基于眼电生物信号调控的经皮穴位电刺激治疗儿童精神发育迟滞:随机对照试验

Transcutaneous electrical acupoint stimulation based on electro-oculogram signal regulation for children with mental retardation:a randomized controlled trial

目的:观察基于眼电生物信号调控的经皮穴位电刺激长强穴治疗精神发育迟滞(MR)患儿的临床疗效,探讨目标成就量表(GAS)对MR的评价效应。方法:将60例MR患儿随机分为观察组和对照组,各30例。对照组采用常规康复治疗,每周5次;观察组在对照组的基础上,采用基于眼电生物信号调控的经皮穴位电刺激长强穴进行治疗,当采集到的眼电信号与眼电模板的相似度在其眼电阈值范围内时,触发1次20 s的长强穴位电刺激治疗(连续波,频率70~100 Hz,脉宽0.1~0.2 ms),每次治疗30 min,每周2次。两组均4周为一疗程,共治疗3个疗程。分别于治疗前后比较两组患儿婴儿-初中学生社会生活能力量表(S-M)、GAS评分。结果:治疗后,观察组患儿独立生活评分、对照组患儿交往评分较治疗前升高(P<0.01,P<0.05),观察组患儿参加集体活动、运动评分高于对照组(P<0.05)。治疗后,两组患儿GAS评分均较治疗前升高(P<0.001),且观察组高于对照组(P<0.05)。结论:基于眼电生物信号调控的经皮穴位电刺激长强穴有助于提升MR患儿参加集体活动、运动和独立生活能力,并能促进患儿个体化目标的实现;与S-M的标准分相比,GAS评分(T值)更能体现出患儿个体化的细微进步。

Objective To observe the clinical efficacy of transcutaneous electrical acupoint stimulation(TEAS)at Changqiang(GV 1)based on the modulation of electro-oculogram(EOG)signal for children with mental retardation,and explore the evaluation effect of the goal attainment scale(GAS)in children with mental retardation.Methods Sixty children with mental retardation were randomly divided into a treatment group and a control group,with 30 cases in each one.The children in the control group were treated with conventional rehabilitation,5 times a week.On the basis of the control group,TEAS at Changqiang(GV 1)under the modulation of EOG signal was adopted in the treatment group.When the similarity between the collected EOG signal and the template was within the range of EOG threshold,one electric stimulation was triggered at Changqiang(GV 1)for 20 s(continuous wave,70-100 Hz in frequency,0.1-0.2 ms in pulse width),lasting 30 min in each treatment,the intervention was given twice a week.One course of treatment was composed of 4 weeks,and 3 courses were required in total in the two groups.The infant-junior high school student's social living ability scale(S-M)and GAS were scored and compared before and after treatment in the two groups.Results After treatment,the scores of self-living ability in the treatment group and communication ability in the control group were higher than those before treatment(P<0.01,P<0.05).The scores of collective activity and motor ability in the treatment group were higher than those in the control group(P<0.05).After treatment,GAS scores were higher than before treatment in both groups(P<0.001),and the score in the treatment group was higher than the control group(P<0.05).Conclusion TEAS under the modulation of EOG signal is conductive to improving the collective,motor and self-living abilities of the children with mental retardation and promoting children's individual goals.Compared with the standard score of S-M,the T value of GAS can better reflect the subtle progress of individual.