点穴疗法治疗产伤性痉挛型脑瘫疗效评价

Evaluation of effect for the treatment of spastic cerebral palsy cause by birth trauma with acupoint therapy

目的:通过点穴治疗痉挛型脑瘫的临床观察,探讨中医治疗脑瘫疗效的评价方法。方法:40 例痉挛型脑瘫患儿,男23例,女17例;年龄:1-3岁15例,4-6岁18例,7-9岁5例,10-12岁2例。将患儿的智力、语言、流涎、手持物、拇指内收、翻身、坐、站立、行走、剪刀腿10项指标分为正常、轻度、中度、重度异常(障碍)4级,分别评6、4、2、0分,治疗后每项每改善1级得2分;同时记录治疗前后肩外展、伸肘、伸腕、前臂旋后、髋外展、下肢直腿抬高、伸膝、踝背伸的度数并进行评分,治疗后挛缩关节活动度改善大于10°、15°、20°、25°、30°者,分别得1、2、3、4、5分。结果:18个观察项目除智力外,其余各项治疗前后有明显差异,治疗后改善明显(P<0.01),根据疗效评定标准:优5例,良17例,中15例,差3例。有效率92.5％。结论:制定的疗效评价标准能较好反映患者功能改善情况。

Objective: Passing clinical observation on treatment of spastic cerebral palsy cause by birth trauma with acupoint therapy, to expore the therapeutic effect of traditional chinese medicine (TCM). Methods Forty patients with spastic cerebral palsy such as intelligence, speech, salivation, substance holding, thumb-adduction, turning body over,sitting,standing, walking and scissors-gait were divided into four degrees: normal,slight abnormal,medium abnormal, severe abnormal (malfunction), which were respectively obtained 6,4,2,0 score,every degree of improvement got 2 score. Meanwhile, the range of shoulder-abduction,elbow-extention, wrist-extention, forearm-rotation, hip-abduction, straight-leg-lifting, knee-extention, ankle-dorsiflex-ion before and after treatment were recorded and evaluated. The patients with joint range of motion excelled at 10,15,20,25,30 degrees,respectively got 1,2,3,4,5 score.Results:Except the intelligence,the 18 items got a significant improvement (P<0.01). According standard of effect to evaluate:5 cases got excellent, 17 cases good, 15 fair and 3 poor. The effective rate was 92.5% . Conclusion:This effective evaluation criterion can reflect the functional improvement.