针刺督脉为主治疗肌张力低下型脑瘫患儿疗效的价值研究

Study on the Value of Acupuncturing Du Meridian for the Treatment of Hypotonia in Children with Cerebral Palsy

目的:观察针刺督脉为主治疗肌张力低下型脑瘫患儿的疗效。方法:选取我院收纳的98例肌张力低下型脑瘫患儿,按随机分配原则分为观察组和对照组,对照组采用常规头针治疗方案加上推拿按摩,观察组在对照组基础治疗上加用针刺督脉治疗。观察两组患者治疗前后ADL评分以及GMFM评分,采用尼莫地平法对两种治疗方案的肌张力低下型脑瘫患儿临床效果进行评价。结果:两组肌张力低下型脑瘫患儿治疗前在ADL评分以及GMFM评分上无明显差异,不具有统计学意义(P>0.05)。两组患者治疗后在ADL评分以及GMFM评分上有明显差异,具有统计学意义(P<0.05)。观察组肌张力低下型脑瘫患儿总有效率95.9%,对照组肌张力低下型脑瘫患儿总有效率77.5%,观察组总有效率比对照组高,有明显差异,具有统计学意义(P<0.05)。两组肌张力低下型脑瘫患儿治疗后肌张力波动水平对比,有显著改善,具有统计学意义(P<0.05)。结论:针刺督脉为主治疗肌张力低下型脑瘫患儿疗效显著,明显改善患儿前后坐位肌肉相关肌张力,减轻肌张力波动水平,提高患儿ADL评分以及GMFM评分,通过改变血清中的抑制因子,促使神经干细胞向神经元分化,从而改善神经因子生存的脑内微环境,达到改善肌张力低下型脑瘫患儿症状的效果。其临床选择优势较高,无严重不良反应,值得临床上进一步推广应用。

Objective： To observe the effect of mainly using acupuncturing Du meridian for the treatment of hypotonia in children with cerebral palsy. Methods： Selected 98 patients with hypotonic children with cerebral palsy from March 2013 to November2014in our hospital and randomly divided into observation group and control group according to the random allocated principle,the controlled group was accepted routine scalp acupuncture and massage,and the observation group was accepted Du meridianacupuncture treatment on the basis of the controlled group. The ADL score and GMFM score were observed before and after treatment in the two groups,and the clinical effect of two kinds of treatment plans were evaluated by Nimodipine method. Modified Ashworth scale was used to evaluate the level of muscle tension in two groups of patients after treatment. Results： There was no significant difference in ADL score and GMFM score between the two groups before treatment and after treatment（ P〉0. 05）. The two groups of patients after treatment in the ADL score and GMFM score were significantly different,with statistical significance（ P〈0. 05）. The total effective rate was 95. 9% in the observation group,and the total effective rate was 77. 5% in the controlled group,and the total effective rate in the observation group was significantly higher than that in the controlled group（ P〉0. 05）.There was no significant difference between the two groups in the treatment of anterior muscle tension and low level of cerebral palsy（ P〈0. 05）. There was significant difference between the two groups（ P〈0. 05）. Treatment of children with cerebral palsy hypotonia type had obvious effect. Conclusion： Acupuncture of Du meridian can significantly improve before and after sitting the muscle tension of children,reduce muscle tension fluctuation level,improve children＇s score of function area,through the change of serum inhibitory factor,promote neural stem cells to differentiate into neurons,so as to improve the neural factor for the survival of the brain microenvironment,so as to improve the effect of hypotonic symptoms in children with cerebral palsy. Its clinical choice has high advantages,no serious adverse reactions,it is worthy of further clinical application.