指压术联合平衡疗法训练治疗肌张力低下型脑瘫患儿临床研究

Clinical Study on Finger Pressing Combined with Balance Therapy Training for Children with Cerebral Palsy of Hypotonia Type

目的:观察指压术联合平衡疗法训练治疗肌张力低下型脑瘫患儿的临床疗效。方法:选取180例肌张力低下型脑瘫患儿,按随机数字表法将其分为对照组、观察组各90例,对照组予以平衡疗法,观察组予以指压术联合平衡疗法,2组均治疗3个月。观察2组临床疗效,比较2组治疗前后粗大运动功能测试量表(GMFM)评分、血清脑源性神经营养因子(BDNF)、髓鞘碱性蛋白(MBP)及神经元特异性烯醇化酶(NSE)水平变化,比较2组治疗前后日常生活活动能力量表(BI)以及中文版儿童生活质量测定量表(PedsQLTM)评分变化。结果:观察组临床疗效总有效率为97.78%,高于对照组总有效率86.67%,差异有统计学意义(P<0.05)。治疗后,2组粗大运动A区、B区、C区、D区、E区功能评分均较治疗前升高,观察组上述5个区评分均高于对照组,差异均有统计学意义(P<0.05)。治疗后,2组血清BDNF水平均较治疗前升高,MBP、NSE水平较治疗前下降;观察组血清BDNF水平高于对照组,MBP、NSE水平均低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组BI及PedsQLTM评分均较治疗前升高,差异具有统计学意义(P<0.05);观察组上述2项评分均高于对照组,差异均有统计学意义(P<0.05)。结论:指压术联合平衡疗法训练治疗有利于肌张力低下型脑瘫患儿的肌力恢复,改善脑损伤程度,提升日常生活活动能力和生活质量。

Objective:To observe the curative effect of the therapy of finger pressing combined with balance therapy training on children with cerebral palsy of hypotonia type.Methods:A total of 180 children with cerebral palsy of hypotonia type were selected and divided into the control group and the observation group according to the random number table method,with 90 cases in each group.The control group was given balance therapy,and the observation group was given finger pressing combined with balance therapy.The clinical effects in the two groups were observed.Before and after treatment,the scores of Gross Motor Function Measure(GMFM),the changes of levels of serum brain-derived neurotrophic factor(BDNF),myelin basic protein(MBP)and neuron-specific enolase(NSE)and the changes of scores of Barthel Index(BI)and Pediatric Quality of Life InventoryTM(PedsQLTM)in the two groups were compared.Results:The total effective rate was97.78%in the observation group,higher than that of 86.67%in the control group,the difference being significant(P<0.05).After treatment,the scores of function of areas A,B,C,D and E of gross motor in the two groups were increased when compared with those before treatment,and the above five scores in the observation group were higher than those in the control group,differences being significant(P<0.05).After treatment,the levels of serum BDNF in the two groups were increased when compared with those before treatment,and the levels of MBP and NSE were decreased;the level of serum BDNF in the observation group was higher than that in the control group,and the levels of MBP and NSE were lower,differences being significant(P<0.05).After treatment,the scores of BI and PedsQLTM in both groups were increased when compared with those before treatment,the difference being significant(P<0.05);the scores of BI and PedsQLTM in the observation group were higher than those in the control group,differences being significant(P<0.05).Conclusion:The therapy of finger pressing combined with balance therapy training can effectively recover the muscle strength,improve the damage degree of brain,activity ability of daily living and quality of life in children with cerebral palsy of hypotonia type.