头皮针刺治疗对脑瘫患儿癫痫样放电的影响

Scalp acupuncture for epileptiform discharges of children with cerebral palsy

目的:探讨头皮针刺治疗对脑瘫患儿脑电图癫痫样放电的影响。方法:将184例存在脑电图癫痫样放电的脑瘫或合并癫痫患儿随机分为针康组(99例)和常规康复组(85例)。研究期间两组患儿均维持原抗癫痫用药方案,常规康复组予常规运动训练、推拿等康复治疗,每日1次,每周5次,15次为一疗程,休息20d后进行第2个疗程,共3个疗程;针康组在此基础上接受头皮针刺治疗,以神庭、本神、四神针为主穴,配穴取运动区、足运感区、平衡区、颞三针等,隔日针刺1次,10次为一疗程,休息15d后进行第2个疗程,共3个疗程。比较治疗前后患儿临床发作及视频脑电图(VEEG)情况。结果:治疗后针康组好转27例,无变化47例,加重25例;常规康复组好转11例,无变化46例,加重28例,两组疗效比较差异无统计学意义(P>0.05)。对于脑瘫合并癫痫患儿,针康组好转8例、无变化4例、加重4例,常规康复组无变化4例、加重7例,针康组疗效优于常规康复组(P<0.05);脑瘫合并癫痫样放电患儿,针康组好转19例、无变化43例、加重21例,常规康复组好转11例、无变化42例、加重21例,两组疗效比较差异无统计学意义(P>0.05)。结论:头皮针刺并不会增加脑瘫合并癫痫或癫痫样放电患儿癫痫发作或脑电图异常加重风险,并且对脑瘫合并癫痫发作患儿,头皮针针刺配合康复训练的疗效优于单纯康复训练。

Objective To explore the effect of scalp acupuncture for children with cerebral palsy whose videoelectroencephalogram（VEEG）showed epileptiform discharges.Methods A total of 184 children with cerebral palsy whose VEEG showed epileptiform discharges or those combined with epilepsy were randomly assigned into a combination group（99cases）and a rehabilitation group（85cases）.All the cases were treated with the original antiepileptic drugs.The conventional physical training and massage were applied in the rehabilitation group for3 courses with 20 dat the interval,once a day,5times a week and 15 times as one course.Based on the treatment as the rehabilitation group,scalp acupuncture was used in the combination group for 3courses with 15 dat the interval,once the other day and 10 times as one course.Shenting（GV 24）,Benshen（GB 13）,Sishencong（EX-HN1）were selected as the main acupoints,combined with motor zone,foot motor-sensory area,balance zone,and temple-three-needle etc.Clinical onset and VEEG results were observed before and after treatment.Results After treatment in the combination group,27 cases improved;47cases had no effect;25cases aggravated.While in the rehabilitation group,11 cases improved;46cases had no effect;28cases aggravated.There was no statistically significance between the two groups（P〈0.05）.As for the cases with epilepsy onset in the combination group,8cases improved;4cases had no effect;4cases aggravated.In the rehabilitation group,4cases had no effect;7cases aggravated.The result in the combination group was better than that in the rehabilitation group（P〈0.05）.As for the cases with epileptiform discharges in the combination group,19 cases improved;43cases had no effect;21cases aggravated.In the rehabilitation group,11 cases improved;42cases had no effect;21cases aggravated.There was no significance between the two groups（P〈0.05）.Conclusion Scalp acupuncture therapy does not increase the risk of onset or epileptiform discharges in the children with cerebral palsy combined with epilepsy or epileptiform discharges.Scalp acupuncture combined with rehabilitation is better than simple rehabilitation for thosewith cerebral palsy and epilepsy onset.