舒筋解痉方、捏脊、头皮针等三联疗法结合Bobath技术对步行痉挛型脑瘫患儿三维步态时空和表面肌电的影响

Effect of Traditional Chinese Medicine Triple Therapy and Bobath Technology on Three-Dimensional Gait Time-Space and Surface Myoelectricity of Children with Walking Spastic Type Cerebral Palsy

目的:观察中药舒筋解痉熏蒸方、捏脊和头皮针等三联疗法结合Bobath技术对步行痉挛型脑瘫患儿三维步态时空和表面肌电等指标的影响。方法:将131例步行痉挛型脑瘫患儿随机分为三联疗法治疗组(简称A组,n=43)、Bobath治疗组(简称B组,n=44)、三联疗法加Bobath治疗组(简称C组,n=44),分别予以相应的方法治疗2个疗程,检测治疗前、后三维步态时空参数和踝关节痉挛肌及拮抗肌的i EMG、AEMG、CR等指标。结果:3组患儿治疗后的三维步态时空参数,腓肠肌被动活动状态下的i EMG及MIVC下的i EMG、MF、CR,胫骨前肌MIVC下的i EMG、MF、CR与各组治疗前相比,均有不同程度的改善,具有统计学意义(P<0.05或P<0.01);治疗后的C组与治疗后的A、B组比较,上述指标均有改善,具有统计学意义(P<0.05)。结论:中药舒筋解痉熏蒸方、捏脊和头皮针等三联疗法联合Bobath技术能改善步行痉挛型脑瘫患儿三维步态时空和表面肌电等各项指标,值得临床推广。

Objective： To observe the effect of the triple therapy of traditional Chinese medicine and Bobath technology on three- dimensional gait and the surface myoelectricity of children with walking spastic type cerebral palsy. Methods： A total of 131 patients were randomly divided into three groups： the triple therapy group（ A group,n = 43）,the Bobath group（ B group,n = 4 4） and the triple therapy with Bobath group（ C group,n = 4 4）. The corresponding methods were used.After 2 courses,we detected patients＇ i EMG,AEMG,CR and three- dimensional gait before and after the treatment. Results： After treatment,three groups＇ three- dimensional gait parameters were better improved. The i EMG of gastrocnemius in the passive state and i EMG,MF and CR of gastrocnemius in the active state and i EMG,MF and CR of the tibialis anterior muscle in the active state,all had statistical significance（ P〈0. 05 or P〈0. 01）; the above indicators of the C group were better improved than those of the A and B groups,with statistical significance（ P〈0. 05）. Conclusion： The triple therapy of traditional Chinese medicine and Bobath technology could improve the indicators of three- dimensional gait and myoelectricity for children with walking spastic type cerebral palsy,which is worthy of clinical promotion.