头针配合低频重复经颅磁刺激治疗痉挛性脑性瘫痪疗效观察  

Scalp acupuncture combined with low frequency repetitive transcranial magnetic stimulation in the treatment of spastic cerebral palsy

作　　者：阳芸 李水帝 罗丽辉[1] 黄振波[1] 常燕群[1] 徐宁[1] 吴满红[1] YANG Yun;LI Shuidi;LUO Lihui;HUANG Zhenbo;CHANG Yanqun;XU Ning;WU Manhong(Guangdong Women and Children Hospital,Guangzhou 510000,China)

机构地区：[1]广东省妇幼保健院,广州510000

出　　处：《上海针灸杂志》2024年第5期487-493,共7页Shanghai Journal of Acupuncture and Moxibustion

基　　金：广东省中医药局科研项目(20221046)。

摘　　要：目的基于脑电频谱技术,观察头针配合低频重复经颅磁刺激治疗痉挛性脑性瘫痪的临床疗效。方法将90例痉挛性脑性瘫痪患者和20例健康儿童分为病例组和正常组,通过采集静息态脑电信号比较各频谱(δ、θ、α、β、γ)密度。再将病例组随机分为A组、B组和C组,每组30例。在接受常规康复训练的基础上,A组采用头针治疗,B组采用低频重复经颅磁刺激治疗,C组采用头针配合低频重复经颅磁刺激治疗。观察3组治疗前后粗大运动功能测试量表-88(gross motor function measure-88,GMFM-88)评分(D区、E区)、Gesell发育诊断量表各项评分、颅内椎基底节动脉血流状态各项指标[左侧椎动脉(left vertebral artery,LVA)、右侧椎动脉(right vertebral,RLA)、基底动脉(basilar artery,BA)平均流速]、各项炎症因子[血清白细胞介素-6(interleukin-6,IL-6)、白细胞介素-33(interleukin-33,IL-33)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)]水平及脑电信号各频谱密度的变化情况,比较3组临床疗效。结果C组治疗后D区、E区GMFM-88评分及Gesell发育诊断量表各项评分较同组治疗前显著上升,LVA、RLA、BA平均流速显著加快,各项炎症因子水平显著降低,差异均具有统计学意义(P<0.05)。C组治疗后D区、E区GMFM-88评分及Gesell发育诊断量表各项评分均明显高于A组和B组,LVA、RLA、BA平均流速明显快于A组和B组,各项炎症因子水平明显低于A组和B组,差异均具有统计学意义(P<0.05)。病例组治疗前脑电信号δ、θ频谱密度明显高于正常组(P<0.05);3组治疗后脑电信号δ、θ频谱密度均较同组治疗前显著降低(P<0.05)。C组总有效率为83.3%,明显高于A组的63.3%和B组的56.7%,差异均具有统计学意义(P<0.05)。结论在常规康复训练的基础上,头针配合低频重复经颅磁刺激治疗痉挛性脑性瘫痪疗效确切,能改善患者运动功能和认知功能,其机制主要与该方法能下调炎症因子�Objective To observe the clinical efficacy of scalp acupuncture combined with low frequency repetitive transcranial magnetic stimulation in the treatment of spastic cerebral palsy based on electroencephalogram spectrum technology.Method Ninety spastic cerebral palsy patients and 20 healthy children were divided into the case group and normal group.The density of spectrum(δ、θ、α、β、γ)of resting state electroencephalogram(EEG)signals were collected and compared.Then the case group was randomly divided into group A,group B and group C,with 30 cases in each group.On the basis of routine rehabilitation training,group A was treated with scalp acupuncture,group B was treated with low frequency repetitive transcranial magnetic stimulation,and group C was treated with scalp acupuncture combined with low frequency repetitive transcranial magnetic stimulation.The gross motor function measure-88(GMFM-88)score(D,E regions),diagnosis of Gesell developmental diagnosis scale score,the indicators of intracranial vertebral artery blood flow state in basal ganglia[(left vertebral artery(LVA),right vertebral(RLA),basilar artery(BA)average flow velocity],inflammatory factors[serum interleukin-6(IL-6),interleukin-33(IL-33),tumor necrosis factorα(TNF-α)]and the changes of spectral density of EEG signals were observed before and after treatment in the three groups.The clinical efficacy of the three groups was compared.Result In group C,GMFM-88 scores and Gesell developmental diagnostic scale scores in D and E regions after treatment were significantly higher than those before treatment,the average flow velocity of LVA,RLA and BA was significantly faster,and the levels of inflammatory factors were significantly lower than those before treatment,and the differences were statistically significant(P<0.05).After treatment,the GMFM-88 scores and each score of the Gesell developmental diagnosis Scale in D and E regions in group C were significantly higher than those in group A and group B(P<0.05).The average flow velocities of LVA

关 键 词：针刺疗法 头针 脑性瘫痪 重复经颅磁刺激 脑电信号频谱 炎症因子 

分 类 号：R246.3[医药卫生—针灸推拿学]