针灸推拿联合黄芪穴位注射对脑瘫患儿运动功能、脑血流的影响研究

Study on effect of acupuncture and massage combined with acupoint injection of astragalus on motor function and cerebral blood flow in children with cerebral palsy

目的分析针灸推拿联合黄芪穴位注射对脑性瘫痪(脑瘫,CP)患儿运动功能、脑血流的影响。方法100例CP患儿作为研究对象,按照随机数字表法分为常规组和治疗组,每组50例。常规组实施针灸推拿疗法,治疗组实施针灸推拿联合黄芪穴位注射疗法。比较两组患儿的临床治疗效果,治疗前后的粗大运动功能测试量表(GMFM)、脑瘫患儿精细运动能力测试量表(FMFM)评分及脑血流情况[大脑中动脉(MCA)、大脑前动脉(ACA)、大脑后动脉(PCA)的平均血流速度和血管搏动指数(PI)]。结果治疗组治疗总有效率96.00%显著高于常规组的82.00%,组间比较体现出差异性表现(P<0.05)。两组患儿治疗前GMFM、FMFM评分组间比较显示出相似性表现(P>0.05);治疗后,治疗组GMFM评分(199.76±21.22)分、FMFM评分(154.37±14.65)分相较于常规组的(176.56±20.34)、(141.43±13.48)分更高,组间比较均体现出差异性表现(P<0.05)。两组患儿治疗前MCA、ACA、PCA的平均血流速度和PI比较显示出相似性表现(P>0.05);治疗后,治疗组MCA、ACA、PCA的平均血流速度分别为(48.21±6.37)、(36.25±3.45)、(33.27±3.78)cm/s,高于常规组的(42.45±6.53)、(34.78±3.27)、(30.76±4.12)cm/s,PI(0.87±0.23)低于常规组的(1.23±0.45),组间比较均体现出差异性表现(P<0.05)。结论将针灸推拿与黄芪穴位注射联合应用在CP患儿治疗中,可以对患儿的粗大、精细运动功能进行改善,同时可以改善脑血流情况,使CP患儿的肌张力、姿势异常得到显著改善,起到不可替代的效果。

Objective To analyze the effect of acupuncture and massage combined with acupoint injection of astragalus on motor function and cerebral blood flow in children with cerebral palsy(CP).Methods 100 children with CP were studied and divided into a conventional group and a treatment group according to random number table method,with 50 patients in each group.The conventional group received acupuncture and massage therapy,and the treatment group received acupuncture and massage combined with acupoint injection of astragalus therapy.Both groups were compared in terms of clinical effects,the scores of Gross Motor Function Measure(GMFM)and Fine Motor Function Measure Scale(FMFM),cerebral blood flow[mean blood flow velocity and vascular pulse index(PI)of middle cerebral artery(MCA),anterior cerebral artery(ACA),posterior cerebral artery(PCA)]before and after treatment.Results The total effective rate of the treatment group was 96.00%,which was significantly higher than 82.00%of the conventional group,and the comparison between the two groups showed differences(P<0.05).The comparison of GMFM and FMFM before treatment showed similarity between the two groups(P>0.05).After treatment,GMFM score of(199.76±21.22)points and FMFM score of(154.37±14.65)points in the treatment group were higher than(176.56±20.34)and(141.43±13.48)points in the conventional group,and the comparison between the two groups showed differences(P<0.05).The mean blood flow velocity and PI of MCA,ACA and PCA before treatment were similar between the two groups(P>0.05).After treatment,the mean blood flow velocity of MCA,ACA and PCA in the treatment group were(48.21±6.37),(36.25±3.45)and(33.27±3.78)cm/s,respectively,which were higher than(42.45±6.53),(34.78±3.27)and(30.76±4.12)cm/s in the conventional group;and PI of(0.87±0.23)was lower than(1.23±0.45)in the conventional group;and the comparison between the two groups showed differences(P<0.05).Conclusion The combined application of acupuncture and massage and acupoint injection of astragalus in the treatment of CP children can improve the gross and fine motor functions of the children,and improve the cerebral blood flow,so that the muscle tension and postural abnormalities of CP children can be significantly improved,and play an irreplaceable effect of other therapies.