针刺配合作业治疗改善痉挛型脑瘫患儿精细功能的观察

Clinical observation on acupuncture plus occupation therapy for fine motor functions in children with spastic cerebral palsy

目的:观察针刺配合作业治疗改善脑性瘫痪患儿上肢精细功能的临床疗效。方法:将精细功能障碍的脑性瘫痪患儿80例采用信封法随机分为治疗组和对照组,每组40例。治疗组在作业治疗的基础上配合针刺手三阳经穴位,对照组仅采用作业治疗,隔日治疗1次,10次为1个疗程,每个疗程后休息15 d,连续观察3个疗程。治疗前后使用Peabody运动发育量表和改良Ashworth法进行评定。结果:治疗后两组抓握标准分、视觉-运动统合标准分、精细动作发育商、改良Ashworth法评分较本组治疗前均有改善(均P<0.05),且治疗组改善明显优于对照组(均P<0.01)。结论:针刺配合作业治疗能有效改善脑性瘫痪患儿的上肢精细功能,疗效优于单纯作业治疗。

Objective： To observe the clinical effect of acupuncture plus occupation therapy for fine motor functions in children with spastic cerebral palsy. Methods： A total of 80 cerebral palsy kids with fine motor dysfunction were allocated into two groups by envelop, 40 cases in each group. Cases in the control group were treated with occupation therapy. Based on the therapy given to the control group, cases in the treatment group were supplemented with acupuncture at the points of the three yang meridians of hand. The treatment was done every other day and 10 times for a course. There was a 15-day interval between two courses, and 3 courses in total. The therapeutic efficacies were evaluated using Peabody developmental motor scale 2 （PDMS-2） and modified Ashworth scale （MAS） before and after treatment. Results： After treatment, the standard score for grasping （Grs）, standard score for visual-motor integration （Vis）, fine motor quotient （FMQ） and modified Ashworth scale （MAS） were significantly improved in both groups （P〈0.05）. The improvement in the treatment group was more obvious than that in the control group （P〈0.01）. Conclusion： Acupuncture plus occupation therapy can achieve better effect than occupation therapy alone in improving fine motor functions of upper limbs in cerebral palsy kids.