头针联合bobath疗法对儿童痉挛型脑瘫智力和运动功能发育的影响  

Effects of scalp acupuncture combined with bobath therapy on the development of intelligence and motor function in children with spastic cerebral palsy

作　　者：李融洲 夏琼[1] 谭碧霞[1] LI Rongzhou;XIA Qiong;TAN Bixia(Rehabilitation Center,Hunan Children’s Hospital,Changsha,Hunan,410007,China)

机构地区：[1]湖南省儿童医院康复中心,湖南长沙410007

出　　处：《中医儿科杂志》2024年第1期70-75,共6页Journal of Pediatrics of Traditional Chinese Medicine

摘　　要：目的观察头针联合bobath疗法对儿童痉挛型脑瘫(CP)智力和运动功能发育的影响。方法选取2021年1月至2022年1月湖南省儿童医院康复中心收治的痉挛型CP患儿62例,按照随机数字表法分为对照组和治疗组,各31例。2组均接受常规药物治疗,包括脑神经活性药物、肌松药物、维生素及营养支持等。对照组在常规药物治疗的基础上给予bobath疗法,治疗组在对照组治疗方法的基础上联合头针疗法。2组均5 d为1个疗程,每个疗程间隔2 d,共治疗6个月。结果治疗前2组改良Ashworth分级法(MAS)评分比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组MAS评分均显著降低,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组降低更显著(P<0.05)。治疗前2组智力发育指数、心理运动发育指数比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组智力发育指数、心理运动发育指数均显著升高,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组升高更显著(P<0.05)。治疗前2组精细运动功能评估量表(FMFM)评分、粗大运动功能评估量表(GMFM)评分比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组FMFM评分、GMFM评分均明显升高,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组升高更显著(P<0.05)。治疗前2组大脑前动脉(ACA)、大脑中动脉(MCA)、大脑后动脉(PCA)血流速度比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组ACA、MCA、PCA血流速度均显著增快,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组增快更显著(P<0.05)。对照组总有效率为70.97%(22/31),治疗组为93.55%(29/31),2组总有效率比较,差异有统计学意义(P<0.05)。结论头针联合bobath疗法治疗儿童痉挛型CP,有助于改善患儿肢体痉挛情况、促进智力和运动功能发育、加快脑血流速度,效果显著,值得临床推广应用。Objective To observe the effect of scalp acupuncture combined with bobath therapy on the devel-opment of intelligence and motor function in children with spastic cerebral palsy.Methods A total of 62 children with spastic cerebral palsy who were admitted to the Rehabilitation Center of Hunan Children’s Hospital from Janu-ary 2021 to January 2022 were selected and grouped according to the random number table method,with 31 cases each group.Both groups received conventional drug therapy,the control group was given bobath therapy on the basis of conventional drug therapy,and the treatment group was given scalp acupuncture combined with bobath therapy on the basis of conventional drug therapy,the degree of limb spasm,intelligence development,motor function,cerebral blood flow velocity and clinical efficacy were compared between the two groups.Results After treatment,the modi-fied Ashworth scale(MAS)scores in both groups were lower than those before treatment(P<0.05),and the MAS scores in the treatment group were lower than those in the control group(P<0.05).The mental development index and psychomotor development index of the children in both groups after treatment were higher than those before treatment(P<0.05),and the mental development index of the treatment group was higher than that of the control group(P<0.05).The fine motor function measure(FMFM)scores and gross motor function measure(GMFM)scores of the two groups of children after treatment were all higher than those before treatment(P<0.05),and the FMFM scores and GMFM scores of the treatment group were higher than those of the control group(P<0.05).The blood flow velocity of the anterior cerebral artery(ACA),middle cerebral artery(MCA),and posterior cerebral ar-tery(PCA)in the two groups after treatment was faster than that before treatment(P<0.05),and the blood flow velocity of ACA,MCA and PCA in the treatment group was faster than that in the control group(P<0.05).The clin-ical effective rate in the treatment group(93.55%)was higher than that in the cont

关 键 词：小儿 脑瘫 痉挛型 BOBATH疗法 头针 智力 运动功能 临床观察 

分 类 号：R255.6[医药卫生—中医内科学]