经颅磁刺激联合头针治疗脑性瘫痪合并睡眠障碍的疗效分析

Clinical study of repetitive transcranial magnetic stimulation combined with scalp acupuncture in the treatment of children with cerebral palsy and sleep disorder

目的探讨重复经颅磁刺激联合头针治疗对小儿脑性瘫痪(简称脑瘫)合并睡眠障碍的疗效比较。方法选择2020年10月至2022年10月成都市中西医结合医院儿童康复中心门诊或住院、成都中童儿童康复医院、成都顾连康复诊所有限公司的脑瘫合并睡眠障碍患儿90例,随机分为对照组、针刺组、联合治疗组各30例。对照组对家长进行睡眠卫生宣教,加强睡眠行为管理。针刺组在对照组基础上进行头针穴位针刺,每周3次,共12周。联合治疗组在对照组和针刺组基础上,加用重复经颅磁刺激,采用睡眠模式,每周治疗3次,治疗5周,间隔1周,再治疗5周。治疗6周、12周后观察各组的睡眠效率、睡眠潜伏期及觉醒次数的变化。结果3组睡眠效率随治疗时间递增,且治疗6周后联合治疗组睡眠效率高于对照组,治疗12周后针刺组和联合治疗组睡眠效率均高于对照组,差异有统计学意义(P<0.05)。3组睡眠潜伏期随治疗时间递减,且治疗6周和12周后联合治疗组睡眠潜伏期均低于针刺组和对照组,差异有统计学意义(P<0.05)。3组觉醒次数随治疗时间递减,且治疗12周后联合治疗组和针刺组觉醒次数均低于对照组,差异有统计学意义(P<0.05)。结论重复经颅磁刺激联合头针治疗能改善脑瘫睡眠障碍儿童的睡眠质量,缩短入睡时间,减少夜间觉醒次数,提高睡眠效率。

Objective To investigate the effect of repetitive transcranial magnetic stimulation combined with scalp acupuncture on children with cerebral palsy(CP)complicated with sleep disorders.Methods From October 2020 to October 2022,90 children with cerebral palsy complicated with sleep disorders were treated in the Children′s Rehabilitation Center of Chengdu Hospital of Integrated Traditional Chinese and Children′s Rehabilitation Hospital,and Chengdu Gulian Rehabilitation Clinic Co.,Ltd.,who were randomly divided into control group,acupuncture group,and combined treatment group,with 30 cases in each group.In the control group the children′s parents received sleep health education to strengthen sleep behavior management.In the acupuncture group the children received scalp acupuncture three times a week for 12 weeks on the basis of the treatment for control group.The combined treatment group received repetitive transcranial magnetic stimulation on the basis of the treatment for control group and the acupuncture group,and the sleep pattern was adopted,three times a week for 5 weeks,with an interval of 1 week,and then another 5 weeks.After 6 and 12 weeks of treatment,the changes in sleep efficiency,sleep latency,and arousal times of each group were observed.Results The sleep efficiency of the three groups increased with the treatment time,and after 6 weeks of treatment,the sleep efficiency of the combined treatment group was higher than that of the control group,and at 12 weeks after treatment,the sleep efficiency of the acupuncture group and the combined treatment group was significantly higher than that of the control group(P<0.05).The sleep latency of the three groups decreased with the treatment time,and the sleep latency of the combined treatment group was lower than that of the acupuncture group and the control group after 6 and 12 weeks of treatment,and the difference was statistically significant(P<0.05).The number of arousal decreased with the treatment time in the three groups,and the number of arousal in the combined treatment group and acupuncture group was lower than that in the control group at 12 weeks after treatment,and the difference was statistically significant(P<0.05).Conclusion Repetitive transcranial magnetic stimulation combined with scalp acupuncture can improve the sleep quality of children with sleep disorders and cerebral palsy,shorten the time of falling asleep,reduce the number of awakening at night,and improve sleep efficiency.