电针治疗痉挛型脑瘫儿童腓肠肌痉挛
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摘要
目的比较电针和普通针刺对痉挛型脑瘫患儿腓肠肌痉挛的即时临床疗效。方法选择2016年5月-2017年6月吉林大学第一医院发育行为儿科门诊或长期康复的痉挛型脑瘫患儿32例,采用随机数表法分为电针组和针刺组,各16例。2组分别于治疗前、当次治疗后进行被动踝关节背屈活动度(PROM)和被动牵伸下腓肠肌表面肌电(s EMG)的均方根值(RMS)的测量。结果电针组PROM较治疗前明显改善(P <0.05);电针组治疗后PROM改善优于针刺组(P <0.05)。2组患儿治疗后RMS均较治疗前有明显改善(P <0.05),且电针组改善优于针刺组(P <0.05)。结论电针治疗痉挛型脑瘫儿童腓肠肌痉挛即时改善效果优于普通针刺;表面肌电评估肌肉痉挛改善效果的敏感度优于踝关节背屈活动度测量。
Objective To compare the immediate clinical ef fects of electro-acupuncture and ordinary acupuncture on gastrocnemius spasm in children with spastic cerebral palsy. Methods From May 2016 to June 2017, 32 children with spastic cerebral palsy were selected from the outpatient department of developmental behavior pediatrics of the First Hospital of Jilin University or from long-term rehabilitation. They were divided into electro-acupuncture group and acupuncture group by random number table, with 16 cases in each group. The ankle passive range of motion(PROM) and the root mean squarevalue(RMS) of gastrocnemius surface electromyography(sEMG) under passive stretching of both groups were measured before and after treatment. Results The PROM in electro-acupuncture group was significantly improved after treatment(P < 0.05). The improvement of PROM in EA group was better than that in acupuncture group(P < 0.05). The root mean square value(RMS) of gastrocnemius muscle after passive stretching was significantly improved in both groups(P < 0.05), and the improvement of RMS in electro-acupuncture group was better than that in acupuncture group(P < 0.05). Conclusion The immediate improvement ef fect of electroacupuncture on gastrocnemius spasm in children with spastic cerebral palsy is better than that of acupuncture, and the sensitivity of surface electromyography to evaluate the improvement ef fect of muscle spasm is better than that of PROM.
Objective To compare the immediate clinical ef fects of electro-acupuncture and ordinary acupuncture on gastrocnemius spasm in children with spastic cerebral palsy. Methods From May 2016 to June 2017, 32 children with spastic cerebral palsy were selected from the outpatient department of developmental behavior pediatrics of the First Hospital of Jilin University or from long-term rehabilitation. They were divided into electro-acupuncture group and acupuncture group by random number table, with 16 cases in each group. The ankle passive range of motion(PROM) and the root mean squarevalue(RMS) of gastrocnemius surface electromyography(sEMG) under passive stretching of both groups were measured before and after treatment. Results The PROM in electro-acupuncture group was significantly improved after treatment(P < 0.05). The improvement of PROM in EA group was better than that in acupuncture group(P < 0.05). The root mean square value(RMS) of gastrocnemius muscle after passive stretching was significantly improved in both groups(P < 0.05), and the improvement of RMS in electro-acupuncture group was better than that in acupuncture group(P < 0.05). Conclusion The immediate improvement ef fect of electroacupuncture on gastrocnemius spasm in children with spastic cerebral palsy is better than that of acupuncture, and the sensitivity of surface electromyography to evaluate the improvement ef fect of muscle spasm is better than that of PROM.
引文
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[14]任宏伟,王恩龙.电针拮抗肌联合康复疗法治疗脑卒中后肌张力增强68例临床观察[J].中医药临床杂志,2017,29(10):1752-1754.
[15]岳增辉,李良,常小荣,等.电针与手针治疗脑卒中痉挛性瘫痪效应差异研究[J].中国针灸,2012,32(7):582-586.
[16]AYDIN A,GENE K,AKHISAROGIU M,et al.Erythropoietin exerts neuroprotective effect in neonatal ratmodel of hypoxic-ischemic brian injury[J].Brian&Development,2003,25(7):494-498.
[17]朱小宁,刘振寰.对小儿脑性瘫痪运动功能评估量表的评价(附100例临床分析)[J].山西医科大学学报,2000,31(1):65-66.
[2]OSKOUI M,COUTINHO F,DYKEMAN J,et al.An update on the prevalence of cerebral palsy:a systematic review and meta-analysis[J].Developmental Medicine&Child Neurology,2013,55(6):509-519.
[3]VAN NIEUWENHUIZEN O,PLATENGA N J,KASTEELT E.Epilepsy in cerebral palsy:etiology,classification and prevalence[J].Europe Paed Neural Soc,1997,1(2-3):111-115.
[4]ORIADY Z M.Cerebral palsy in viewpoint of speech language pathology nature,assessment and treatment[M].Hamedan:Nooreelm,2005.
[5]HIMMELMANN K,HAGBERG G,BECKUNG E,et al.The changing panorama of cerebral palsy in Sweden.IX.Prevalence and origin in the birth-year period 1995-1998[J].Acta Paediatr,2005,94(3):287-294.
[6]JINDAL V,G E A,MANSKY P J.Safety and efficacy of acupuncture in children:a review of the evidence[J].J Pediatr Hematol Oncol,2008,30(6):431-442.
[7]ADAMS D,CHENG F,JOU H,et al.The safety of pediatric acupuncture:a systematic review[J].Pediatrics,2011,128(6):e1575-87.
[8]YANG C,HAO Z,ZHANG L L,et al.Effi cacy and safety of acupuncture in children:an overview of systematic reviews[J].Pediatr Res,2015,78(2):112-119.
[9]唐久来,秦炯,邹丽萍,等.中国脑性瘫痪康复指南(2015)第一部分[J].中国康复医学杂志,2015,30(7):747-754.
[10]中国国家标准化管理委员会.腧穴名称与定位[M].北京中国标准出版社,2006.
[11]PULLMAN S L,GOODIN D S,MARQUINEZ A I,et al.Clinical utility of surface EMG:report of the therapeutics and technology assessment subcommittee of the American Academy of Neurology[J].Neurology,2000(55):171-177.
[12]FU WJ,JIN BX,ZHAO Y,et al.Clinical study on acupuncture combined with low-frequency electric stimulation for scissor gait in children with spastic cerebral palsy[J].Acupunct Tuina Sci,2015,13(3):150-155.
[13]LU D P,LU G P.An Historical Review and Perspective on the Impact of Acupuncture on U.S.Medicine and Society[J].Medical Acupuncture,2013,25(5):311-316.
[14]任宏伟,王恩龙.电针拮抗肌联合康复疗法治疗脑卒中后肌张力增强68例临床观察[J].中医药临床杂志,2017,29(10):1752-1754.
[15]岳增辉,李良,常小荣,等.电针与手针治疗脑卒中痉挛性瘫痪效应差异研究[J].中国针灸,2012,32(7):582-586.
[16]AYDIN A,GENE K,AKHISAROGIU M,et al.Erythropoietin exerts neuroprotective effect in neonatal ratmodel of hypoxic-ischemic brian injury[J].Brian&Development,2003,25(7):494-498.
[17]朱小宁,刘振寰.对小儿脑性瘫痪运动功能评估量表的评价(附100例临床分析)[J].山西医科大学学报,2000,31(1):65-66.