黄芪桂枝五物汤加减联合针灸推拿对痉挛型脑性瘫痪患儿言语康复的疗效观察

Clinical effect of modified Wuwu decoction of Huangqi and Guizhi combined with acupuncture and massage on the speech recovery of children with spastic cerebral palsy

目的探讨黄芪桂枝五物汤加减联合推拿、针灸及言语训练对痉挛型脑性瘫痪(简称脑瘫)患儿言语康复的疗效。方法选择2016年6月至2017年6月湖北医药学院附属襄阳市第一人民医院儿科收治住院的痉挛型脑瘫患儿120例,随机分为观察组和对照组各60例。对照组进行推拿、针灸及言语训练,观察组在对照组治疗基础上联合应用黄芪桂枝五物汤加减治疗,疗程3个月。观察治疗效果,评估两组患儿应人能力、应物能力及格拉斯哥昏迷指数(GCS)和日常生活活动能力(ADL)。结果观察组临床总有效率为96.7%(58/60),显著高于对照组81.7%(49/60),差异有统计学意义(P<0.05)。治疗3、6个月后观察组应人能力及应物能力评分均优于治疗前,观察组优于对照组,差异有统计学意义(P<0.05)。两组治疗后GCS评分和ADL评分均高于治疗前,差异有统计学意义(P<0.05)。观察组患儿GCS评分和ADL评分显著高于对照组,差异有统计学意义(P<0.05)。结论对小儿脑瘫患者的治疗采用黄芪桂枝五物汤加减联合推拿、针灸及言语训练,可以使痉挛型脑瘫患儿言语康复显著的提高,患者的应人能力及应物能力大大提高,言语康复更快更好和最大程度克服构音障碍,有较好的临床效果,因此值得推广应用。

Objective To study the effect of modified Wuwu decoction of Huangqi and Guizhi combined with acupuncture and massage on the speech recovery of children with spastic cerebral palsy.Methods A total of 120 children with spastic cerebral palsy,who were admitted to Xiangyang First People's Hospital Affiliated to Hubei Medical College between June 2016 to June 2017,were chosen as the subjects,and they were randomly divided into two groups,the observation group and control group,60 in each group.Both groups were given massage,acupuncture and speech training.In addition,the observation group was treated with modified Wuwu decoction of Huangqi and Guizhi.The treatment lasted for 3 months.The treatment effect was observed,and the two groups of children were evaluated on the ability to respond to people,the ability to respond to articles,the GCS and ADL.Results The total effective rate of the observation group was 96.7%(58/60),significantly higher than the control group(81.7%,49/60)(P<0.05).After 3 months and 6 months of treatment,the score in the ability to respond to people and articles was both higher than that before treatment,and the observation group was better than the control group(P<0.05).The GCS score and ADL score were both higher after treatment(P<0.05),and it was higher in observation group than in control group(P<0.05).Conclusion The modified Wuwu decoction of Huangqi and Guizhi combined with acupuncture,massage and speech training can significantly improve the speech recovery in children with spastic cerebral palsy.The children's ability to respond to people and articles is greatly increased,and the speech recovery is faster and better,which has better clinical effect and is worthy of clinical application.