头针联合康复训练治疗小儿脑瘫37例临床观察

Clinical observation on 37 cases of children with cerebral palsy treated by scalp acupuncture combined with rehabilitation training

观察头针联合康复训练治疗小儿脑瘫的临床疗效。方法选取2017年2月至2018年9月绍兴第二医院康复医学科收治的脑瘫患儿74例,按随机数字表法分为治疗组和对照组,各37例。2组均予常规康复训练,对照组在康复训练的基础上予Vojta疗法,治疗组在对照组治疗方法的基础上联合头针治疗,2组均治疗3个月后统计疗效。结果治疗组的总有效率为94.59%(35/37),明显高于对照组的72.97%(27/37),2组比较,差异有统计学意义(P<0.05)。治疗前,2组的运动发展指数(psychomotor development index,PDI)及智力发展指数(mental development index,MDI)评分比较,差异无统计学意义(P>0.05),具有可比性;治疗后,治疗组的PDI、MDI评分较同组治疗前及对照组治疗后均明显升高,差异均有统计学意义(P<0.05),而对照组PDI、MDI评分与同组治疗前无明显变化(P>0.05)。治疗前,2组的脑血流动力学指标比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组的脑动脉收缩期峰流速度(systolic peak flow velocity,Vs)、平均血流速度(Mean flow velocity,Vm)均较同组治疗前明显升高,血管搏动指数(pulsatility index,PI)、血管阻力指数(blood vessel resistance index,RI)均显著下降,差异均有统计学意义(P<0.05),且治疗组升高/下降更显著(P<0.05)。结论头针联合康复训练可明显提高脑瘫患儿的PDI及MDI评分,显著改善其脑部血流状态,疗效显著,值得临床推广应用。

Objective To observe the clinical efficacy of scalp acupuncture combined with rehabilitation training in the treatment of children with cerebral palsy.Methods From February 2017 to September 2018,74 cases of children with cerebral palsy admitted into department of rehabilitation medicine in The Second Hospital of Shaoxing were divided into treatment group and control group according to random number table method,with 37 cases in each.The 2 groups were both given routine rehabilitation training,on the basis,the control group was given Vojta therapy,the treatment group was combined with scalp acupuncture on the basis of the therapeutic method of the control group.We kept statistics about the efficacy after the 2 groups were both treated for 3 months.Results The total effective rate of the treatment group was 94.59%(35/37),which was significantly higher than 72.97%(27/37)of the control group,and the difference between the 2 groups was statistically significant(P<0.05).Before treatment,the difference was not statistically significant in psychomotor development index(PDI)score and mental development index(MDI)score between the 2 groups(P>0.05),and they were comparable.After treatment,PDI score and MDI score of the treatment group significantly increased compared with those in the same group before treatment and those in the control group after treatment,and the difference was statistically significant(P<0.05),however,PDI score and MDI score of the control group showed no significant change compared with the same group before treatment(P>0.05).Before treatment,the difference was not statistically significant in cerebral hemodynamic index between the 2 groups(P>0.05),and they were comparable.After treatment,cerebral arteries systolic peak flow velocity(Vs)and mean flow velocity(Vm)increased significantly compared with those in the same group before treatment,while pulsatility index(PI)and blood vessel resistance index(RI)significantly decreased,and the difference was statistically significant(P<0.05),moreover,the treatment group decreased or increased more significantly(P<0.05).Conclusion Scalp acupuncture combined with rehabilitation training can markedly improve the PDI and MDI score of children with cerebral palsy,and markedly improve their cerebral blood flow state with marked efficacy.It is worthy of clinical promotion and application.