头皮针联合健脑益智方治疗小儿脑瘫临床疗效及对肢体运动功能、脑血流影响
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摘要
目的:探讨头皮针联合健脑益智方治疗小儿脑瘫临床疗效及对肢体运动功能、脑血流的影响。方法:根据病例对照研究原则,2015年4月—2017年8月选择我院诊断及治疗的脑瘫患儿76例,随机分为对照组(38例)和观察组(38例),对照组采用常规对症用药和康复训练;在此基础上,观察组采用头皮针(每次留针15 min,每天1次,每周6次)联合健脑益智方治疗,持续治疗2个月。比较两组间临床疗效、中文版GMFM(Gross motor function measure)量表、改良Ashworth法及大脑动脉血流速度(Cerebral artery blood flow velocity,VP)、血管搏动指数(pulsatility index,PI),记录不良反应状况。结果:对照组有效率为78.95%,观察组有效率为94.74%,两组间有效率比较,差异有统计学意义(P <0.05)。治疗后对照组和观察组GMFM量表分别为(43.26±12.69)分、(56.78±14.10)分,改良Ashworth量表分别为(1.64±0.42)分、(1.23±0.38)分,VP数值分别为(131.85±10.58)cm/s、(139.61±11.24)cm/s,PI数值分别为(1.04±0.26)%、(0.89±0.24)%,对照组和观察组上述指标比较,差异有统计学意义(P<0.05)。观察组治疗期间因针刺出现2例皮下瘀青,热敷后消失,未对研究产生影响。结论:头皮针联合健脑益智方治疗小儿脑瘫的临床疗效确切,改善肢体运动和肌张力状态,改善脑微循环,且患儿可以耐受。
Objective:To explore the the clinical efficacy of scalp acupuncture combined with Jiannao Yizhi Decoction in the treatment of cerebral palsy in children in motor function of limbs and cerebral blood flow. Methods:76 children with cerebral palsy diagnosed and treated in our hospital from April 2015 to August 2017 were randomly divided into control group(38 cases)and observation group(38 cases)according to the principle of case control study. The control group was treated with routine medication and rehabilitation training. On this basis,the observation group was treated with scalp needle(15 min each time,1 per day). 6 times a week,combined with the treatment of 2 months. The clinical efficacy of the two groups,the Chinese version of the GMFM(gross motor function measure),the improved Ashworth method and the cerebral artery blood flow velocity(Cerebral artery blood flow velocity,VP)and the vascular pulsation index were compared. Results:The effective rate of the control group(78.95%)was lower than the observation group(94.74%),and the difference between the two groups was statistically significant(P<0.05). Scores of GMFM scales of the control group and the observation group were(43.26±12.69)points and(56.78±14.10)points,and the modified Ashworth scales were(1.64±0.42)points and(1.23±0.38)points,VP were(131.85±10.58)cm/s and(139.61±11.24)cm/s,and PI values were respectively(1.04%±0.26%)and(0.89%±0.24%),the differences were significant(P<0.05). 2 cases of subcutaneous bruises appeared after acupuncture treatment in the observation group,and disappeared after hot compress,which did not affect the study. Conclusion:Scalp acupuncture combined with Jiannao Yizhi Decoction in the treatment of cerebral palsy of children is accurate,it can improve the state of limb movement and muscle tension,improve the cerebral microcirculation,and it can be tolerated in children.
Objective:To explore the the clinical efficacy of scalp acupuncture combined with Jiannao Yizhi Decoction in the treatment of cerebral palsy in children in motor function of limbs and cerebral blood flow. Methods:76 children with cerebral palsy diagnosed and treated in our hospital from April 2015 to August 2017 were randomly divided into control group(38 cases)and observation group(38 cases)according to the principle of case control study. The control group was treated with routine medication and rehabilitation training. On this basis,the observation group was treated with scalp needle(15 min each time,1 per day). 6 times a week,combined with the treatment of 2 months. The clinical efficacy of the two groups,the Chinese version of the GMFM(gross motor function measure),the improved Ashworth method and the cerebral artery blood flow velocity(Cerebral artery blood flow velocity,VP)and the vascular pulsation index were compared. Results:The effective rate of the control group(78.95%)was lower than the observation group(94.74%),and the difference between the two groups was statistically significant(P<0.05). Scores of GMFM scales of the control group and the observation group were(43.26±12.69)points and(56.78±14.10)points,and the modified Ashworth scales were(1.64±0.42)points and(1.23±0.38)points,VP were(131.85±10.58)cm/s and(139.61±11.24)cm/s,and PI values were respectively(1.04%±0.26%)and(0.89%±0.24%),the differences were significant(P<0.05). 2 cases of subcutaneous bruises appeared after acupuncture treatment in the observation group,and disappeared after hot compress,which did not affect the study. Conclusion:Scalp acupuncture combined with Jiannao Yizhi Decoction in the treatment of cerebral palsy of children is accurate,it can improve the state of limb movement and muscle tension,improve the cerebral microcirculation,and it can be tolerated in children.
引文
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[3]陈剑波,余卫,冯梦卉,等.头皮针联合肢体康复训练治疗小儿脑瘫疗效观察[J].针灸临床杂志,2017,33(3):1-4.
