电针头穴对脑瘫患儿康复疗效优化参数研究

Study of optimal parameters of scalp electroacupuncture for rehabilitation effect on children of cerebral palsy

目的:通过正交设计分析电针频率、强度、时间、频次4因素对电针头穴治疗脑瘫患儿康复疗效的差异,优选最佳电针参数。方法:选取90例脑瘫患儿进行正交试验,每组10例,穴取智九针(神庭、四神聪,双侧本神、头维)、双侧运动区、足运感区、言语二区、言语三区、平衡区。双侧运动区、言语三区连接电针。以L9(34)正交表安排试验,研究包括电针频率(疏波2 Hz、密波100 Hz、疏密波2 Hz/100 Hz)、强度(1 m A、2 m A、患儿耐受)、时间(10 min、20 min、30 min)、频次(每日1次、隔日1次、每周2次)。采用盖塞尔发展量表(Gesell developmental scale)观察治疗前后适应行为发育商(DQ),采用粗大运动功能评估(GMFM)分数观察治疗前后运动功能的变化。结果:采用电针频率2 Hz/100 Hz、时间20 min、隔日1次的头针治疗方案对脑瘫患儿DQ和GMFM的影响最显著。结论:电针2 Hz/100 Hz、时间20 min、隔日1次可能为针刺头穴治疗脑瘫的最优参数组合。

Objective To analyze the effect difference of wave, intensity, time and treatment frequency by orthogonal design so as to explore the optimal parameters of scalp electroacupuncture（EA） for rehabilitation effect on children of cerebral palsy. Methods Ninety children of cerebral palsy were assigned into 9 groups by orthogonal design, 10 cases in each one. The acupoints were bilateral excitable area, foot motor sensory area, speech two area, speech three area, balance area, and intelligent nine acupoints, including Shenting（GV 24）, Sishencong（EX-HN 1）, and bilateral Benshen（GB 13） and Touwei（ST 8）. EA was applied at bilateral excitable area and speech three area. We designed an orthogonal experiment with four factors and three levels. We studied wave（sparse wave of 2 Hz, density wave of 100 Hz, sparse and density wave of 2 Hz/100 Hz）, intensity（1 m A, 2 m A, intensity based on tolerance）, time（10 min, 20 min, 30 min）, frequency（once a day, once every other day, twice a week）. The Gesell developmental scale was used to evaluate the developmental quotient（DQ）; and gross motor function measure（GMFM）, motor function before and after treatment. Results The optimal parameters for DQ and GMFM were 2 Hz/100 Hz, 20 min, once every other day. Conclusion The optimal parameters for cerebral palsy may be 2 Hz/100 Hz, 20 min, once every other day.