Bobath法联合针刺治疗小儿脑瘫运动障碍45例临床观察

Clinical observation on 45 cases of dyskinesia in children with cerebral palsy treated by Bobath method combined with acupuncture

目的观察Bobath法联合针刺治疗小儿脑瘫运动障碍的临床疗效。方法选取2017年2月至2019年2月湖南省儿童医院康复科收治的脑瘫运动障碍患儿90例,按照随机数字表法分为对照组和治疗组,各45例。对照组给予Bobath法康复训练,治疗组在对照组治疗方法的基础上给予针刺治疗,2组均4周为1个疗程,连续治疗3个疗程后统计疗效。结果对照组总有效率为75.56%(34/45),治疗组为91.11%(41/45),2组比较,差异有统计学意义(P<0.05)。治疗前,2组粗大运动功能测试量表(GMFM)各项评分比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组卧位和翻身,坐位,爬行和跪,站立,走、跑和跳评分均明显升高,与同组治疗前比较,差异均有统计学意义(P<0.05或P<0.01),且治疗组GMFM各项评分升高更显著(P<0.05)。治疗前,2组发育商(DQ)值比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组DQ值明显升高,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组升高更显著(P<0.05)。治疗前,2组血清血管内皮生长因子(VEGF)、肿瘤坏死因子-α(TNF-α)水平比较,差异无统计学意义(P>0.05),具有可比性。治疗后,2组血清VEGF、TNF-α水平明显下降,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组下降更显著(P<0.05)。结论Bobath法联合针刺治疗小儿脑瘫运动障碍,可改善患儿粗大运动功能,提高DQ,降低血清VEGF、TNF-α水平,疗效显著,值得临床推广应用。

Objective To observe the clinical efficacy of Bobath method combined with acupuncture in the treatment of dyskinesia in children with cerebral palsy.Methods From February 2017 to February 2019,90 cases of dyskinesia in children with cerebral palsy admitted into rehabilitation department of Hunan Children’s Hospital were chosen and divided into control group and treatment group by random number table method,with 45 cases in each.The control group was given Bobath method to carry out rehabilitation training,on this basis,the control group was given acupuncture treatment.Four weeks constituted 1 course of treatment for both groups,we kept statistics about the efficacy after 3 consecutive courses of treatment.Results The total effective rate of the control group was 75.56%(34/45),that of the treatment group was 91.11%(41/45),and the difference was statistically significant between the 2 groups(P<0.05).Before treatment,the difference was not statistically significant in various GMFM scores between the 2 groups(P>0.05),and they were comparable.After treatment,the scores of lying position and turning over,sitting position,crawling and kneeling,standing,walking,running and jumping of the 2 groups all significantly increased,and the difference was statistically significant compared with the same group before treatment(P<0.05 or P<0.01),moreover,the GMFM scores in the treatment group increased more significantly(P<0.05).Before treatment,the difference was not statistically significant in DQ values between the 2 groups(P>0.05),and they were comparable.After treatment,DQ values of the 2 groups significantly increased,and the difference was statistically significant compared with the same group before treatment(P<0.05),moreover,the treatment group increased more significantly(P<0.05).Before treatment,the difference was not statistically significant in serum levels of VEGF and TNF-αbetween the 2 groups(P>0.05),and they were comparable.After treatment,the serum levels of VEGF and TNF-αin the 2 groups significantly decreased,and the difference was statistically significant compared with the same groups before treatment(P<0.05),moreover,the treatment group decreased more significantly(P<0.05).Conclusion It can improve gross motor function to use Bobath method combined with acupuncture in the treatment of dyskinesia in children with cerebral palsy,improve development quotient,reduce the serum levels of VEGF and TNF-αwith marked efficacy,which deserves further clinical promotion and application.