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[10]Du X,Chen J,Jiang K,et al. The Therapeutic Effect of Acupuncture on Cerebral Palsy in Children with Language Retardation Using the Midnight-noon Ebb-flow Method Combined with Syndrome Differentiation[J]. Zhen ci yan jiu Acupuncture research,2017,42(4):346.
[11]宋军利,陈迪,宋国.现代康复训练结合中医针刺治疗小儿脑瘫临床观察[J].湖北中医药大学学报,2016,18(5):28-31.
[12]徐春花,范刚启,赵杨.头皮针流派比较及发挥[J].中国针灸,2016,36(6):663-667.
[13]杨盛,何然,张飞燕,等.细胞共培养模型及其在中枢神经系统疾病研究中的应用[J].药学学报,2016(3):338-346.
[14]武峻艳,王杰,张俊龙.从督脉的循行和作用谈“脑为元神之府”[J].中医杂志,2015,56(8):636-639.
[15]王海祥,张冰清,林久銮,等.基于立体定向脑电图皮质电刺激技术的岛叶及岛盖脑功能定位研究[J].中华医学杂志,2016,96(29):2347-2351.
[16]刘曦.健脑益智散联合康复训练对脑瘫患儿血清IGF-1及炎性细胞因子影响研究[J].辽宁中医药大学学报,2017,19(6):3582-3584.
[17]李新剑,宋伟,仇爱珍,等.经颅磁刺激术联合康复训练对脑性瘫痪患儿日常精细动作及认知功能发育的影响[J].中国全科医学,2016,19(18):2184-2187.
[18]刘涓,谢瑞娟,石翠霞,等.现代康复训练结合中医针刺治疗小儿脑瘫临床疗效及对肢体运动功能与脑血流影响[J].辽宁中医药大学学报,2016,18(8):251-253.
[2]袁记霞,常小维.温水中康复训练联合低频脉冲电刺激治疗痉挛型脑瘫患儿的疗效观察[J].中华物理医学与康复杂志,2013,35(11):896-897.
[3]陈剑波,余卫,冯梦卉,等.头皮针联合肢体康复训练治疗小儿脑瘫疗效观察[J].针灸临床杂志,2017,33(3):1-4.
[4]Dabbous O A,Mostafa Y M,Noamany H A E,et al. Laser acupuncture as an adjunctive therapy for spastic cerebral palsy in children[J]. Lasers in Medical Science,2016,31(6):1061-1067.
[5]常永霞,戈蕾,周迎东,等.针刺联合康复训练治疗小儿脑瘫[J].长春中医药大学学报,2015,31(5):1049-1050.
[6]Punj A,Ahmad S,Shukla A K,et al. A Study on Different Factors Involved in the Clinical and Etiological Profile of Cerebral Palsy in Children[J].2017,3(1):14.
[7]彭桂兰,张端秀,胡恕香,等.厦门市0~5岁儿童脑性瘫痪流行病学调查[J].中国妇幼保健,2016,31(24):5456-5458.
[8]Fazlalizadeh F,Inaloo S,Honar N,et al. Growth and minerals status in children with cerebral palsy in Shiraz[J]. Iran during April,2017,6(3):486.
[9]许丽超,焦云.中医康复疗法在小儿脑瘫临床应用的研究进展[J].世界中医药,2016,11(11):2476-2479.
[10]Du X,Chen J,Jiang K,et al. The Therapeutic Effect of Acupuncture on Cerebral Palsy in Children with Language Retardation Using the Midnight-noon Ebb-flow Method Combined with Syndrome Differentiation[J]. Zhen ci yan jiu Acupuncture research,2017,42(4):346.
[11]宋军利,陈迪,宋国.现代康复训练结合中医针刺治疗小儿脑瘫临床观察[J].湖北中医药大学学报,2016,18(5):28-31.
[12]徐春花,范刚启,赵杨.头皮针流派比较及发挥[J].中国针灸,2016,36(6):663-667.
[13]杨盛,何然,张飞燕,等.细胞共培养模型及其在中枢神经系统疾病研究中的应用[J].药学学报,2016(3):338-346.
[14]武峻艳,王杰,张俊龙.从督脉的循行和作用谈“脑为元神之府”[J].中医杂志,2015,56(8):636-639.
[15]王海祥,张冰清,林久銮,等.基于立体定向脑电图皮质电刺激技术的岛叶及岛盖脑功能定位研究[J].中华医学杂志,2016,96(29):2347-2351.
[16]刘曦.健脑益智散联合康复训练对脑瘫患儿血清IGF-1及炎性细胞因子影响研究[J].辽宁中医药大学学报,2017,19(6):3582-3584.
[17]李新剑,宋伟,仇爱珍,等.经颅磁刺激术联合康复训练对脑性瘫痪患儿日常精细动作及认知功能发育的影响[J].中国全科医学,2016,19(18):2184-2187.
[18]刘涓,谢瑞娟,石翠霞,等.现代康复训练结合中医针刺治疗小儿脑瘫临床疗效及对肢体运动功能与脑血流影响[J].辽宁中医药大学学报,2016,18(8):251-253.