针刺联合按摩及语言训练治疗不同年龄儿童构音障碍疗效观察

Effect of acupuncture combined with massage and language training in the treatment of dysarthria in children of different ages

目的探讨针刺联合按摩及语言训练治疗不同年龄儿童构音障碍的临床效果。方法选择2017年11月至2019年11月平顶山市中医医院收治的243例构音障碍患儿为研究对象,按照年龄将患儿分为低年龄组(2~4岁,n=128)和高年龄组(5~8岁,n=115)。所有患儿给予针刺联合按摩及语言训练治疗12周,分别于治疗前及治疗6、12周后评估患儿构音清晰度和口部运动功能,分别于治疗前、治疗12周后对患儿进行构音检查,评估患儿构音障碍改善情况;治疗12周后根据患儿构音障碍改善情况评估患者治疗效果。结果治疗前2组患儿构音清晰度、唇部运动功能、舌部运动功能及下颌运动功能评分比较差异均无统计学意义(P>0.05);2组患儿治疗6、12周后构音清晰度、唇部运动功能、舌部运动功能及下颌运动功能评分均显著高于治疗前(P<0.05);2组患儿治疗12周后构音清晰度、唇部运动功能、舌部运动功能及下颌运动功能评分均显著高于治疗6周后(P<0.05);治疗6、12周后,低年龄组患儿构音清晰度、唇部运动功能、舌部运动功能及下颌运动功能评分均显著高于高年龄组(P<0.05);治疗前2组患儿言语功能比较差异无统计学意义(Z=0.820,P>0.05);2组患儿治疗12周后言语功能显著优于治疗前(Z=3.354、7.941,P<0.05),治疗12周后低年龄组患儿言语功能显著优于高年龄组(Z=3.941,P<0.05)。低年龄组和高年龄组患儿治疗总有效率分别为88.28%(113/128)、74.78%(86/115),低年龄组患儿治疗总有效率显著高于高年龄组(χ^(2)=7.444,P<0.05)。结论针刺联合按摩及语言训练可以有效改善构音障碍患儿构音清晰度、构音功能和口部运动功能,尤以低年龄患儿疗效更显著。

Objective To investigate the clinical effect of acupuncture combined with massage and language training in the treatment of dysarthria in children of different ages.Methods A total of 243 children with dysarthria admitted to Pingdingshan Hospital of Traditional Chinese Medicine from November 2017 to November 2019 were selected as the research subjects,and the children were divided into low-age group(2-4 years old,n=128)and high-age group(5-8 years old,n=115)according to their age.All children were treated with acupuncture combined with massage and language training for 12 weeks.The articulation and oral motor function of children were evaluated before treatment and 6,12 weeks after treatment,and the children were performed with articulation examination before treatment and 12 weeks after treatment to evaluate the improvement of articulation disorder.After 12 weeks of treatment,the treatment effect was evaluated according to the improvement of dysarthria.Results There was no significant difference in the scores of articulation articulation,labial move ment function,glossal movement function and mandibular movement function between the two groups before treatment(P>0.05).The scores of articulation,labial movement function,glossal movement function and mandibular movement function at 6 and 12 weeks of treatment were significantly higher than those before treatment in the two groups(P<0.05).The scores of articulation,labial movement function,glossal movement function and mandibular movement function at 12 weeks of treatment were significantly higher than those at 6 weeks of treatment in the two groups(P<0.05).After 6 and 12 weeks of treatment,the scores of articulation,labial movement function,glossal movement function and mandibular movement function in the low-age group were significantly higher than those in the high-age group(P<0.05).There was no significant difference in speech function between the two groups before treatment(Z=0.820,P>0.05).The speech function of children after 12 weeks of treatment was significantly better than that before treatment in the two groups(Z=3.354,7.941;P<0.05).After 12 weeks of treatment,the speech function of children in the low-age group was significantly better than that in the high-age group(Z=3.941,P<0.05).The total effective rate in the low-age group and high-age group was 88.28%(113/128)and 74.78%(86/115),respectively.The total effective rate in the low-age group was significantly higher than that in the high-age group(χ^(2)=7.444,P<0.05).Conclusion Acupuncture combined with massage and language training can effectively improve the articulation definition and function and oral movement function of children with dysarthria,especially in young children.