超声引导下穴位埋线深度对降低痉挛型脑瘫患儿下肢肌张力的影响

Effects of ultrasound-guided acupoint catgut embedding depth on reducing muscular tension of lower limbs in children with spastic cerebral palsy

目的观察超声引导下穴位埋线深度对降低痉挛型脑瘫患儿下肢肌张力的临床疗效。方法选取2019年1月至2020年1月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90例痉挛型脑瘫患儿,采用随机数字表法分为浅层埋线组、中层埋线组和深层埋线组,各30例。3组均给予基础康复治疗(物理治疗、推拿、中药熏洗及蜡疗),选取解剪、后血海和承山穴,分别分3个深度进行埋线治疗,均连续治疗10次后,比较治疗前后的改良Ashworth量表(MAS)评分、综合痉挛量表(CSS)评分和粗大运动功能评估(GMFM)评分,并分析不同埋线深度与临床疗效的关系。结果治疗前,3组MAS、CSS和GMFM评分比较,差异均无统计学意义(P>0.05),具有可比性。治疗后,3组MAS、CSS和GMFM评分较同组治疗前均降低/升高,差异有统计学意义(P<0.05),且深层埋线组MAS、CSS和GMFM评分降低/升高最显著(P<0.05)。结论超声引导下进行穴位深层埋线对降低痉挛型脑瘫患儿下肢肌张力疗效满意,可有效改善CSS、GMFM和MAS评分,值得临床推广运用。

Objective To observe the clinical efficacy of ultrasound-guided acupoint catgut embedding depth on reducing muscular tension of lower limbs in children with spastic cerebral palsy.Methods From January 2019 to January 2020,90 cases of spastic cerebral palsy consulted in children rehabilitation department of Nanhai Maternity and Children Hospital Affiliated to Guangzhou University of Chinese Medicine were divided into shallow layer embedding group,middle layer embedding group and deep layer embedding group according to random number table method,with 30 cases in each group.The 3 groups were all given basic rehabilitation treatment(physical treatment,tuina,Chinese materia medica fumigation and washing and wax therapy).Jiejian,Houxuehai and Chengshan(BL 57)acupoints were selected for catgut embedding treatment at three depths.After 10 consecutive treatment,modified Ashworth scale(MAS)score,comprehensive spasm scale(CSS)score and gross motor function measure(GMFM)score were compared before and after treatment,and the relationship between different embedding depth and clinical efficacy was analyzed.Results Before treatment,there was no significant difference in the scores of MAS,CSS and GMFM among the 3 groups(P>0.05),and they were comparable.After treatment,the scores of MAS,CSS and GMFM in the 3 groups decreased or increased compared with those before treatment in the same group,and the difference was statistically significant(P<0.05);the scores of MAS,CSS and GMFM in the deep layer catgut embedding group decreased or increased the most significantly(P<0.05).Conclusion It has satisfactory efficacy and can effectively improve the scores of CSS,GMFM and MAS to carry out ultrasound-guided acupoint deep layer catgut embedding on reducing muscular tension of lower limbs in children with spastic cerebral palsy,which deserves clinical promotion and application.