针刺联合康复训练对脑瘫患儿肢体运动功能、智力恢复及脑血流的影响

Effects of Acupuncture Combined with Rehabilitation Training on Limb Motor Function,Intelligence Recovery and Cerebral Blood Flow in Children with Cerebral Palsy

目的:探讨针刺联合康复训练对脑瘫患儿肢体运动功能、智力恢复及脑血流的影响。方法:选取2015年7月至2017年11月华北理工大学附属医院收治的脑瘫患儿124例为研究对象,随机分为观察组和对照组,每组62例。2组均接受常规治疗及康复训练,观察组在此基础上加用针刺治疗,4周为1个疗程,2组均连续治疗3个疗程。比较2组治疗前后肢体痉挛程度、肢体运动功能、智力恢复状况及脑血流速度。结果:观察组总有效率为93.55%,高于对照组的72.58%(P<0.05);治疗后2组证候积分均较治疗前降低,且观察组显著低于对照组(P<0.05);治疗后2组Ashworth评分较治疗前显著降低,粗大运动功能量表(GMFM)、精细运动功能量表(FMFM)、Berg平衡量表(BBS)评分均较治疗前显著升高,10 m步行时间较治疗前显著缩短,且2组差异有统计学意义(P<0.05);治疗后2组智力发育指数(MDI)、心理运动发育指数(PDI)、社会适应能力患儿发育商(DQ)、个人社交能力DQ、语言发育能力DQ值均较治疗前显著升高,且观察组显著高于对照组(P<0.05);治疗后2组大脑中动脉(MDA)、大脑前动脉(ACA)、椎动脉(VA)及观察组基底动脉(BA)脑血流速度显著加快,血管搏动指数(PI)显著增加,且观察组上述指标水平均显著高于对照组(P<0.05)。结论:针刺联合康复训练可有效改善脑瘫患儿肢体运动功能,促进其智力恢复,并加快脑血流速度,临床疗效显著。

Objective： To explore the effects of acupuncture combined with rehabilitation training on limb motor function,intelligence recovery and cerebral blood flow in children with cerebral palsy.Methods： A total of 124 children with cerebral palsy treated in our hospital from July 2015 to November 2017 were selected as the research objects and randomly divided into treatment group and control group,with 62 cases in each group.Both groups received routine treatment and rehabilitation training.Treatment group was additionally treated with acupuncture for 4 weeks as a course,and 2 groups were treated continuously for 3 courses.The degree of limb spasm,limb motor function,intelligence recovery and cerebral blood flow velocity of 2 groups were compared before and after treatment.Results： The total effective rate of treatment group was 93.55%,which was significantly higher than the72.58% of control group（ P〈0.05）; The syndromes scores in 2 groups after treatment were significantly lower than those before treatment,and the scores in treatment group were significantly lower than that of control group（ P〈0.01）; The Ashworth scores of 2 groups after treatment were significantly lower than those before treatment.The GMFM,FMFM,BBS scores of 2 groups after treatment were significantly higher than those before treatment.The walking times of 10 m were significantly shorter than that before treatment,and there was significant difference between 2 groups（ P〈0.05 or P〈0.01）; The MDI index,PDI index,social adaptability DQ,personal social ability DQ,language development ability DQ value of 2 groups after treatment were markedly higher than before treatment,and treatment group were significantly higher than that of control group（ P〈0.05 or P〈0.01）; The cerebral blood flow velocities of MDA,ACA,VA of 2 groups and BA of treatment group significantly quickened,and PI significantly increased.The above indexes of treatment group were significantly higher than that of control group（ P〈0.05 or P〈0.01）.Conclusion： Acupuncture combined with rehabilitation training can effectively improve the limb motor function of children with cerebral palsy,promote their intelligence recovery,and accelerate the speed of cerebral blood flow.The clinical curative effect is remarkable.