水针联合康复训练对脑瘫患儿认知功能及日常生活能力的影响

Effect of aqueous acupuncture combined with comprehensive rehabilitation training on cognitive function and activity of daily living of children with cerebral palsy

目的探讨水针联合康复训练对脑瘫患儿认知功能及日常生活能力影响。方法选择2012年2月至2016年1月桐乡市康复医院收治的82例脑瘫患儿作为研究对象,按随机数字表法分为对照组与观察组各41例,对照组采用常规康复训练干预,观察组采用康复干预联合应用水针治疗,并采用婴幼儿智能发育量表(CDCC)、儿童粗大运动功能测试表(GMFM)、能力低下儿童评定量表(PEDI)评定患儿干预前后认知功能、运动功能及日常生活能力的改善情况;头颅血流多普勒超声法测定大脑中动脉(MCA)收缩期峰值流速(Vs)、舒张末期流速(Vd)、平均血流速度(Vm)与血管阻力指数(RI)。结果 (1)观察组干预总有效率为95.12%(39/41),明显高于对照组的78.05%(32/41),χ~2=5.15,P<0.05;(2)干预前,两组患儿CDCC(t=0.05~0.95,P>0.05)、GMFM(t=0.01~1.22,P>0.05)、PEDI(t=0.01~0.02,P>0.05)评分比较差异无统计学意义;干预9周后,干预组CDCC(t=6.86~11.14,P<0.05)、PEDI显著高于对照组(t=3.36~7.27,P<0.05),GMFM评分显著低于对照组(t=4.31~6.49,P<0.05);(3)干预前,两组患儿脑血流动力学指标比较差异无统计学意义(t=0.00~0.11,P>0.05),干预9周后观察组Vs、Vd、Vm高于对照组(t=13.41~37.78,P<0.05),RI低于对照组(t=14.31,P<0.05)。结论在脑瘫患儿的临床干预中,采用水针联合综合康复训练干预可改善患儿认知功能障碍程度,提高其运动功能及日常生活能力,改善患儿脑部血流灌注。

Objective To explore the effect of aqueous acupuncture combined with comprehensive rehabilitation training on cognitive function and activity of daily living of children with cerebral palsy.Methods Eighty-two children with cerebral palsy admitted in our hospital from February 2012 to January 2016 were selected as study subjects,and they were randomly divided into control group and observation group with 41 cases in each group.Control group was given routine rehabilitation intervention while observation group was given aqueous acupuncture combined with rehabilitation intervention.Improvements of cognitive function,motor function and activity of daily living were evaluated with intellectual development scale of infants（CDCC）,gross motor function measure（GMFM）and pediatric evaluation of disability inventory（PEDI）before and after intervention.Middle cerebral artery（MCA）,peak systolic velocity（Vs）,end diastolic velocity（Vd）,average blood flow velocity（Vm）and vascular resistance index（RI）were measured by cranial blood flow doppler ultrasonography.Results Total effective rate of the observation group was95.12%（39/41）,which was obviously higher than（78.05%,32/41）of the control group（χ~2=5.15,P 0.05）.Before intervention,there was no significant difference between two groups in scores of CDCC（t value ranged 0.05-0.95,P〈0.05）,GMFM（t value ranged 0.01-1.22,P〈0.05）and PEDI（t value ranged 0.01-0.02,P〈0.05）.After 9 weeks of intervention,CDCC（t value ranged 6.86-11.14,P〈0.05）and PEDI scores（t value ranged 3.36-7.27,P〈0.05）in the observation group were higher than those in the control group,while GMFM score（t value ranged 4.31-6.49,P〈0.05）was lower than that in the control group.Before intervention cerebral hemodynamic indexes in two groups had no significant difference（t value ranged 0.00-0.11,P〈0.05）.After 9 weeks of intervention,the values of Vs,Vd and Vm in the observation group were higher than those in the control group（t value ranged 13.41-37.78,P〈0.05）,while value of RI was lower（t=14.31,P〈0.05）.Conclusion Aqueous acupuncture combined with comprehensive rehabilitation training in clinical intervention of cerebral palsy children can relieve cognitive impairment degree,improve motor function,activity of daily living and brain blood perfusion of patients.