针刺锥体区治疗痉挛型小儿脑瘫的随机对照研究

Randomized Controlled Clinical Trials for Acupuncture Treatment of Spastic Cerebral Palsy Children by Bilateral Horizontal Puncturing from Yuzhen(BL 9) to Tianzhu(BL 10)

目的:观察针刺椎体区对痉挛型小儿脑瘫的疗效,探索痉挛型脑瘫的有效治疗途径。方法:采用简单随机方法将120例小儿脑瘫患者分为针刺组和对照组各60例。对照组采用现代康复疗法,治疗组在康复训练的基础上针刺锥体区,治疗3个月。观察两组治疗前后的改良Ashworth痉挛分级、粗大运动功能(GMFM)评分情况,根据综合功能评估进行疗效评价。结果:经治疗后,对照组总有效率84.75%(50/59),治疗组总有效率91.38%(53/58),两组疗效差异有统计学意义(P<0.05);在改良Ashworth痉挛分级方面,针刺组疗效优于对照组(P<0.05);GMFM结果表明,针刺组评分较对照组改善更加明显(P<0.05)。结论:针刺结合康复训练对于痉挛型小儿脑瘫患者有很好的疗效,且优于单纯康复训练治疗。

Objective To observe the effect of acupuncture of the body surface projection region of the pyramidal decussationes on spastic cerebral palsy （CP） so as to explore an effective therapy for it. Methods A total of 120 CP infant pa- tients were randomized into control group（treated with modern rehabilitation training, n = 60）and acupuncture group（treated with acupuncture combined with modern rehabilitation training, n = 60）. Four acupuncture needles were penetrated subcutaneously through the region between Yuzhen （BL 9） and Tianzhu（ BL 10） equidistantly （the superficial projection region of the pyramidal decussationes）, once daily for 3 months. The modified Ashworth rating,gross motor function measure （GMFM）-88 scores and synthetic function scale were adopted to assess the therapeutic effect after the treatment. Results After the treatment,of the 59 and 58 CP children in the control and acupuncture groups, 17 （28.81%） and 26 （44.83 %） experienced marked improvement in their symptoms, 33（55.84% ） and 27 （46.55 % ） had an improvement, 9（ 15.25% ） and 5（8.62 % ） failed in the treatment, with the total effective rates being 84.75 % and 91.38 %, respectively. The effective rate of the acupuncture group was significantly superior to that of the control group（ P〈0.05）. The scores of modified Ashworth rating and GMFM-88 of the control group were significantly lower than those of the acupuncture group after the treatment （P〈0.05）. Conclusion Acupuncture combined with modern rehabilitation training is effective in the treatment of CP children patients.