热补针法结合康复训练对小儿脑瘫患儿功能影响的随机对照研究

Clinical Study on the Treatment of Infant Cerebral Palsy with Warm-reinforcing Needling Combined with Rehabilitation Training

目的:探讨热补针法结合康复训练治疗小儿脑瘫的疗效。方法:将40例小儿脑瘫患儿随机分为康复组19例,针刺结合康复组21例,康复组患儿采用康复训练进行治疗,针刺结合康复组患儿采用热补针法结合康复训练治疗。针刺治疗体针取百会、哑门、曲池、环跳、三阴交等穴,施热补针法,不留针;头针取智三针、脑三针、运动区、平衡区等穴,不提插捻转,留针1 h。均隔日1次,3个月为1疗程,共治疗2个疗程。采用粗大运动功能评价量表(GMFM)和脑瘫患儿综合功能评定量表进行功能评定。结果:康复组与针刺结合康复组显效、无效和有效率分别为12(63.16%),18(85.71%);7(36.84%),3(14.29%);63.16%和85.71%,针刺结合康复治疗组的疗效显著优于单纯康复治疗组(P<0.05)。两组治疗前比较GMFM评分和脑瘫综合功能评分均无显著性差异(P>0.05),两组治疗后比较GMFM评分和脑瘫综合功能评分均有显著增加(P<0.01);针刺结合康复治疗的增加幅度明显高于单纯康复组(P<0.01)。结论:针刺结合康复训练提高脑瘫患儿的综合功能的疗效明显优于单纯康复治疗。

Objective： To observe the therapeutic effect of warm-reinforcing needling combined with modern rehabilitation training for infant cerebral palsy （CP）. Methods. Forty cases of cerebral palsy children were randomly divided into rehabilitation （Rehab, n = 19） and acupuncture （Acup） ＋ Rehab （n = 21） groups, Body acupoints used were Baihui （GV 20）, Zusanli （ST 36）, Quchi （LI 11）, Huantiao （GB 30）, Yinlingquan （GB 34）, Sanyinjiao （SP 6）, etc., and scalp-acupoints Zhisanzhen （the cross-point between the anterior hairline and the median line of the head, 3 curt bilateral to the crossing point）, Naosanzhen ENao- hu （GV 17）, 1.5 cun bilateral to GV17], Balance Zone, Motor Zone, etc.. The treatment was conducted once every other day, with 3 months being a therapeutic course, 2 courses altogether. Rehabilitation training included physical training （PT）, occupational therapy （OT） training, and speech training （ST）, 5 times a week, with 3 months being a therapeutic course, 2 courses altogether. Gross motor function measure （GMFM） and comprehensive function （OF, including cognition, speech, motor, self-care and social-adaptable abilities） were evaluated. Results： After the treatment, of the 19 and 21 cases in Rehab and Acup＋ Rehab groups, 12 （63. 16%） and 18 （85.71%） experienced marked improvement, 7 （36.84%） and 3 （14.29%） failed, with the effective rates being 63. 16% and 85.71% respectively. The therapeutic effect of Acup ＋ Rehab group was markedly superior to that of Rehab group （ P〈0.05）. Self-comparison of two groups showed that the scores of CF and GMFM increased significantly in comparison with pre-treatment （P〈0.01）, and the scores of OF and GMFM of Acup＋ Rehab group were obviously higher than those of Rehab group （P〈0.01）. Conclusion： Rehabilitation training combined with acupuncture can apparently improve CP children＇s motor and comprehensive functions, and the therapeutic effect of Acup＋ Rehab is evidently superior to that of simple rehabilitation training therapy.