“扶阳通经”督脉艾灸对痉挛型脑性瘫痪儿童平衡功能的影响

Influence of"Fuyang Tongjing"Dumai moxibustion on balance function of children with spastic cerebral palsy

目的观察“扶阳通经”督脉艾灸对痉挛型脑性瘫痪(简称脑瘫)儿童平衡功能的影响。方法本研究选取2022年1月至12月在郑州大学附属郑州中心医院儿童康复科治疗的痉挛型脑瘫患儿共78例为研究对象,随机分为观察组和对照组各39例。对照组给予多媒体感觉统合训练、悬吊训练、目标导向性训练,观察组加予“扶阳通经”督脉(神庭、大椎、至阳、身柱、筋缩、命门)艾灸,连续治疗6个月。比较两组患儿的平衡功能早期临床评估(ECAB)量表、粗大运动功能评定88项(GMFM)量表以及脑瘫儿童日常生活活动能力(ADL)康复护理评定量表得分及其相关性。结果治疗后两种治疗方法对脑瘫患儿平衡功能改善的差异有统计学意义,“扶阳通经”督脉艾灸联合常规康复训练治疗优于常规康复训练治疗(P<0.05)。两组患儿治疗后GMFM88项总分、脑瘫儿童ADL康复护理评定量表得分均显著升高,且观察组高于对照组,差异有统计学意义(P<0.05)。两组治疗后GMFM88各能区比较,两组治疗后卧位和翻身,坐位,爬行和跪位,立位4个能区得分均较治疗前显著提高,差异有统计学意义(P<0.05);观察组治疗后走、跑、跳能区得分较治疗前显著提高,差异有统计学意义(P<0.01)。治疗后观察组爬行和跪位,立位2个能区得分高于对照组,差异有统计学意义(P<0.05)。对照组和观察组治疗前ECAB得分与GMFM88总分、ADL康复护理评定量表得分均呈正相关(r=0.860,0.704,0.760,0.688,P<0.01);对照组和观察组治疗后ECAB得分与GMFM88总分、ADL康复护理评定量表得分均呈正相关(r=0.884,0.745,0.794,0.651,P<0.01)。结论“扶阳通经”督脉艾灸能改善痉挛型脑瘫儿童平衡功能,其平衡功能提高有助于促进运动功能、日常生活活动能力发展。

Objective To observe the effect of"Fuyang Tongjing"Dumai moxibustion on balance function of children with spastic cerebral palsy.Methods By the random number table,78 children with spastic cerebral palsy were randomly divided into control group(n=39)and treatment group(n=39).The both groups were given multimedia sensory integration training,suspension training and goal-directed training;additionally,the treatment group was given"Fuyang Tongjing"Dumai(Shenting,Dazhui,Zhiyang,Shenzhu,Jinsuo,Mingmen)moxibustion;the treatment lasted for 6 months.The scores of the Early Clinical Assessment of Balance scale,the Gross motor function measurement 88 scale and the ADL Rehabilitation Nursing Rating Scale for children with spastic cerebral palsy were compared between the control group and treatment group,and their correlations were compared.Results After treatment,there was statistical difference in the improvement of balance function in the children with cerebral palsy."Fuyang Tongjing"Dumai moxibustion combined with conventional rehabilitation training was better than conventional rehabilitation training alone(P<0.05).After treatment,the total scores of GMFM88 and the scores of ADL Rehabilitation Nursing Rating Scale in children with cerebral palsy significantly increased in both groups,and the scores of the treatment group were higher than those of control group(P<0.05).The comparison in the energy areas of GMFM88 between the two groups showed:the scores in the four areas(supine position and turning over,sitting position,crawling and kneeling position,standing position)significantly increased after treatment compared with those before treatment(P<0.05);the scores in the energy areas of walking,running and jumping significantly increased in the treatment group after treatment(P<0.01).After treatment,the scores in the two energy areas of crawling and kneeling position and standing position were higher in the treatment group than in the control group(P<0.05).Before treatment,the ECAB score was positively related to GMFM88 total score and the scores of ADL Rehabilitation Nursing Scale(r=0.860,0.704,0.760,0.688,P<0.01)in both groups;after treatment,ECAB score was positively associated with GMFM88 total score and the scores of ADL Rehabilitation Nursing Scale in both groups(r=0.884,0.745,0.794,0.651,P<0.01).Conclusion"Fuyang Tongjing"Dumai moxibustion can improve the balance function of children with spastic cerebral palsy,and the improvement in balance function is helpful to promote the development of motor function and ability of daily activities.