肌内神经针刺联合当归四逆汤外用对脑瘫步态异常患儿的影响  

Effects of Intramuscular Neuroacupuncture Combined with External Application of Danggui Sini Decoction on Gait Abnormalities in Children with Cerebral Palsy

作　　者：李杰[1] 余素芳[1] 江瑞娟 LI Jie;YU Sufang;JIANG Ruijuan(The Second People's Hospital of Anyang City,Anyang 455000,China)

机构地区：[1]安阳市第二人民医院,河南安阳455000

出　　处：《中医药信息》2025年第3期62-67,73,共7页Information on Traditional Chinese Medicine

基　　金：2019年度河南省医学科技攻关计划(联合共建)项目(LHGJ20191533)。

摘　　要：目的:探讨肌内神经针刺联合当归四逆汤外用治疗脑瘫步态异常患儿的临床疗效。方法:选择符合纳入标准的90例脑瘫步态异常患儿,依据随机数字表随机分为对照组、观察A组和观察B组,每组各30例。对照组给予常规综合康复训练,观察A组在对照组治疗基础上给予当归四逆汤外用,观察B组在对照组治疗基础上给予肌内神经针刺方案联合当归四逆汤外用,3组均连续治疗8周。比较3组治疗前后精细运动能力[精细运动能力测试(FMFM)评分]、粗大运动功能[粗大运动功能测试(GMFM)评分]、痉挛程度[临床痉挛指数(CSI)]、步态异常的纠正效果(步长、步速、步频、步宽)、内囊前肢(左侧、右侧)、胼胝体膝部FA值及不良反应情况。结果:治疗后,3组FMFM、GMFM量表A~E区评分均高于治疗前(P<0.05),且观察B组治疗后FMFM、GMFM量表A~E区评分高于观察A组和对照组(P<0.05);治疗后3组痉挛程度均较治疗前改善(P<0.05),且观察B组治疗后痉挛程度分布优于观察A组和对照组(P<0.05);治疗后3组步长、步速、步频高于治疗前(P<0.05),步宽低于治疗前(P<0.05),且观察B组治疗后步长、步速、步频和内囊前肢(左侧、右侧)、胼胝体膝部FA值高于观察A组和对照组(P<0.05),步宽低于观察A组和对照组(P<0.05);3组患儿在治疗过程中均无不良反应发生。结论:肌内神经针刺联合当归四逆汤外用可改善脑瘫步态异常患儿精细运动、粗大运动功能,缓解肌肉痉挛,纠正步态异常,且安全性高。Objective:To investigate the clinical efficacy of intramuscular neuroacupuncture combined with external application of Danggui Sini Decoction in treating gait abnormalities in children with cerebral palsy.Methods:Ninety children with cerebral palsy exhibiting gait abnormalities were selected according to inclusion criteria and randomly divided into a control group,observation group A,and observation group B,with 30 cases in each group.The control group received routine comprehensive rehabilitation training.Observation group A received the same plus Danggui Sini Decoction external application,while observation group B received a combination of intramuscular neuroacupuncture and external Danggui Sini Decoction in addition to the treatment in control group.All groups underwent continuous treatment for 8 weeks.Fine motor skills[Fine Motor Function Measure(FMFM)scores],gross motor function[Gross Motor Function Measure(GMFM)scores],spasticity[Clinical Spasticity Index(CSI)],gait correction outcomes(step length,speed,frequency,width),and fractional anisotropy(FA)values of the anterior limbs of the internal capsule(left and right)and genu of the corpus callosum were assessed before and after treatment.Adverse reactions were also recorded.Results:Post-treatment,FMFM and GMFM scores across domains A-E were higher in all groups compared to pre-treatment(P<0.05),with observation group B showing significantly higher scores than observation group A and the control group(P<0.05).All groups showed improvements in spasticity levels(P<0.05),with observation group B displaying superior outcomes compared to observation group A and the control group(P<0.05).Step length,speed,and frequency were higher,and step width was lower post-treatment in all groups(P<0.05).Observation group B had significantly improved step length,speed,frequency,and FA values of the internal capsule(left and right)and genu of the corpus callosum compared to observation group A and the control group(P<0.05),with a lower step width(P<0.05).No adverse reactions we

关 键 词：脑瘫 肌内神经针刺 步态异常 当归四逆汤 

分 类 号：R277.7[医药卫生—中医学]