穴位注射联合梅花针治疗小儿植物状态:随机对照研究

Vegetative state treated with acupoint injection combined with plum-blossom needle in children:a randomized controlled trial

目的:观察在基础治疗上配合穴位注射联合梅花针与配合西药治疗小儿植物状态的临床疗效差异。方法:48例植物状态患儿随机分为观察组和对照组,各24例。两组在经颅磁刺激治疗仪、导平治疗仪及按摩治疗的基础上,观察组采用穴位注射及梅花针叩刺,将醒脑静注射液、鼠神经生长因子注射液、单唾液酸四己糖神经节苷脂钠注射液、复方丹参注射液两两分为一组,共6组,每组连续使用10天,分别注射于百会、涌泉、风府、哑门等穴,每穴0.5mL,每天1次,联合梅花针叩刺背部督脉及夹脊穴;对照组采用胞磷胆碱钠注射液、甘露醇注射液、地塞米松注射液静脉点滴。两组均每天治疗1次,20天为一疗程,共治疗3个疗程。分别于治疗20天、40天、60天后观察两组临床疗效、植物状态评分和平均痊愈时间。结果:治疗20天、40天、60天后观察组有效率分别为58.3%(14/24)、70.8%(17/24)、79.2%(19/24),对照组分别为20.8%(5/24)、45.8%(11/24)、58.3%(14/24),观察组疗效均优于对照组(P<0.01,P<0.05);两组治疗20天、40天、60天后各时间点植物状态评分均较治疗前明显提高(均P<0.05),观察组治疗后各时间点较对照组提高更明显(3.34±2.41vs 2.64±1.56,6.20±1.46vs 4.34±1.64,11.26±2.63vs8.75±2.18,均P<0.05);观察组平均痊愈时间为(45.67±16.24)天,明显短于对照组的(55.34±4.57)天(P<0.05)。结论:基础治疗配合穴位注射联合梅花针叩刺治疗小儿植物状态疗效可靠。

Objective To observe the clinical efficacy difference on vegetative state in children between acupoint injection combined with plum-blossom needle and western medication based on basic treatment. Methods Forty- eight children of vegetative state were randomized into an observation group and a control group, 24 cases in each one. On the basis of the treatment of transcranial magnetic stimulation apparatus, balancing treatment apparatus and massage, the acupoint injection and tapping method with plum-blossom needle were adopted in the observation group, in which Xingnaojing injection, mouse nerve growth factor （mNGF） injection, monosialotetrahexosylgan- glioside sodium injection （MSI）, compound Danshen injection were divided in 6 pairs and were injected respectively in Baihui （GV 20）, Yongquan （KI 1）, Fengfu （GV 16）, Yamen （GV 15） and the others, 0.5 mL in each acu- point, once a day for continuous 10 days. Additionally, the tapping method with plum-blossom needle was used on the Governor Vessel and Jiaji （EX-B 2） on the back. In the control group, the intravenous infusion was adopted with citicoline sodium injection, mannitol injection and dexamethasone injection. The treatment was given once a day, 20 days of treatment made one session and totally 3 sessions were required in the two groups. The clinical el- ficacy, the vegetative state score and the mean curing time were observed after 20 days, 40 days and 60 days of treatment between the two groups. Results The effective rates were 58. 3% （14/24）, 70.8% （17/24） and 79.2% （19/24） in 20 days, 40 days and 60 days of treatment in the observation group and 20.8% （5/24）, 45.8% （11/24） and 58.3% （14/24） in the control group respectively. The efficacy in the observation group was superior to those in the control group （P〈0.01, P〈0.05）. The vegetative state score was improved apparently after20 days, 40 days and 60 days of treatment as compared with those before treatment separately （all P〈0.05）. It was improved obviously at the each time point after treatment in the observation group as compared with that in the control group （3.34±2.41 vs 2.64±1.56,6.20±1.46 vs 4.34±1.64,11.26±2.63 vs 8.75±2.18, all P〈 0.05）. The mean curing time was （45.67 ±16.24） days in the observation group, which was shorter apparently than that of （55. 34±4.57） days in the control group （P〈0.05）. Conclusion Based on basic treatment acupoint injection combined with tapping method of plum-blossom needle achieve the reliable efficacy on vegetative state in children.