头针治疗不同月龄早产儿脑损伤疗效观察
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摘要
目的:探讨头针对不同月龄早产儿脑损伤的临床疗效差异。方法:将90例早产儿脑损伤按纠正月龄分为头针1组(纠正月龄3~6个月)、头针2组(纠正月龄7~9个月)和头针3组(纠正月龄10~12个月),每组30例,在常规早期干预基础上给予头针治疗,头针1组取智七针、运动区;头针2组取智七针、运动区、足运感区;头针3组取智七针、运动区、足运感区、平衡区。隔日1次,共治疗30次。观察治疗前后Alberta婴儿运动量表(Alberta infant motor scale,AIMS)评分、盖塞尔发展量表(Gesell developmental scale)各功能区适应行为发育商(DQ)值,并比较各组临床疗效,分析临床疗效与月龄的相关性。结果:各组治疗后AIMS总分、Gesell各功能区DQ值均较治疗前提高(均P<0.01);治疗后各组间AIMS总分、Gesell各功能区DQ值比较差异均有统计学意义(P<0.05,P<0.01),且头针1组高于头针2组、头针3组(P<0.05,P<0.01)。头针1组总有效率为96.3%(26/27),高于头针2组[89.7%(26/29)]和头针3组[83.3%(25/30)]。临床疗效与月龄呈相关性(P<0.05),且月龄越小,干预效果越好。结论:头针对早产儿脑损伤恢复具有良好的促进作用,尤其对≤6月龄的早产儿脑损伤疗效更为显著。
Objective To explore the clinical efficacy differences of scalp acupuncture on brain injury in premature infants with different months of age. Methods According to the corrected months of age, 90 cases of premature infants with brain injury were divided into a group A(3 through 6 corrected months of age), a group B(7 through 9 corrected months of age)and group C(10 through 12 corrected months of age), 30 patients in each one. Based on the conventional early intervention,the infants in the group A were treated with scalp acupuncture at Zhiqizhen, motor area; the infants in the group B were treated with scalp acupuncture at Zhiqizhen, motor area and foot motor sensory area; the infants in the group C were treated with scalp acupuncture at Zhiqizhen, motor area, foot motor sensory area and balance area. All the treatment was given once every other day, and totally 30 treatments were given. The Alberta infant motor scale(AIMS), development quotient(DQ) of each function indexes in Gesell developmental scale(GDS) were observed before and after treatment; the clinical efficacy of each group was compared and the correlation between clinical efficacy and months of age was analyzed. Results Compared before treatment,the total score of AIMS and DQ of each function indexes of GDS were all improved in the three groups after treatment(all P<0.01). After treatment, the differences of total score of AIMS and DQ of each function indexes of GDS among the three groups were significant(P<0.05, P<0.01), and the results in the group A were higher than those in the group B and the group C(P<0.05, P<0.01). The total effective rate was 96.3%(26/27) in the group A, which was higher than 89.7%(26/29) in the group B and 83.3%(25/30) in the group C. The correlation analysis indicated less months of age was significantly corelated with better efficacy(P<0.05). Conclusion Scalp acupuncture has superior improvement on the recovery of brain damage in premature infants, especially for those with 6 months of age or less.
Objective To explore the clinical efficacy differences of scalp acupuncture on brain injury in premature infants with different months of age. Methods According to the corrected months of age, 90 cases of premature infants with brain injury were divided into a group A(3 through 6 corrected months of age), a group B(7 through 9 corrected months of age)and group C(10 through 12 corrected months of age), 30 patients in each one. Based on the conventional early intervention,the infants in the group A were treated with scalp acupuncture at Zhiqizhen, motor area; the infants in the group B were treated with scalp acupuncture at Zhiqizhen, motor area and foot motor sensory area; the infants in the group C were treated with scalp acupuncture at Zhiqizhen, motor area, foot motor sensory area and balance area. All the treatment was given once every other day, and totally 30 treatments were given. The Alberta infant motor scale(AIMS), development quotient(DQ) of each function indexes in Gesell developmental scale(GDS) were observed before and after treatment; the clinical efficacy of each group was compared and the correlation between clinical efficacy and months of age was analyzed. Results Compared before treatment,the total score of AIMS and DQ of each function indexes of GDS were all improved in the three groups after treatment(all P<0.01). After treatment, the differences of total score of AIMS and DQ of each function indexes of GDS among the three groups were significant(P<0.05, P<0.01), and the results in the group A were higher than those in the group B and the group C(P<0.05, P<0.01). The total effective rate was 96.3%(26/27) in the group A, which was higher than 89.7%(26/29) in the group B and 83.3%(25/30) in the group C. The correlation analysis indicated less months of age was significantly corelated with better efficacy(P<0.05). Conclusion Scalp acupuncture has superior improvement on the recovery of brain damage in premature infants, especially for those with 6 months of age or less.
