循经针灸推拿法对小儿痉挛型脑瘫的治疗效果及其对运动发育、肌肉痉挛的影响研究

Therapeutic Effect of Acupuncture and Tuina along Channels on Children with Spastic Cerebral Palsy and Its Influence on Motor Development and Muscle Spasm

目的研究循经针灸推拿法对小儿痉挛型脑瘫的治疗效果及其对运动发育、肌肉痉挛的影响。方法选取医院2017年1月—2020年1月诊治的小儿痉挛型脑瘫80例为研究对象,按照随机数字表法均分为两组,对照组40例进行常规脑瘫康复治疗,观察组40例在对照组基础上采用循经针灸推拿法治疗。比较两组患儿的总有效率,粗大运动功能(GMFM88项)测试评分,改良Ashworth痉挛量表(MAS)评分以及临床痉挛指数(CSI)。结果观察组总有效率为97.5%(39/40),显著高于对照组的80.0%(32/40),差异有统计学意义(P<0.05)。治疗前两组GMFM-88总分及卧位与翻身、坐位、爬与跪位、站立位、行走与跑跳功能区评分比较,差异均无统计学意义(P>0.05),治疗3个月后两组以上各项评分均得到改善,并且观察组GMFM-88总分及坐位、站立位、爬与跪位功能区评分显著高于对照组(P<0.05)。治疗前两组上肢、下肢MAS评分比较,差异均无统计学意义(P>0.05),治疗3个月后,两组以上各项评分均显著降低,并且观察组显著低于对照组(P<0.05)。治疗前两组CSI总分及腱反射、肌张力、阵挛评分比较,差异均无统计学意义(P>0.05),治疗3个月后两组以上各项评分均得到改善,并且观察组CSI总分及肌张力、阵挛评分显著低于对照组(P<0.05)。结论循经针灸推拿法对小儿痉挛型脑瘫的治疗效果满意,能够显著改善患儿的运动发育、肌肉痉挛状况,提高患儿生活质量。

Objective To investigate the effect of acupuncture and Tuina along channels on children with spastic cerebral palsy and its influence on motor development and muscle spasm.Methods Eighty cases of children with spastic cerebral palsy diagnosed and treated in our hospital from January 2017 to January 2020 were selected as the research objects,and they divided into two groups according to the random number table method,40 cases of the control group received conventional cerebral palsy rehabilitation treatment,and 40 cases of the observation group were treated with acupuncture and Tuina along channels.The total effective rate,gross motor function(GMFM88 items)test score,modified ashworth scale(MAS)score and clinical spasticity index(CSI)were compared between two groups.Results The total effective rate of observation group was 97.5%(39/40),which was significantly higher than 80.0%(32/40)of the control group and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in GMFM-88 total score or functional area scores between lying and turning,sitting,climbing and kneeling,standing,walking and running and jumping positions between two groups(P>0.05).After 3 months of treatment,the above scores of two groups were improved,and the total score of GMFM-88 and the functional area scores of sitting,standing,climbing and kneeling positions in the observation group were significantly higher than those in the control group(P<0.05).Before treatment,there was no significant difference in MAS scores of the upper and lower limbs between two groups(P>0.05).After 3 months of treatment,the scores of upper and lower limbs in two groups were significantly reduced,and those of the observation group were significantly lower than those of the control group(P<0.05).Before treatment,there was no significant difference in CSI total scores,tendon reflexes,muscle tone or clonic scores between two groups(P>0.05).After 3 months of treatment,the scores of above items of two groups were improved,and the CSI total scores and the scores of muscle tension and clonus in the observation group were significantly lower than those of the control group(P<0.05).Conclusion The meridian acupuncture and Tuina method is satisfactory in the treatment of children with spastic cerebral palsy,and can significantly improve the motor development,muscle spasm and the quality of life of children with spastic cerebral palsy.