摘要
Objective To observe the clinical efficacy of acupuncture plus MOTOmed intelligent motor training in treating children with spastic cerebral palsy,and analyze the effects on lower limb motor function,intelligence development level,immune function and cerebral hemodynamics.Methods A total of 42 children with spastic cerebral palsy were selected as the observation objects,and enrolled into the observation group.Another 42 cases treated in the same period were selected as the control group.Both groups received MOTOmed intelligent motor training,and the observation group was given additional acupuncture therapy,and the control group was given additional conventional rehabilitation treatment.After 2 consecutive treatment courses,the psychomotor development index(PDI)and mental development index(MDI)of Children’s Developmental Center of China(CDCC)scale,the scores of gross motor function measure(GMFM)scale and modified Ashworth scale(MAS),and the changes in CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)were observed.The peak systolic velocity(PSV)and mean flow velocity(MFV)of the anterior cerebral artery(ACA),middle cerebral artery(MCA)and posterior cerebral artery(PCA)were observed and measured.The clinical efficacy was evaluated.Results Compared with the same group before treatment,the scores of GMFM,PDI and MDI,levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+),PSV and MFV levels of ACA,MCA and PCA in both groups were significantly increased after treatment(all P<0.05),while the CD8^(+)level had no significant change(both P>0.05).After treatment,the total effective rate of lower limb spasm in the observation group was 90.5%,significantly higher than 71.4%in the control group(P<0.05).The scores of GMFM,PDI and MDI,the levels of CD3^(+)and CD4^(+),PSV and MFV,and the levels of ACA,MCA and PCA in the observation group were all significantly higher than those in the control group(all P<0.05).There were no significant differences in the CD8^(+)level and CD4^(+)/CD8^(+)between the groups(all P>0.05).Conclusion Acupuncture plus MOTOmed intelligent motor training has a better clinical efficacy than conventional rehabilitation plus MOTOmed intelligent motor training in treating children with spastic cerebral palsy,and is also superior in improving lower limb motor function and the level of intellectual development.And the mechanism may be related to the improvement of cerebral hemodynamics.
目的:观察针刺联合MOTOmed智能运动训练治疗痉挛型脑瘫患儿的疗效,分析其对患儿下肢运动功能、智力发育水平、免疫功能及脑血流动力学的影响.方法:选择42例痉挛型脑瘫患儿作为研究对象,纳入观察组.选取同期治疗的42例作为对照组.两组患儿均接受MOTOmed智能运动训练,观察组加用针刺治疗,对照组加用常规康复治疗.连续治疗2个疗程后观察两组患儿中国儿童发展研究中心(CDCC)量表的心理运动发育指数(PDI)与智力发育指数(MDI)、粗大运动功能测定(GMFM)量表、改良Ashworth量表(MAS)评分及CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)的变化,观测患儿大脑前动脉(ACA)、大脑中动脉(MCA)及大脑后动脉(PCA)的收缩期流速峰值(PSV)与平均血流速度(MFV)的变化,并评估两组疗效.结果:与同组治疗前比较,治疗后两组患儿GMFM、PDI及MDI评分,CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)及ACA、MCA、PCA的PSV和MFV均显著升高(均P<0.05),CD8^(+)水平均无显著变化(均P>0.05).治疗后,观察组下肢痉挛的总有效率90.5%,明显高于对照组的71.4%(P<0.05);观察组患儿GMFM、PDI及MDI评分,CD3^(+)、CD4^(+)水平及ACA、MCA、PCA的PSV和MFV均显著高于对照组(均P<0.05),CD8^(+)及CD4^(+)/CD8^(+)的组间差异均无统计学意义(均P>0.05).结论:针刺加MOTOmed智能运动训练治疗痉挛型脑瘫患儿临床疗效优于常规康复加MOTOmed智能运动训练;前者在改善患儿的下肢运动功能,提升患儿的智力发育水平方面亦优于后者;其作用机制可能与改善患儿脑血流动力学有关.