引文
[1]鲍珊,陈大鹏,杨晓燕,等.我国早产儿脑损伤研究现状——基于国内期刊的共词分析[J].中国新生儿科杂志,2013,28(6):366-370.
[2]Kolb B,Gibb R.Brain plasticity and behaviour in the developing brain[J].J Can Acad Child Adolesc Psychiatry,2011,20(4):265-276.
[3]何金华,张惠佳,刘志雄,等.头针配合认知训练治疗婴幼儿脑损伤综合征智力发育迟缓患儿的疗效观察[J].中医药导报,2011,17(8):61-62.
[4]齐放.头针加体针点刺早期干预婴儿脑损伤的临床价值分析[J].针灸临床杂志,2016,32(6):27-30.
[5]中国医师协会新生儿专业委员会.早产儿脑损伤诊断与防治专家共识[J].中国当代儿科杂志,2012,14(12):883-884.
[6]刘振寰,戴淑凤.儿童运动发育迟缓康复训练图谱[M].北京:北京大学医学出版社,2014.
[7]岑丽婷,刘振寰.通督醒脑益肾健脾按摩对脑损伤早产儿神经发育影响的观察[J].中国儿童保健杂志,2012,20(12):1064-1066.
[8]苏连菊.视听综合训练刺激护理模式在颅脑损伤患者认知功能的应用效果观察[J].中国实用神经疾病杂志,2015,18(9):135-136.
[9]金炳旭,赵勇,李诺,等.“痉挛三针”对痉挛型脑瘫患儿内收肌肌张力的影响[J].中国针灸,2015,35(3):217-220.
[10]胡恕香,黄蓉,彭桂兰,等.Alberta婴儿运动量表在高危儿早期干预中的应用分析[J].中国康复医学杂志,2015,30(2):157-159.
[11]蔡霞,丘小奎,徐芝兰.Alberta婴儿运动量表在高危儿早期运动发育评价中的应用[J].中国继续医学教育,2016,8(9):123-124.
[12]金炳旭,符文杰,钱旭光,等.基于正交设计的不同头针方案的脑性瘫痪临床疗效研究[J].中国康复医学杂志,2014,30(6):591-593.
[13]段洋,毛健,富建华,等.以磁共振成像诊断早产儿脑损伤相关危险因素的回顾性分析[J].中国循证儿科杂志,2007,2(6):427-433.
[14]赵萍,周春梅,廖火生,等.早期干预对改善新生儿缺氧缺血性脑病患儿智力发育的研究[J].临床儿科杂志,2002,20(1):9-11.
[15]彭桂兰,刘虹,丁德琴,等.300例婴儿脑损伤综合征干预效果分析[J].中国妇幼保健,2012,27(2):214-215.
[16]周园,刘振寰,章马兰,等.早期中西医综合干预对不同胎龄全面性发育迟缓患儿的疗效研究[J].中国儿童保健杂志,2017,25(6):643-645.
[17]岑丽婷,刘振寰.早期干预对早产儿脑损伤神经发育的新进展[J].中国妇幼保健,2013,28(32):5408-5411.
[18]徐春花,范刚启,赵杨,等.头皮针流派比较及发挥[J].中国针灸,2016,36(6):663-667.
[19]刘彩霞,景卫莉,谢集建.早产儿脑损伤发病机制研究进展[J].医学综述,2015,21(9):1638-1640.
[20]汤健,张跃,朱敏,等.头针对脑性瘫痪儿童认知功能和脑干听觉诱发电位的影响[J].南京中医药大学学报,2013,29(6):532-534.
