左右分治推拿法对痉挛型偏瘫儿童粗大运动功能及下肢痉挛的影响  

Effect of left-right divided massage method on gross motor function and lower limb spasm in children with spastic hemiplegia

作　　者：郭志丹 李海峰 都修波[1] GUO Zhidan;LI Haifeng;DU Xiubo(Pediatric Hospital,the First Affiliated Hospital of Henan University of Chinese Medicine,Henan Province,Zhengzhou 450000,China;School of Pediatrics,Henan University of Chinese Medicine,Henan Province,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第一附属医院儿科医院,河南郑州450000 [2]河南中医药大学儿科医学院,河南郑州450000

出　　处：《中国医药导报》2025年第4期159-163,共5页China Medical Herald

基　　金：河南省中医药科学研究专项课题(20-21ZY 2172);河南省特色骨干学科中医学第二批学科建设项目(STG-ZYX07-202151)。

摘　　要：目的探讨左右分治推拿法对痉挛型偏瘫儿童粗大运动功能及下肢痉挛的影响。方法选取2020年6月至2024年1月就诊于河南中医药大学第一附属医院儿童脑病诊疗康复中心1~8岁60例痉挛型偏瘫患儿,根据随机数字表法将其分为两组,各30例。对照组给予常规推拿法,治疗组给予左右分治推拿法,治疗12周。比较两组治疗前后粗大运动功能测试量表88项(GMFM-88)总分、临床痉挛指数(CSI)评分、下肢痉挛肌肉表面肌电均方根平均值及步行功能。结果治疗后,两组GMFM-88总分均高于治疗前,CSI评分及内收肌、腘绳肌、腓肠肌表面肌电均方根平均值均低于治疗前,步长、1分钟步行试验(1MWT)均长于治疗前,步宽、10米步行测试(10MWT)均短于治疗前(P<0.05)。治疗组GMFM总分、CSI评分和下肢痉挛肌肉表面肌电均方根平均值治疗前后差值均高于对照组(P<0.05)。治疗组步长、步宽、10MWT、1MWT治疗前后差值均大于对照组(P<0.05)。结论左右分治推拿法和常规推拿法均能改善痉挛型偏瘫儿童的粗大运动功能、CSI、下肢痉挛肌肉表面肌电及步行功能,且左右分治推拿法的效果更显著。Objective To explore the effect of left-right divided manipulation method on gross motor function and lower limb spasm in children with spastic hemiplegia.Methods A total of 60 children with spastic hemiplegia aged one to eight years treated at Children’s Brain Disease Diagnosis and Rehabilitation Center,the First Affiliated Hospital of Henan University of Chinese Medicine from June 2020 to January 2024 were selected,they were divided into the two groups by using a random number table method,30 cases in each group.The control group received conventional massage method,while the treatment group received left-right divided massage method,treatment for 12 weeks.Gross motor function measure-88(GMFM-88)total score,clinic spasticity index(CSI)score,root mean square value of surface electromyography of spastic muscles in lower limbs and walking function of the two groups before and after treatment were compared.Results After treatment,total scores of GMFM-88 in the two groups were higher than before treatment,CSI scores,root mean square value of surface electromyography of adductor muscle,hamstring muscle,and gastrocnemius muscle in the two groups were lower than before treatment,stride length and 1 minute walk test(1MWT)in the two groups were longer than before treatment,stride width and 10 meters walk test(10MWT)in the two groups were shorter than before treatment(P<0.05).Difference before and after treatment of total score of GMFM-88,CSI score and root mean square value of surface electromyography of spastic muscles in lower limb in the treatment group were higher than those in the control group(P<0.05).Difference before and after treatment of stride length,stride width,10MWT and 1MWT in the treatment group were greater than those in the control group(P<0.05).Conclusion Left-right divided massage method and conventional massage method can improve gross motor function, CSI, urface electromyography of spastic muscles in lower limbs and walking function in children with spastic hemiplegia, the effect of left-right div

关 键 词：痉挛型偏瘫 儿童 左右分治推拿法 粗大运动功能 痉挛 下肢 

分 类 号：R742.3[医药卫生—神经病学与精神病学]