中药塌渍配合蜡疗治疗小儿痉挛型脑瘫30例临床观察

Clinical observation on 30 cases of children with spastic cerebral palsy treated by Chinese materia medica soakage cooperated with wax therapy

目的观察中药塌渍配合蜡疗治疗小儿痉挛型脑瘫的临床疗效。方法选取2019年1月至2020年1月在广州中医药大学附属南海妇产儿童医院儿童康复科就诊的痉挛型脑瘫患儿60例,采用随机数字表法分为治疗组和对照组,各30例。对照组采用康复、推拿、针刺等综合治疗方法,治疗组在对照组治疗方法的基础上联合中药塌渍和蜡疗疗法。2组均治疗3个疗程后,比较治疗前后改良的Ashworth量表(MAS)、精细运动发育商(FMQ)和日常生活能力评估量表(ADL)的评分。结果治疗前,2组上肢MAS评分比较,差异无统计学意义(P>0.05),具有可比性。治疗后,2组上肢MAS评分较同组治疗前明显下降(P<0.05),且治疗组下降更显著,差异有统计学意义(P<0.01)。治疗前,2组FMQ、ADL评分比较,差异无统计学意义(P>0.05),具有可比性。治疗后,2组上述指标较同组治疗前明显升高(P<0.05),且治疗组升高更显著,差异有统计学意义(P<0.05或P<0.01)。结论中药塌渍配合蜡疗不仅能缓解痉挛型脑瘫患儿上肢肌肉痉挛、降低肌张力、提高精细动作能力,而且提高了患儿的日常生活自理能力,为其早日回归社会打下良好基础,值得临床推广应用。

Objective To observe the clinical efficacy of Chinese materia medica(CMM)soakage cooperated with wax therapy on the treatment of children with spastic cerebral palsy.Methods From January 2019 to January 2020,60 children with spastic cerebral palsy consulted in children’s rehabilitation department of Nanhai District Maternity and Children’s Hospital were divided into treatment group and control group according to random number table method,with 30 cases in each group.The control group was treated with the comprehensive therapeutic methods,namely rehabilitation,tuina and acupuncture etc.,on this basis,the treatment group was combined with CMM soakage and wax therapy.After the 2 groups were both treated for 3 courses of treatment,the scores of modified Ashworth Scale(MAS),fine motor development quotient(FMQ)and activities of daily living(ADL)were compared before and after treatment.Results Before treatment,there was no significant difference in MAS scores between the 2 groups(P>0.05),and they were comparable.After treatment,the upper limb MAS scores of the 2 groups decreased significantly compared with those before treatment in the same group(P<0.05),and the decrease in the treatment group was more significant(P<0.01).Before treatment,there was no significant difference in FMQ and ADL scores between the 2 groups(P>0.05),and they were comparable.After treatment,the above mentioned indexes in the 2 groups were significantly higher than those before treatment in the same group(P<0.05),moreover,the increase in the treatment group was more significant,and the difference was statistically significant(P<0.05 or P<0.01).Conclusion It not only can relieve upper limb muscle spasm,reduce muscular tension and improve fine motor ability,but also improve the daily life self-care ability of the children to use CMM soakage cooperated with wax therapy in the treatment of children with spastic cerebral palsy,which lays a good foundation for their early return to society.It deserves clinical promotion and application.