[21]刘振寰,陈杰奎.针刺促进脑神经发育与修复的新进展[C]//广东省针灸学会第十一次学术研讨会论文汇编.广州,2010:499-500.
[22]赵霞,汪受传,陈争光,等.中医儿科技术方法操作规范——小儿针灸疗法(征求意见稿)[J].中医儿科杂志,2014,10(3):1-9.
[2]Kolb B,Gibb R.Brain plasticity and behaviour in the developing brain[J].J Can Acad Child Adolesc Psychiatry,2011,20(4):265-276.
[3]何金华,张惠佳,刘志雄,等.头针配合认知训练治疗婴幼儿脑损伤综合征智力发育迟缓患儿的疗效观察[J].中医药导报,2011,17(8):61-62.
[4]齐放.头针加体针点刺早期干预婴儿脑损伤的临床价值分析[J].针灸临床杂志,2016,32(6):27-30.
[5]中国医师协会新生儿专业委员会.早产儿脑损伤诊断与防治专家共识[J].中国当代儿科杂志,2012,14(12):883-884.
[6]刘振寰,戴淑凤.儿童运动发育迟缓康复训练图谱[M].北京:北京大学医学出版社,2014.
[7]岑丽婷,刘振寰.通督醒脑益肾健脾按摩对脑损伤早产儿神经发育影响的观察[J].中国儿童保健杂志,2012,20(12):1064-1066.
[8]苏连菊.视听综合训练刺激护理模式在颅脑损伤患者认知功能的应用效果观察[J].中国实用神经疾病杂志,2015,18(9):135-136.
[9]金炳旭,赵勇,李诺,等.“痉挛三针”对痉挛型脑瘫患儿内收肌肌张力的影响[J].中国针灸,2015,35(3):217-220.
[10]胡恕香,黄蓉,彭桂兰,等.Alberta婴儿运动量表在高危儿早期干预中的应用分析[J].中国康复医学杂志,2015,30(2):157-159.
[11]蔡霞,丘小奎,徐芝兰.Alberta婴儿运动量表在高危儿早期运动发育评价中的应用[J].中国继续医学教育,2016,8(9):123-124.
[12]金炳旭,符文杰,钱旭光,等.基于正交设计的不同头针方案的脑性瘫痪临床疗效研究[J].中国康复医学杂志,2014,30(6):591-593.
[13]段洋,毛健,富建华,等.以磁共振成像诊断早产儿脑损伤相关危险因素的回顾性分析[J].中国循证儿科杂志,2007,2(6):427-433.
[14]赵萍,周春梅,廖火生,等.早期干预对改善新生儿缺氧缺血性脑病患儿智力发育的研究[J].临床儿科杂志,2002,20(1):9-11.
[15]彭桂兰,刘虹,丁德琴,等.300例婴儿脑损伤综合征干预效果分析[J].中国妇幼保健,2012,27(2):214-215.
[16]周园,刘振寰,章马兰,等.早期中西医综合干预对不同胎龄全面性发育迟缓患儿的疗效研究[J].中国儿童保健杂志,2017,25(6):643-645.
[17]岑丽婷,刘振寰.早期干预对早产儿脑损伤神经发育的新进展[J].中国妇幼保健,2013,28(32):5408-5411.
[18]徐春花,范刚启,赵杨,等.头皮针流派比较及发挥[J].中国针灸,2016,36(6):663-667.
[19]刘彩霞,景卫莉,谢集建.早产儿脑损伤发病机制研究进展[J].医学综述,2015,21(9):1638-1640.
[20]汤健,张跃,朱敏,等.头针对脑性瘫痪儿童认知功能和脑干听觉诱发电位的影响[J].南京中医药大学学报,2013,29(6):532-534.
[21]刘振寰,陈杰奎.针刺促进脑神经发育与修复的新进展[C]//广东省针灸学会第十一次学术研讨会论文汇编.广州,2010:499-500.
[22]赵霞,汪受传,陈争光,等.中医儿科技术方法操作规范——小儿针灸疗法(征求意见稿)[J].中医儿科杂志,2014,10(3):1-9.