针刺结合低频电刺激治疗脑性瘫痪流涎症的效果

Effect of Acupuncture Combined with Low Frequency Electrical Stimulation on Cerebral Palsy Salivation

目的探讨口腔感觉运动疗法（OSMT）、针刺和低频电刺激等不同治疗方案治疗脑瘫流涎症的效果。方法选择2014年9月~2015年10月本院脑瘫伴发流涎症患儿80例,随机分为A组（OSMT,n=20）、B组（针刺,n=20）、C组（低频电刺激,n=20）和D组（针刺联合低频电刺激,n=20）。同期选取门诊就诊患儿20例作为对照组。所有患儿治疗前和治疗8周后由分别采用教师流涎法和舌骨下肌群表面肌电进行评定。结果对照组和A组舌骨下肌群表面肌电均方根（RMS）值与治疗前比较无显著性差异（t〈1.668,P〉0.05）,B组、C组和D组显著高于治疗前（t〉8.983,P〈0.001）。治疗后对照组和A组间流涎的临床疗效和RMS值均无显著性差异（W=389.5,t=2.041,P〉0.05）,B组、C组和D组均明显优于对照组和A组（W〉226.0,t〉8.534,P〈0.01）,D组优于B组和C组（W〉306.0,t〉3.663,P〈0.05）。结论针刺和低频电刺激治疗均可以有效改善脑瘫患儿的流涎情况,二者联合疗效优于单一治疗,而OSMT治疗未见明显疗效。

Objective To explore the effect of oral sensorimotor therapy（OSMT）, acupuncture, and low frequency electrical stimulation on salivation in patients with cerebral palsy. Methods From September, 2014 to October, 2015, 80 cerebral palsy patients with salivation were recruited. They were randomly divided into four treatment groups： group A was treated with OSMT, group B was treated with acupuncture, group C was treated with frequency electrical stimulation, and group D was treated with acupuncture and low frequency electrical stimulation, for eight weeks. Meanwhile, 20 cerebral palsy patients with salivation from outpatients were chosen as control group. Results There was no improvement in the root mean square（RMS） value of surface electromyography（s EMG） after treatment in both the control group and group A（t〈1.668, P〈0.05）, and the RMS value significantly improved in the groups B, C and D（t〉8.983, P〈0.001）. There was no significant difference in the salivation score and RMS value between the control group and group A（W=389.5, t=2.041, P〈0.05）, and they was better in the groups B, C and D than in the control group and group A（W〉226.0, t8.534, P〈0.01）, as well as in group D than in groups B and C（W〉306.0, t3.663, P〈0.05）. Conclusion Acupuncture and low frequency electrical stimulation could effectively improve salivation in children with cerebral palsy, and their combination was superior to either ones, while OSMT did not show obvious benefit.