互动式头针结合振动疗法对脑瘫患儿粗大运动功能、平衡能力及脑血流动力学的影响

Effect of interactive scalp acupuncture combined with vibration therapy on gross motor function,balance ability,and cerebral hemodynamics in children with cerebral palsy

目的观察互动式头针结合振动疗法对脑瘫患儿粗大运动功能、平衡能力及脑血流动力学的影响。方法选择2020年1月至2022年2月于济宁市妇幼保健计划生育服务中心治疗的70例痉挛型双瘫患儿,以随机数字表法分为2组。研究组35例,男性患儿18例、女性患儿17例,年龄(3.43±1.02)岁;对照组35例,男性患儿19例、女性患儿16例,年龄(3.51±1.06)岁。35例对照组患儿给予振动疗法,35例研究组患儿在对照组基础上给予互动式头针治疗,治疗前后检测两组患儿神经元特异性烯醇化酶(NSE)、泛素羧基末端水解酶L1(UCH-L1)、脑源性神经营养因子(BDNF)、脑动脉收缩期峰流速度(Vs)、平均血流速度(Vm)、血管阻力指数(RI),给予患儿粗大运动功能评定量表(GMFM)、Berg平衡量表(BBS)评价。采用t检验、χ^(2)检验。结果研究组治疗后NSE、UCH-L1水平低于对照组[(13.15±4.12)μg/L比(19.41±5.87)μg/L,(12.36±3.11)μg/L比(19.51±4.15)μg/L],BDNF水平高于对照组[(5.92±1.56)μg/L比(4.57±1.29)μg/L](均P<0.05)。研究组患儿治疗后Vm、Vs高于对照组[(140.18±4.24)cm/s比(133.14±3.17)cm/s,(126.97±7.29)cm/s比(114.71±6.21)cm/s],RI低于对照组[(0.61±0.11)比(0.74±0.15)](均P<0.05)。研究组治疗后GMFM量表A区、B区、C区、D区、E区评分高于对照组(均P<0.05)。研究组患儿治疗后BBS评分高于对照组(P<0.05)。结论互动式头针结合振动疗法治疗脑瘫患儿,可减轻神经损伤,改善患儿脑血流循环,提升患儿粗大运动功能及平衡能力。

Objective To observe the effect of interactive scalp acupuncture combined with vibration therapy on gross motor function,balance ability,and cerebral hemodynamics in children with cerebral palsy.Methods A total of 70 children with spastic diplegia treated in Jining Maternal and Child Health and Family Planning Service Center from January 2020 to February 2022 were divided into two groups with the random number table method.There were 35 children in the study group,including 18 males and 17 females,with an age of(3.43±1.02)years old;there were 35 children in the control group,including 19 males and 16 females,with an age of(3.51±1.06)years old.The 35 children in the control group were given vibration therapy,and the 35 children in the study group were given interactive scalp acupuncture on the basis of the control group.Neuron-specific enolase(NSE),ubiquitin carboxyl-terminal hydrolase-L1(UCH-L1),brain-derived neurotrophic factor(BDNF),cerebral artery systolic peak flow velocity(Vs),mean blood flow velocity(Vm),and vascular resistance index(RI)were detected before and after treatment in the two groups.The Gross Motor Function Measure Scale(GMFM)and Berg Balance Scale(BBS)were evaluated for the two groups.t test andχ^(2) test were used.Results After treatment,the levels of NSE and UCH-L1 in the study group were lower than those in the control group[(13.15±4.12)μg/L vs.(19.41±5.87)μg/L,(12.36±3.11)μg/L vs.(19.51±4.15)μg/L],and the level of BDNF was higher than that in the control group[(5.92±1.56)μg/L vs.(4.57±1.29)μg/L](all P<0.05).After treatment,the Vm and Vs in the study group were higher than those in the control group[(140.18±4.24)cm/s vs.(133.14±3.17)cm/s,(126.97±7.29)cm/s vs.(114.71±6.21)cm/s],and the RI was lower than that in the control group[(0.61±0.11)vs.(0.74±0.15)](all P<0.05).After treatment,the scores of A,B,C,D,and E areas of GMFM in the study group were higher than those in the control group(all P<0.05).The BBS score of the study group was higher than that of the control group after treatment(P<0.05).Conclusion Interactive scalp acupuncture combined with vibration therapy in the treatment of children with cerebral palsy can reduce the nerve damage,improve their cerebral blood circulation,and improve their gross motor function and balance ability.