蜡疗、针刺联合作业疗法治疗小儿臂丛神经损伤临床研究

Clinical study on the treatment of brachial plexus injury in children with wax therapy combined with acupuncture

目的观察蜡疗、针刺联合作业疗法治疗小儿臂丛神经损伤(BPI)的临床疗效。方法将80例小儿BPI按照随机数字表法分为2组。2组均常规给予低频脉冲疗法和生物刺激反馈修复疗法,对照组40例加用作业疗法治疗;治疗组40例在对照组基础上联合蜡疗、针刺治疗。2组均治疗1个月为1个疗程,疗程间隔1周,治疗5个疗程后统计疗效,比较2组治疗前后患肢正中神经、桡神经、尺神经、腋神经及肌皮神经传导速度变化情况,比较2组患儿治疗前后Mallet量表评分及Peabody精细运动发育量表-2版(PDMS-2FM)评分变化情况。结果治疗组总有效率97.50%(39/40),对照组总有效率72.50%(29/40),治疗组疗效优于对照组(P<0.05)。2组治疗后患侧正中神经、桡神经、尺神经、腋神经及肌皮神经传导速度与本组治疗前比较均明显提高(P<0.05),且治疗组治疗后各神经传导速度均高于对照组(P<0.05)。2组治疗后Mallet评分及PDMS-2FM评分与本组治疗前比较均明显增加(P<0.05),且治疗组治疗后Mallet评分及PDMS-2FM评分均高于对照组(P<0.05)。结论蜡疗、针刺联合作业疗法治疗小儿BPI临床疗效确切,可明显提高神经传导速度,促进神经功能恢复,改善肩关节功能,促进患儿精细运动发育,提高临床疗效。

Objective To observe the effect of wax therapy combined with acupuncture in the treatment of children brachial plexus injury(BPI). Methods 80 children with BPI were divided into two groups according to random number table method. Both groups were treated by low-frequency pulse therapy and biological stimulation feedback therapy. 40 cases in control group were treated by occupational therapy. 40 cases in treatment group were treated by wax therapy and acupuncture on the basis of the control group. Two groups were treated for one month as a course of treatment, the interval of the course was one week, after five courses of treatment, the statistical effect was compared. The changes of conduction velocity of median nerve, radial nerve, ulnar nerve, axillary nerve and musculocutaneous nerve were compared before and after treatment in the two groups, and the changes of Mallet scale score and Peabody fine motor development scale version 2(PDMS-2 FM) score before and after treatment in the two groups were compared. Results The total effective rate was 97.50%(39/40) in the treatment group and 72.50%(29/40) in the control group. The clinical curative effect of the treatment group was better than that of the control group(P<0.05). After treatment, the conduction velocity of median nerve, radial nerve, ulnar nerve, axillary nerve and musculocutaneous nerve in the two groups were significantly higher than that in the group before treatment(P<0.05), and the nerve conduction velocity in the treatment group was higher than that in the control group(P<0.05). After treatment, the Mallet score and PDMS-2 FM score of the two groups were significantly higher than that in the group before treatment(P<0.05), and the treatment group was higher than the control group(P<0.05). Conclusion The therapeutic effect of wax therapy combined with acupuncture on BPI in children is definite. It can obviously improve the nerve conduction velocity, promote the recovery of nerve function, improve the shoulder joint function, promote the fine motor development of children, and improve the clinical effect.