聪脑通络法针刺联合芍药甘草汤熏洗对小儿痉挛型脑瘫脑流量及运动能力的影响

Effect of Congnao Tongluo Acupuncture Combined with Shaoyao Gancao Decoction Fumigation on Cerebral Blood Flow and Motor Ability of Children with Spastic Cerebral Palsy

目的:探讨聪脑通络法针刺联合芍药甘草汤熏洗对小儿痉挛型脑瘫脑流量及运动能力的影响。方法:选取我院2013年3月—2016年1月住院或门诊治疗的痉挛型脑瘫患儿72例,按随机数字表法分为两组,分别36例,对照组采用运动与智力训练;观察组在对照组基础上采用聪脑通络法针刺联合芍药甘草汤熏洗治疗,治疗前和治疗2月后分别评定GMFM量表、痉挛指数、改良Ashworth评分,采用多普勒超声测定脑血流动力学指标,取肘部静脉血,测定血清25(OH)D3、AKP、P水平,同时对比临床疗效及不良反应状况。结果:对照组总有效率为72.22%,低于观察组总有效率91.67%(P<0.05);与治疗前比较,两组患儿治疗2月后GMFM评分升高,痉挛指数、Ashworth评分降低,ACA、MCA、PCA升高,血清25(OH)D3升高,血清P、AKP降低(P<0.05);与对照组比较,观察组患儿治疗2月后GMFM评分较高,痉挛指数、Ashworth评分较低,ACA、MCA、PCA较高,血清25(OH)D3较高,血清P、AKP较低(P<0.05)。结论:聪脑通络法针刺联合芍药甘草汤熏洗对小儿痉挛型脑瘫疗效确切,能提高脑血流速度和粗大运动功能,降低肌肉痉挛状态,可以作为一种有效的康复方案。

Objective:To investigate the effect of Congnao Tongluo acupuncture combined with Shaoyao Gancao Decoction fumigation on cerebral blood flow and motor ability of children with spastic cerebral palsy. Methods:72 cases of spastic cerebral palsy were randomly divided into the control group( n =36) and the observation group( n =36).The control group was treated with exercise and mental training;on which basis,the observation group was also treated with Congnao Tongluo acupuncture combined with Shaoyao Gancao decoction fumigation.The two groups were treated for two months.The scores of GMFM scale,spasticity index,modified Ashworth score were compared before and after the treatment,cerebral hemodynamic parameters were measured by Doppler ultrasound,and serum levels of 25 (OH) D3,AKP and P were measured in venous blood of the elbow.Also,the clinical efficacy and adverse reactions were compared between the two groups Results:The total effective rate of the observation group was 91.67%,which was significantly higher than 72.22% of the control group( P <0.05).The GMFM scores were increased,but the scores of spasticity index and Ashworth were decreased;the ACA MCA and PCA were increased;the serum levels of 25 (OH) D3 were increased,however the serum levels of P and AKP were decreased in the two groups after two months of the treatment( P <0.05).The improvements of the observation group were more significant than the control group in terms of the above indexes( P <0.05). Conclusion:Congnao Tongluo acupuncture combined with Shaoyao Gancao Decoction fumigation is effective for spastic cerebral palsy of children.It can improve cerebral blood flow and gross motor ability,as well as reduce spasticity;which is an effective rehabilitation scheme.