黄芪桂枝五物汤结合有氧康复运动治疗小儿痉挛型脑瘫的疗效及对血清BDNF、NSE含量和运动功能的影响

Influences of Huangqi Guizhi Wuwu Decoction Combined with Aerobic Rehabilitation Exercise on Therapeutic Effect,Serum BDNF,NSE Levels,and Motor Function in the Treatment of Children with Spastic Cerebral Palsy

目的观察黄芪桂枝五物汤结合有氧康复运动治疗小儿痉挛型脑瘫疗效及对血清脑源性神经营养因子(BDNF)、神经元特异性烯醇化酶(NSE)含量和运动功能的影响。方法选取我院收治的痉挛型脑瘫患儿84例作为研究对象,按照随机数字表法分为观察组与对照组,每组42例。两组均给予对症治疗,在此基础上对照组给予有氧康复运动治疗,观察组在对照组基础上给予黄芪桂枝五物汤。比较两组中医证候积分、临床疗效、肌张力、生存质量、运功功能,同时检测病人血清BDNF、NSE水平。结果治疗后两组中医证候积分显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05);观察组总有效率为90.48%,显著高于对照组的73.81%(P<0.05);治疗后两组改良Ashworth痉挛量表(MAS)评分显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05);两组儿童生存质量普适性核心量表(PedsQL)评分显著高于治疗前(P<0.05),且观察组显著高于对照组(P<0.05);治疗后两组粗大运动功能评估量表(GMFM)、精细运动功能评定量表(PDMS-2)评分显著高于治疗前(P<0.05),且观察组显著高于对照组(P<0.05);治疗后两组血清BDNF水平显著高于治疗前(P<0.05),且观察组显著高于对照组(P<0.05);两组NSE水平显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05)。结论黄芪桂枝五物汤结合有氧康复运动可有效改善痉挛型脑瘫患儿中医证候积分、肌张力、生活质量、运动功能和血清BDNF、NSE水平,提高临床疗效。

Objective To observe the effect of Huangqi Guizhi Wuwu decoction combined with aerobic rehabilitation exercise in the treatment of children with spastic cerebral palsy and its influence on serum brain-derived neurotrophic factor (BDNF), neuron specific enolase (NSE) levels,and motor function. Methods Eighty-four cases of spastic cerebral palsy children in our hospital were selected,and were divided into observation group and control group according to random number table method,with 42 cases in each group.The two groups were given symptomatic treatment,on this basis,the control group was given aerobic rehabilitation exercise treatment, the observation group was treated with Huangqi Guizhi Wuwu decoction on the basis of the control group.The symptom scores,clinical efficacy, muscle tension,quality of life,and motor function of the two groups were observed,the serum levels of BDNF and NSE were detected. Results After treatment,TCM syndrome scores of the two groups were significantly lower than those before treatment ( P <0.05), and the observation group was significantly lower than that in the control group ( P <0.05).The total effective rate of the observation group was 90.48%,which was significantly higher than that of the control group (73.81%, P <0.05);After treatment,the MAS scores of the two groups were significantly lower than those before treatment ( P <0.05), and the observation group was significantly lower than that in the control group ( P <0.05).The PedsQL scores of the two groups were significantly higher than those before treatment ( P <0.05),and the observation group was significantly higher than that in the control group ( P <0.05).After treatment, the scores of GMFM and PDMS-2 in the two groups were significantly higher than those before treatment ( P <0.05), and the observation group was significantly higher than that in the control group ( P <0.05).After treatment,the levels of BDNF in the two groups were significantly higher than before treatment ( P <0.05),and the observation group was significantly higher than that in control group ( P <0.05). The levels of NSE in the two groups were significantly lower than those before treatment ( P <0.05),and the observation group was significantly lower than that in the control group ( P <0.05). Conclusion Huangqi Guizhi Wuwu decoction combined with aerobic rehabilitation exercise could effectively improve the serum BDNF,NSE levels,motor function,and the clinical efficacy in children with spastic cerebral palsy.