电针刺激联合A型肉毒毒素综合康复治疗痉挛型脑性瘫痪尖足患儿临床研究

Clinical research of electroacupuncture stimulation combined with botulinum toxin A on spastic cerebral palsy accompanied by tiptoe in children

目的观察电针刺激联合A型肉毒毒素(BTX-A)综合康复治疗痉挛型脑性瘫痪(以下简称脑瘫)尖足患儿的临床疗效。方法将50例痉挛型脑瘫尖足患儿按照随机数字表法分为2组,对照组25例采用BTX-A肌肉注射治疗,注射后并进行常规康复训练,治疗组25例在对照组治疗基础上加电针刺激。比较2组治疗前及治疗1、3、6个月4个时间点小腿三头肌综合痉挛量表(CSS)评分、踝关节改良Ashworth量表(modified ashworth scale,MAS)评分和粗大运动功能测试量表(GMFM)88项中站立功能(D区)和走跑跳功能(E区)评分。结果治疗1、3、6个月,2组小腿三头肌CSS评分、踝关节MAS评分及GMFM 88项(D区+E区)评分均较本组治疗前明显改善,比较差异均有统计学意义(P<0.05),且2组治疗1、3、6个月同一时间点比较差异也均有统计学意义(P<0.05)。结论电针刺激联合BTX-A治疗痉挛型脑瘫尖足患儿,可以显著改善肌痉挛、踝关节活动度和运动功能。

Objective To observe the clinical efficacy of electroacupuncture stimulation combined with botulinum toxin A(BTX-A)on spastic cerebral palsy(SCP)accompanied by tiptoe in children.Methods Totally 50 children with SCP accompanied by tiptoe were divided into equal group according to the random number table,in addition BTX-A,control group received routine training,and treatment group received electroacupuncture based on control group.The aim was to compare composite spasticity scale(CSS)for triceps surae,modified ashworth scale(MAS),standing function(dimension D)and walking,run and jump function(dimension E)of Gross Motor Function Measure(GMFM)88 before treatment(day 0)and on the 1st,3rd,6th month post-treatment.Results Difference was statistically significant in the CSS,MAS and GMFM 88(dimension D&E)scores of triceps surae in groups on the 1st,3rd,6th month post-treatment verses before treatment(P<0.05),difference was also statistically significant between groups on the 1st,3rd,6th month post-treatment(P<0.05).Conclusion For children with SCP accompanied by tiptoe,electroacupuncture stimulation combined with BTX-A is capable of improving muscle spasm,ankle mobility and motor function.