温针灸联合作业疗法治疗脑瘫的疗效观察及对患者脑电波、神经认知发育的影响

Efficacy observation of treating cerebral palsy with needle-warming moxibustion plus occupational therapy and its impact on patient’s brain wave and neurocognitive development

目的 观察温针灸联合作业疗法治疗脑瘫的临床疗效及对患者脑电波、神经认知发育的影响。方法将102例脑瘫患者随机分为对照组和观察组,每组51例。两组均采取常规康复手段,对照组采取作业疗法,观察组采取温针灸联合作业疗法。观察两组治疗前后Gesell智商发育评分、脑电功率指标(θ波、β波、α/SMR功率比值)、神经认知发育指标[脑源性神经营养因子(brain-derived neuro-trophic factor, BDNF)、高迁移率族蛋白-1(high mobility group box chromosomal protein 1, HMGB-1)、神经元特异性烯醇化酶(neuron-specific enolase, NSE)]、精细运动能力测试量表(fine motor funetion measure, FMFM)评分和肌张力(内收肌、腓肠肌、腘绳肌)的变化,并比较两组临床疗效。结果 观察组总有效率为86.3%,高于对照组的66.7%(P<0.05)。治疗后,观察组Gesell智商发育评分高于对照组(P<0.05);观察组θ波功率、α/SMR功率比值低于对照组(P<0.05),β波功率高于对照组(P<0.05);观察组血清HMGB-1和NSE水平低于对照组(P<0.05),BDNF水平高于对照组(P<0.05);观察组FMFM评分高于对照组(P<0.05);观察组内收肌、腓肠肌、腘绳肌肌张力评分低于对照组(P<0.05)。结论 温针灸联合作业疗法有利于改善脑瘫患者脑电波,恢复精细运动能力,促进神经认知发育。

Objective To observe the clinical efficacy of needle-warming moxibustion plus occupational therapy in treating cerebral palsy and its impact on the patient’s brain wave and neurocognitive development. Method A total of 102 cerebral palsy patients were randomly allocated to a control group and an observation group, with 51 cases in each group. Conventional rehabilitation techniques were offered to both groups. In addition, the control group received occupational therapy, and the observation group received needle-warming moxibustion plus occupational therapy.Before and after the treatment, the Gesell developmental schedule score, electroencephalogram(EEG) power spectrum(θ wave, β wave, and α/SMR), neurocognitive development markers [brain-derived neurotrophic factor(BDNF), high mobility group box chromosomal protein 1(HMGB-1), and neuron-specific enolase(NSE)], the scores of fine motor function measure(FMFM), and muscle tone(adductor, gastrocnemius, and hamstring muscles) were observed. The clinical efficacy was also compared. Result The total effective rate was 86.3% in the observation group, higher than 66.7% in the control group(P<0.05). After the treatment, the observation group was higher than the control group in comparing the Gesell score(P<0.05);the observation group had lower θ wave power and α/SMR(P<0.05) and lower β wave power(P<0.05) than the control group;the observation group had lower serum HMGB-1 and NSE levels(P<0.05) and higher BDNF level(P<0.05) than the control group;the scores of muscle tone of adductor, gastrocnemius,the FMFM score was higher in the observation group than in the control group(P<0.05);and hamstring was lower in the observation group than in the control group(P < 0.05). Conclusion Needle-warming moxibustion plus occupational therapy helps improve brain wave, restore fine motor function, and enhance neurocognitive development in cerebral palsy patients.