针刺治疗孤独症谱系障碍儿童便秘的效果

Effect of Acupuncture on Constipation in Children with Autism Spectrum Disorder

目的观察针刺对孤独症谱系障碍(ASD)儿童便秘问题及核心症状的治疗效果。方法2019年1月至2020年11月,黑龙江中医药大学附属第二医院康复中心收治50例ASD并发便秘患儿,随机分为针康组(n=25)和药康组(n=25)。针康组采用头针、体针结合康复训练法;药康组采用口服益生菌结合康复训练法;两组均进行便秘和核心症状的康复训练。便秘治疗8周,核心症状治疗12周。治疗前,治疗8周、12周后进行便秘疗效判定和便秘主症评分,并采用孤独症儿童行为量表(ABC)和孤独症治疗评估表(ATEC)对核心症状进行评估。结果治疗前两组便秘主症评分、ABC评分和ATEC总分比较均无显著性差异(P>0.05)。治疗8周,两组主症评分均显著降低(t>5.473,P<0.001);治疗12周,针康组便秘疗效和主症评分均优于药康组(Z=2.848,t=-2.139,P<0.05)。治疗8周后,两组ABC评分和ATEC总分均较治疗前显著降低(t>7.139,P<0.001),两组间比较均无显著性差异(P>0.05);针康组ATEC行为评分明显降低(t=3.849,P<0.01),优于药康组(t=-2.643,P<0.05),两组间其他项评分无显著性差异(P>0.05);治疗12周,针康组ABC评分、ATEC总分及各项评分均低于药康组(|t|>2.156,P<0.05)。结论针刺结合康复训练法可改善ASD儿童便秘问题,疗效较持久,也可改善孤独症的核心症状,均优于药物结合康复训练法。

Objective To observe the effect of acupuncture on constipation in children with autism spectrum disorder(ASD).Methods From January,2019 to November,2020,50 ASD children with constipation from Rehabilitation Center of the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine were admitted and randomly divided into acupuncture-rehabilitation group(n=25)and medicine-rehabilitation group(n=25).For constipation,the acupuncture-rehabilitation group used scalp acupuncture,body acupuncture combined with rehabilitation;the medicine-rehabilitation group took probiotics orally combined with rehabilitation.Both groups received conventional rehabilitation for constipation and the core symptoms.Constipation was treated for eight weeks,and ASD symptoms was treated for twelve weeks.After eight weeks and twelve weeks,the efficacy of constipation and the scores of main symptoms of constipation were compared,and they were also evaluated with Autism Child Behavior Scale(ABC)and Autism Treatment Evaluation Scale(ATEC).Results Before treatment,there was no significant difference in the main symptoms of constipation,nor the scores of ABC and ATEC between two groups(P>0.05).Eight weeks after treatment,the main symptoms of constipation significantly improved(t>5.473,P<0.001);twelve weeks after treatment,the efficacy of constipation and the main symptoms of constipation were better in the acupuncture-rehabilitation group than in the medicine-rehabilitation group(Z=2.848,t=-2.139,P<0.05).Eight weeks after treatment,the scores of ABC and ATEC significantly decreased(t>7.139,P<0.001),and there was no significant difference between two groups(P>0.05);the score of behavior of ATEC significantly decreased in the acupuncture-rehabilitation group(t=3.849,P<0.01),and was lower than that of the medicine-rehabilitation group(t=-2.643,P<0.05),and no significant difference in other items was found between two groups(P>0.05);twelve weeks after treatment,the scores of ABC and ATEC were lower in the acupuncture-rehabilitation group than in the medicine-rehabilitation group(|t|>2.156,P<0.05).Conclusion Acupuncture-rehabilitation can improve the longer-lasting effect of constipation,and also improve the core symptoms of ASD,which is superior to medicine-rehabilitation.