靳三针联合“通督调神”针刺治疗儿童智力障碍临床及机制研究

Clinical effect and mechanism of Jin’s three-needle combined with Tongdu Tiaoshen acupuncture for intellectual disability in children

目的:观察靳三针联合"通督调神"针刺对智力障碍患儿发育水平和日常生活能力的影响,并探讨其作用机制。方法:将60例智力障碍患儿随机分为观察组(30例,脱落2例)和对照组(30例,脱落2例)。对照组予康复训练及常规针刺,均治疗30 min,每天1次,每周6次,共治疗3个月。观察组在对照组基础上予靳三针联合"通督调神"针刺,靳三针中四神针、智三针、脑三针及颞三针留针1 h,手智针、足智针留针30 min;"通督调神"针刺选取百会、神庭、水沟等穴,留针30 min,每天1次,每周6次,共治疗3个月。分别于治疗前后记录两组患儿发育商(DQ)和日常生活能力(ADL)评分,并检测治疗前后血清神经元特异性烯醇化酶(NSE)和单胺类神经递质[多巴胺(DA)、去甲肾上腺素(NE)和5-羟色胺(5-HT)]水平。结果:与治疗前比较,两组患儿治疗后DQ、ADL评分及血清DA、NE、5-HT水平升高(P<0.05),血清NSE水平下降(P<0.05);观察组治疗后DQ、ADL评分及血清DA、NE、5-HT水平高于对照组(P<0.05),血清NSE水平低于对照组(P<0.05)。结论:在康复训练及常规针刺基础上,采用靳三针联合"通督调神"针刺可明显提高智力障碍患儿发育水平和日常生活能力,其机制可能与调节血清NSE及单胺类神经递质水平有关。

Objective To observe the effect of Jin’s three-needle combined with Tongdu Tiaoshen acupuncture on development level and activity of daily living in children with intellectual disability, and explore its mechanism. Methods A total of 60 children with intellectual disability were randomly divided into an observation group(30 cases, 2 cases dropped off) and a control group(30 cases, 2 cases dropped off). In the control group, rehabilitation training and routine acupuncture were adopted, 30 min each time, once a day, 6 times a week for 3 months. On the base of the treatment as the control group,Jin’s three-needle combined with Tongdu Tiaoshen acupuncture were adopted in the observation group. Jin’s three-needle was applied at Sishenzhen, Zhisanzhen, Naosanzhen and Niesanzhen for 1 h, Shouzhizhen and Zuzhizhen for 30 min. Tongdu Tiaoshen acupuncture was applied at Baihui(GV 20), Shenting(GV 24), Shuigou(GV 26), etc. for 30 min, once a day, 6 times a week for 3 months. Before and after treatment,the scores of developmental quotient(DQ) and activity of daily living(ADL) were recorded, and the serum levels of neuron-specific enolase(NSE) and monoamine neurotransmitters(dopamine [DA], norepinephrine [NE] and 5-hydroxytryptamine [5-HT]) were detected in the two groups. Results Compared before treatment, the scores of DQ and ADL and the serum levels of DA, NE, 5-HT after treatment were increased(P<0.05), the serum levels of NSE were decreased(P<0.05) in the two groups. After treatment, the scores of DQ and ADL and the serum levels of DA, NE, 5-HT in the observation group were higher than the control group(P<0.05), while the serum level of NSE was lower than the control group(P<0.05). Conclusion On the base of rehabilitation training and routine acupuncture, Jin’s three-needle combined with Tongdu Tiaoshen acupuncture can significantly improve development level and activity of daily living in children with intellectual disability, and its mechanism may be related to the regulation of serum levels of NSE and monoamine neurotransmitter.