中药蜡疗联合Bobath技术治疗痉挛型脑瘫患儿运动功能障碍临床观察

Clinical Observation on Traditional Chinese Medicine Wax Therapy Combined with Bobath in the Treatment of Motor Function of Children with Spastic Cerebral Palsy

目的观察中药蜡疗联合Bobath技术对痉挛型脑瘫患儿下肢功能康复的临床疗效。方法选择河南中医药大学第一附属医院96例患儿作为观察对象,按1∶1比例将研究对象随机分组到对照组和观察组;对照组主要选择使用Bobath疗法康复训练为主,40 min/次,1次/d,6次/周,休息1 d;观察组在对照组康复治疗的基础上,加用中药蜡疗,40 min/次,1次/d,6次/周,休息1 d;2组均连续治疗6周。治疗前分别进行粗大运动功能测试(GMFM)和精细运动能力(FMFM)测试作基础水平评价,治疗后再次行GMFM和FMFM测试评价治疗效果;治疗前后痉挛程度的评价采用的是采用改良Ashworth量表(MAS)和临床痉挛指数(CSI)。结果观察组患儿在治疗后GMFM量表的A、B、C 3个功能区评分高于对照组(P<0.05),GMFM总分高于对照组(P<0.05);观察组患儿FMFM量表B、C、D、E功能区评分和FMFM分值均高于对照组(P<0.05);治疗后,MAS分级在观察组患儿显著低于对照组患儿(Z=-2.337,P<0.05);CSI分级在观察组患儿显著低于对照组(Z=-3.021,P<0.05)。结论以Bobath康复技能训练作为基础治疗,在此治疗的基础上,联合采用中药蜡疗,对提高痉挛型脑瘫患儿的粗大运动功能和精细运动功能有临床价值,并能有效减轻痉挛程度。

Objective To observe the clinical efficacy of therapeutic effect of TCM wax therapy combined with Bobath treatment for motor function of children with spastic cerebral palsy.Methods 96 patients were randomly divided into control group and observation group by random number table at 1:1 ratio.Patients in control group received rehabilitation training according to Guidelines for the rehabilitation of Cerebral Palsy in China,accompanied by the treatment of Bobath,40 min/time,1 time/day,6 times/week.Based on the treatment in control group,patients in observation group received additional treatment of TCM wax therapy,40 min/time,1 time/day,6 times/week.The treatment course was 6 weeks in both groups.Gross Motor Function Measure(GMFM)and Fine Motor Function Measure(FMFM)were conducted before and after treatment,and Modified Ashworth Scale(MAS)and Clinic Spasticity Index(CSI)were evaluated at the same time.Results After treatment,scores of three functional areas of A,B,C of GMFM scale and the total score in observation group were higher than which in control group(P<0.05).And the scores of functional areas of B,C,D,E of FMFM scale and the total score were also higher than those in control group(P<0.05).Otherwise,classifications of MAS and CSI in observation group were less than those in control group(Z=-2.337,P<0.05 and Z=-3.021,P<0.05).Conclusion Based on the treatment of Bobath treatment,TCM wax therapy can improve GMFM,FMFM and relieve the degree of spasm.