针刺联合双手-臂强化训练对偏瘫型脑瘫患儿上肢功能、步行能力、平衡功能及粗大运动功能的影响

Effect of Acupuncture Combined with Two Arms and Hands Intensive Training on Upper Limb Function, Walking Ability, Balance Function and Gross Motor Function in Children with Hemiplegic Cerebral Palsy

目的：探讨针刺联合双手-臂强化训练对偏瘫型脑瘫患儿上肢功能、步行能力、平衡功能及粗大运动功能的影响。方法：偏瘫型脑瘫患儿94例,按照随机数字表法（获得患儿家属同意权）随机分为观察组47例与对照组47例。对照组采用双手-臂强化训练,观察组在对照组基础上结合针刺治疗。两组疗程均为12周。比较两组前壁旋后角度、握力评分和Peabody精细评分,步行能力,平衡功能及粗大运动功能变化。结果：两组治疗后前壁旋后角度、握力评分和Peabody精细评分增加（观察组：t=21.610 8、9.676 6、13.398 3,对照组：t=11.912 0、4.502 2、6.918 2,P〈0.05）;观察组治疗后前壁旋后角度、握力评分和Peabody精细评分高于对照组（t=9.211、6.038、5.735,P〈0.05）。两组治疗后步宽减少,而步长和步速增加（观察组：t=11.259 3、10.066 3、13.605 4,对照组：t=4.874 1、4.042 3、6.144 4,P〈0.05）;观察组治疗后步宽低于对照组,而步长和步速高于对照组（t=6.007、5.999、6.376,P〈0.05）。两组治疗后Fugl-Meyer平衡功能评分增加（观察组：t=12.239,对照组：t=5.918,P〈0.05）;观察组治疗后Fugl-Meyer平衡功能评分高于对照组（t=5.602,P〈0.05）。两组治疗后GMFM-88评分增加（观察组：t=12.702,对照组：t=6.169,P〈0.05）;观察组治疗后GMFM-88评分高于对照组（t=5.545,P〈0.05）。观察组总有效率（87.23%）高于对照组（68.09%）（P〈0.05）。结论：针刺联合双手-臂强化训练可改善偏瘫型脑瘫患儿上肢功能、步行能力、平衡功能及粗大运动功能,具有重要研究意义。

Objective ： To explore the effect of acupuncture combined with two arms and hands intensive training on upper limb function, walking ability, balance function and gross motor function in children with hemiplegic cerebral palsy. Methods：Ninety -four children with hemiplegia caused by cerebral palsy, according to the random number table, （obtai- ning the consent right of the family members of children） were divided into the observation group （47 cases） and the con- trol group （47 cases）. The control group was treated with two arms and hands intensive training, and the observation group was treated with acupuncture on the basis of the control group. The two groups were treated for 12 weeks. The pro- nation angle, grip strength score, Peabody fine score, walking ability, balance function and gross motor function of the two groups were compared. Results ：After treatment,two groups＇ anterior wall of supination angles, grip strength score and Peabody score increased（observation group：t =21. 610 8, 9. 676 6,13. 398 3, control group：t = 11. 912 0, 4. 502 2, 6. 918 2, P 〈0. 05）. The observation group＇ s anterior wall of supination angles, grip strength score and Peabody fine score after treatment were higher than those of the control group（ t =9. 211,6. 038, 5. 735, P 〈0. 05）. The two groups＇ wide reduction, and stride length and gait velocity increased after treatment（ observation group ： t = 11. 259 3, 10.066 3,13. 605 4, the control group ： t = 4. 874 1, 4.042 3, 6. 144 4,P 〈 O. 05 ）. The observation group＇ s wide after treatment was lower than that of the control group, while the step length and velocity were higher than those of the control group （t = 6. 007, 5. 999, 6,376, P 〈 0. 05）. The two groups＇ Fugl - Meyer balance function scores after treatment were in- creased （ observation group ： t = 12.239, control group ： t = 5. 918, P 〈 0. 05）. The Fugl - Meyer balance function score in the observation group was higher than that in the control group （t = 5. 602, P 〈 0.05）. The two groups＇ GMFM - 88 scores after treatment were increased（ observation group ： t = 12. 702, control group ： t = 6. 169, P 〈 0.05 ）. The GMFM - 88 score in the observation group was higher than that in the control group （t = 5. 545, P 〈 0. 05）. The total effective rate of the observation group （ 87.23 % ） was higher than that of the control group （68.09 % ） （ P 〈 0. 05 ）. Conclusion： Ac- upuncture combined with two arms and hands intensive training can improve the upper limb function, walking ability, balance function and gross motor function of children with hemiplegic cerebral palsy, and has important research significance.