循经针灸联合推拿手法对小儿痉挛型脑瘫肌张力和运动发育的影响

Effect of Meridian-based Acupuncture Combined with Massage on Muscle Tension and Motor Development in Children with Spastic Cerebral Palsy

目的:研究循经针灸联合推拿手法对痉挛型脑瘫患儿肌张力与运动发育的影响。方法:选取2017年1月-2018年1月来本院儿科治疗并已确诊为痉挛型脑瘫的患儿80例作为研究对象,按照随机数字表法将其分为观察组与对照组,各40例。对照组给予传统西医康复治疗(主要为Bobath法),观察组给予循经针灸与推拿手法治疗,观察比较两组治疗前后的肌张力情况、痉挛指数、粗大运动评分及临床疗效。结果:治疗后两组肌张力分级情况与治疗前比较均明显改善,且观察组肌张力0、1级情况均明显优于对照组,差异均有统计学意义(P<0.05)。治疗后,两组痉挛指数评分与治疗前比较均明显降低,粗大运动评分均明显升高;且观察组痉挛指数评分明显低于对照组,粗大运动评分明显高于对照组,差异均有统计学意义(P<0.05)。观察组的总有效率为95.0%明显高于对照组的62.5%,差异有统计学意义(字2=12.64,P=0.02)。结论:循经针灸联合推拿手法可用于改善痉挛型脑瘫患儿肌张力,提高运动发育能力效果明显,值得在临床进行推广。

Objective:To study the effect of meridian-based acupuncture combined with massage on muscle tension and motor development in children with spastic cerebral palsy.Method:A total of 80 children with spastic cerebral palsy who had been treated and confirmed in paediatrics department of our hospital from January 2017 to January 2018 were selected as the study objects.According to the random number table method,they were divided into observation group and control group,40 cases in each group.The control group was given traditional western medicine rehabilitation therapy(mainly Bobath method),the observation group was given meridianbased acupuncture and massage manipulation therapy.The muscle tension,spasticity index,gross motor scores before and after treatment and clinical efficacy between the two groups were observed and compared.Result:After treatment,the grading of muscle tension in the two groups were significantly improved,and the 0 and 1 grade of muscle tension in the observation group were significantly better than those in the control group,the differences were statistically significant(P<0.05).After treatment,the scores of spasticity index in the two groups were significantly lower than those before treatment,the scores of gross motor were significantly higher than those before treatment;and the score of spasticity index in the observation group was significantly lower than that in the control group,the score of gross motor was significantly higher than that in the control group,the differences were statistically significant(P<0.05).The total effective rate of the observation group was 95.0%,which was significantly higher than 62.5% of the control group,the difference was statistically significant( χ^2=12.64,P=0.02).Conclusion:Meridian-based acupuncture combined with massage can improve the muscle tension and motor development ability of children with spastic cerebral palsy,which is worth popularizing in clinic.