推拿疗法对孤独症谱系障碍儿童核心症状及胃肠道疾病症状的影响

Effects of massage therapy on clinical manifestations and gastrointestinal symptoms of children with autism spectrum disorder

目的基于肠-脑轴理论,观察推拿疗法对儿童孤独症谱系障碍(autism spectrum disorder,ASD)核心症状及胃肠道疾病症状的治疗效果。方法选择ASD患儿80例,随机分为对照组(n=40)和试验组(n=40),对照组予以常规康复治疗;试验组在常规康复治疗的基础上增加中医推拿疗法,每周6次,每次30 min,4周1个疗程,共3个疗程。采用孤独症行为量表(autism behavior checklist,ABC)、儿童孤独症评定量表(childhood autism rating scale,CARS)和胃肠疾病中医证候评分表,对2组患儿治疗前后的ASD核心症状及合并的胃肠道疾病症状进行评分和比较。结果试验组和对照组最终纳入统计分析的患儿分别为36例和34例。试验组与对照组患儿治疗后的ABC、CARS得分均较治疗前显著下降(P<0.05),且试验组优于对照组(P<0.05)。试验组治疗后显效27例、有效9例,治疗总有效率100%;对照组治疗后显效18例、有效13例,治疗总有效率91.2%。治疗后2组患儿胃肠疾病中医证候评分均较治疗前显著下降(P<0.05),且试验组优于对照组(P<0.05)。治疗前试验组有25例患儿存在胃肠道疾病症状,治疗后显效13例、有效12例,总有效率100%;治疗前对照组有23例患儿存在胃肠道疾病症状,治疗后显效6例、有效11例,总有效率73.9%。结论基于肠-脑轴理论的推拿疗法可改善ASD患儿的核心症状,同时减轻合并的胃肠道疾病症状。

Objective To observe the effects of massage therapy on the clinical efficacy and comorbid gastrointestinal symptoms of children with autism spectrum disorder(ASD)based on the theory of gut-brain axis theory.Methods A total of 80 children with ASD were selected and randomly divided into control group(n=40)and experiment group(n=40).The control group was given conventional rehabilitation treatment.The experiment group was treated with conventional rehabilitation treatment and massage therapy,which was 6 times a week,30 min each time,4 weeks as a course of treatment,and 3 courses in total.The autism behavior checklist(ABC),childhood autism rating scale(CARS),and the symptom scale for gastrointestinal diseases were used.The scores of the core ASD symptoms and combid gastrointestinal symptoms of the two groups before and after treatment were compared.Results The actual enrollment was 36 cases in the experiment group and 34 cases in the control group.After treatment,the ABC and CARS scores of both groups were significantly lower than those before treatment(P<0.05),and scores of the experiment group were better than those of the control group(P<0.05).In the experiment group,27 cases were markedly effective and 9 cases were effective;the total effective rate was 100%.In the control group,18 cases were markedly effective and 13 cases were effective;the total effective rate was 91.2%.After treatment,the scores of gastrointestinal diseases symptom in both groups were lower than those before treatment(P<0.05),and scores of the experiment group were better than those of the control group(P<0.05).In 25 patients with gastrointestinal symptoms in the experiment group,13 cases were markedly effective and 12 cases were effective,with a total effective rate of 100%.In 23 patients with gastrointestinal symptoms in the control group,6 cases were markedly effective and 11 cases were effective,with a total effective rate of 73.9%.Conclusion According to the gut-brain axis theory,massage therapy can improve the clinical symptoms of children with ASD and at the same time reduce the comorbid gastrointestinal symptoms.