针灸对小儿脑瘫患者脑血液循环与神经功能的影响

Effects of acupuncture on cerebral blood circulation and nerve function in children with cerebral palsy

目的探讨针灸对小儿脑瘫患者大脑动脉收缩期峰值血流速度(VP)、血管搏动指数(PI)水平及神经功能的影响,为改善患儿预后提供依据。方法按照随机数字表法将2020年2月至2021年2月中国人民解放军联勤保障部队第九八八医院收治的80例脑瘫患儿分为对照组与观察组,各40例,对照组患儿实施综合治疗疗法[单唾液酸四己糖神经节苷脂纳联合神经生理学疗法(Bobath疗法)],观察组患儿在对照组的基础上加用针灸疗法,两组患儿均连续治疗3个月。比较两组患儿治疗后临床疗效,治疗前后VP、PI、血清血管内皮生长因子(VEGF)、肌酸激酶脑型同工酶(CK-BB)水平、Barthel指数(BI)及粗大运动功能评估量表(GMFM)评分。结果治疗后,观察组患儿的临床总有效率高于对照组;与治疗前比,治疗后两组患儿VP、BI及GMFM评分均升高,且观察组高于对照组;而两组患儿PI与血清VEGF、CK-BB水平均降低,且观察组低于对照组(均P<0.05)。结论在小儿脑瘫的治疗中,采用针灸治疗可提升患儿的治疗效果,促进脑血液循环,改善神经与运动功能,并提升日常生活自理能力。

Objective To investigate the effects of acupuncture treatment on peak systolic blood flow velocity(VP), vascular pulsatility index(PI) levels and neurological function in children with cerebral palsy, in order to provide evidence for improving the prognosis of children.Methods According to the random number table method, 80 children with cerebral palsy admitted to the 988 th Hospital of the Joint Service Support Force of the Chinese People’s Liberation Army from February 2020 to February 2021 were divided into the control group and the observation group, each with 40 cases. And the control group was treated with monosialotetrahexose ganglioside sodium combined with neurophysiological therapy(Bobath therapy), the observation group was treated with acupuncture on the basis of the control group. Both groups were treated for 3 months continuously. The clinical efficacy of the two groups of children after treatment, VP, PI, serum vascular endothelial growth factor(VEGF), creatine kinase isoenzyme BB(CK-BB) levels, Barthel index(BI) and Gross motor function measure(GMFM) score were compared before and after treatment. Results After treatment, the total clinical effective rate of the observation group was higher than that of the control group;compared with before treatment, the VP, BI and GMFM scores of the two groups of children increased after treatment, and the observation group was higher than those of the control group;while the levels of PI and serum VEGF and CK-BB of the two groups of children decreased, and the observation group was lower than those of the control group(all P<0.05). Conclusion In the treatment of children with cerebral palsy, the use of acupuncture can improve the treatment effects of children, promote cerebral blood circulation,improve nerve and motor function, and enhance the ability to take care of themselves in daily life.