“调肠治神”法针刺对孤独症谱系障碍儿童行为及胃肠功能影响研究

Influence Study of ‘Tiao Chang Zhi Shen’ Acupuncture on Behaviorand Gastrointestinal Function of Children with ASD

目的:观察“调肠治神”法针刺对孤独症谱系(ASD)儿童行为及胃肠功能的影响。方法:招募60例ASD儿童随机分为针刺康复组(30例)与康复组(30例)。康复组实施教育康复训练,针刺康复组在教育康复训练基础上加用“调肠治神”法针刺治疗,取穴选用头针(四神针、智三针和言语三区)与体针(天枢、足三里与上巨虚)相结合,并于针刺前行开穴法,隔日1次,每周3次,两组均治疗3个月。以行为量表评分(CARS评分、ABC评分)及胃肠功能评分(GSI评分)作为观察指标,比较两组患儿治疗前后各评分及各评分变化率的差异,并分析治疗前ASD患儿行为量表评分与胃肠功能评分的相关性,以及治疗后ASD患儿行为量表评分变化率与胃肠功能评分变化率的相关性。结果:治疗前两组ASD患儿的CARS评分、ABC评分和GSI评分差异均无统计学意义(P>0.05);治疗前两组ASD患儿胃肠功能GSI评分与行为量表评分(CARS量表及ABC量表)均具有显著相关性(P<0.05);与治疗前比较,治疗后两组患儿行为量表评分与GSI评分均降低,差异均有统计学意义(P<0.05);与康复组比较,针刺康复组患儿各量表评分前后变化率更高,差异均有统计学意义(P<0.05);治疗后针刺康复组GSI总分变化率与CARS总分、ABC总分变化率均具有显著相关性,差异有统计学意义(P<0.05);治疗后康复组GSI总分变化率与CARS总分、ABC总分变化率无显著相关性(P>0.05),但具有相关趋势。结论:“调肠治神”法针刺可改善ASD患儿的行为症状及胃肠功能,且ASD患儿行为症状与胃肠症状的针刺疗效存在相关性。

Objective:To observe the effect of‘Tiao Chang Zhi Shen’acupuncture on the behavior and gastrointestinal function of children with autism spectrum disorder(ASD).Methods:60 children with ASD were randomly assigned into the acupuncture and rehabilitation group(n=30)and the rehabilitation group(n=30).The rehabilitation group was treated by education and rehabilitation training;on which basis,the observation group was also treated with‘Tiao Chang Zhi Shen’acupuncture.The acupoints were selected using a combination of scalp acupuncture(Four-Shen needles,Three-Zhi needles,speech area-III)and body acupuncture[Tianshu(ST25),Zusanli(ST36),and Shangjuxu(ST37)],and the manipulation of opening acupoints was applied before needling,once every other day,three times a week for three months.Behavioral scale scores(CARS score,ABC score)and gastrointestinal function score(GSI score)were compared between before and after the treatment in the two groups,and the score difference rate was compared between the two groups.The correlation between the behavioral scale scores and the gastrointestinal function scores before the treatment,as well as the correlation between the difference rates in terms of behavioral scale scores and gastrointestinal function scores after the treatment were analyzed in the two groups.Results:There were no statistical differences in CARS scores,ABC scores and GSI scores between the two groups before the treatment(P>0.05).GSI scores were significantly associated with behavior scale(CARS scale and ABC scale)scores before the treatment in the two groups(P<0.05).Behavior scale scores and GSI scores were significantly decreased after the treatment compared with those before the treatment(P<0.05);the changes in the acupuncture and rehabilitation group were more significant(P<0.05).The difference rate of GSI total score was significantly associated with the difference rate of CARS total score and ABC total score in the acupuncture and rehabilitation group(P<0.05).There was no significant association between the difference rate of GSI total score and the difference rates of CARS total score and ABC total score(P>0.05),but there was an association tendency.Conclusion:‘Tiao Chang Zhi Shen’acupuncture can improve the behavior and gastrointestinal function of children with ASD,and there is a correlation between the behavior of children with ASD and the acupuncture effect on gastrointestinal symptoms.