益肾通痹汤结合针刺治疗小儿脑瘫的临床效果及对肌张力、脑血流动力学的影响

Clinical effect of Yishen Tongbi decoction combined with acupuncture in the treatment of cerebral palsy in children and its influences on muscle tension and cerebral hemodynamics

目的探讨益肾通痹汤结合针刺治疗小儿脑瘫的临床效果及对肌张力、脑血流动力学的影响。方法选取2020年1月至12月我院收治的90例脑瘫患儿,随机将其分为常规组(45例,常规康复运动)和观察组(45例,常规康复运动+益肾通痹汤+针刺)。比较两组的治疗效果。结果观察组的治疗总有效率为97.78%,高于常规组的84.44%(P<0.05)。治疗后,观察组大脑前动脉(ACA)、大脑中动脉(MCA)、大脑后动脉(PCA)的平均血流速度(Vm)高于常规组,阻力指数(RI)低于常规组,差异具有统计学意义(P<0.05)。治疗后,观察组的粗大运动功能量表(GMFM)及Gesell发育量表评分高于常规组,改良Ashworth量表(MAS)评分低于常规组,差异具有统计学意义(P<0.05)。治疗后,观察组的血尿素氮(BUN)、肌酸激酶(CK)及25-羟维生素D_(3)[25-(OH)D_(3)]水平高于常规组,碱性磷酸酶(AKP)及磷(P)水平低于常规组,差异具有统计学意义(P<0.05)。结论益肾通痹汤结合针刺治疗小儿脑瘫效果较好,可调节脑血流动力学指标,促进肢体功能恢复,改善肌张力及生化指标。

Objective To explore the clinical effect of Yishen Tongbi decoction combined with acupuncture in the treatment of cerebral palsy in children and its influences on muscle tension and cerebral hemodynamics.Methods A total of 90 children with cerebral palsy admitted in our hospital from January to December 2020 were selected and randomly divided into routine group(45 cases,routine rehabilitation exercise)and observation group(45 cases,routine rehabilitation exercise+Yishen Tongbi decoction+acupuncture).The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the observation group was 97.78%,which was higher than 84.44%in the routine group(P<0.05).After treatment,the mean blood flow velocity(Vm)of anterior cerebral artery(ACA),middle cerebral artery(MCA)and posterior cerebral artery(PCA)in the observation group were higher than those in the routine group,the resistive index(RI)were lower than those in the routine group,and the differences were statistically significant(P<0.05).After treatment,the Gross Motor Function Measure Scale(GMFM)and Gesell development scale scores of the observation group were higher than those of the routine group,the Modified Ashworth Scale(MAS)score was lower than that of the routine group,and the differences were statistically significant(P<0.05).After treatment,the levels of blood urea nitrogen(BUN),creatine kinase(CK)and 25-hydroxy vitamin D_(3)[25-(OH)D_(3)]in the observation group were higher than those in the routine group,the levels of alkaline phosphatase(AKP)and phosphorus(P)were lower than those in the routine group,and the differences were statistically significant(P<0.05).Conclusion Yishen Tongbi decoction combined with acupuncture is effective in the treatment of cerebral palsy in children.It can regulate cerebral hemodynamic indexes,promote the recovery of limb function,and improve muscle tension and biochemical indexes.