针刺夹脊穴配合肉毒毒素注射对痉挛型脑瘫坐位能力的影响

Effect of Acupuncture at Jiaji(EX-B 2) plus Botulinum Toxin Injection on Seated Function of Patients with Spastic Cerebral Palsy

目的观察针刺腰段夹脊穴配合肉毒毒素肌肉注射治疗对痉挛型脑瘫患者坐位能力的影响。方法将60例1-4岁痉挛型脑瘫患者随机分为治疗组和对照组,每组30例。治疗组采用针刺腰段夹脊穴配合肉毒毒素肌肉注射治疗,对照组采用常规针刺配合肉毒毒素肌肉注射治疗。治疗3个疗程后,两组分别进行粗大运动功能评估（GMFM）中坐位功能区（B区）的评估,并比较两组临床疗效。结果治疗组治疗1、2、3个疗程后总有效率分别为46.7%、73.3%和83.3%,对照组分别为33.3%、46.7%和60.0%。两组治疗2、3个疗程后总有效率比较,差异均具有统计学意义（P〈0.05）。两组治疗1个疗程后GMFM坐位功能评分与同组治疗前比较,差异均具有统计学意义（P〈0.01）。两组治疗2个疗程后GMFM坐位功能评分与同组治疗1个疗程后比较,差异均具有统计学意义（P〈0.01）。两组治疗3个疗程后GMFM坐位功能评分与同组治疗2个疗程后比较,差异均有统计学意义（P〈0.01）。两组治疗2个疗程后与治疗1个疗程后GMFM坐位功能评分差值比较,差异具有统计学意义（P〈0.01）。两组治疗3个疗程后与治疗2个疗程后GMFM坐位功能评分差值比较,差异具有统计学意义（P〈0.05）。结论针刺腰段夹脊穴配合肉毒毒素肌肉注射治疗能更好地提高痉挛型脑瘫患者的坐位能力。

Objective To observe the effect of acupuncture at lumbar Jiaji （EX-B 2） points plus botulinum toxin injection on the seated function of patients with spastic cerebral palsy.Method Sixty patients aged 1-4 years old with spastic cerebral palsy were randomized into a treatment group and a control group, 30 in each group. The treatment group was intervened by acupuncture at lumbar Jiaji （EX-B 2） points plus botulinum toxin injection, while the control group was by conventional acupuncture plus botulinum toxin injection. After 3 treatment courses, the seated function zone （zone B） of Gross Motor Function Measure （GMFM） was used for evaluation, and the clinical efficacies were compared.Result Respectively after 1, 2, and 3 treatment courses, the total effective rates were 46.7%, 73.3% and 83.3% in the treatment group, versus 33.3%, 46.7% and 60.0%. There were significant differences in comparing the total effective rate between the two groups after 2 and 3 courses （P〈0.05）. After the first treatment course, the seated function score of GMFM was significantly changed in both groups （P〈0.01）. After the second course, the seated function score was significantly different from that after the first course in both groups （P〈0.01）. After the third course, the seated function score was significantly different from that after the second course in both groups （P〈0.01）. There was a significant between-group difference in comparing the changes of the seated function score during the second treatment course （P〈0.01）. There was a significant between-group difference in comparing the changes of the seated function score during the second treatment course （P〈0.05）. Conclusion Acupuncture at lumbar Jiaji （EX-B 2） points plus botulinum toxin injection can produce a more significant efficacy in improving the seated function of patients with spastic cerebral palsy.