results After treatment, the scores of FMFM and PDMS-2 in patients of the three groups were higher than those before treatment(P<0.01), and the scores of FMFM and PDMS-2in the fast needling group and the needle retaining group were higher than those in the occupational therapy group(P<0.05,P<0.01). The incidence of acupuncture abnormalities in the fast needling group was 0.3%(5/1 440), which was lower than 1.4%(20/1 440) in the needle retaining group(P<0.05). Conclusion Acupuncture combined with occupational therapy has better clinical effect than occupational therapy alone in improving hand dysfunction in children with spastic cerebral palsy,and there is no statistical differ

关 键 词：痉挛型脑瘫 手功能障碍 针刺 快针 留针 作业疗法 随机对照试验 

分 类 号：R246.6[医药卫生—针灸推拿学]