揿针配合感觉统合训练治疗共济失调型脑性瘫痪疗效观察

Therapeutic observation of thumbtack needles plus sensory integration training for ataxic cerebral palsy

目的观察揿针配合感觉统合训练治疗共济失调型脑性瘫痪的临床疗效。方法将105例共济失调型脑性瘫痪患者随机分为对照A组、对照B组和联合组,每组35例。对照A组采取揿针治疗,对照B组采用感觉统合训练治疗,联合组采用揿针配合感觉统合训练治疗。观察3组治疗前后粗大运动功能测试量表-88(gross motor function measure-88,GMFM-88)各功能区(A~E区)评分、步态各项指标(步长、步速、步宽)、平衡控制能力各项指标(躯干前后标准差、躯干左右标准差及躯干总标准差)、表面肌电信号各项指标[内收肌及腓肠肌积分肌电值(integrated electromyography,IEMG)、表面肌电均方根值(root mean square,RMS)]及儿科生活质量量表(the pediatric quality of life inventory,PedsQL)各项评分(生理功能、情感功能、社交功能)的变化情况,比较3组临床疗效。结果3组治疗前后GMFM-88各功能区评分、步态各项指标、平衡控制能力各项指标、表面肌电信号各项指标及PedsQL各项评分组内比较,差异具有统计学意义(P<0.01)。联合组治疗后GMFM-88各功能区评分及步长、步速均明显高于对照A组和对照B组,步宽及表面肌电信号各项指标均明显低于对照A组和对照B组,差异均具有统计学意义(P<0.05)。联合组及对照B组治疗后平衡控制能力各项指标均明显低于对照A组,PedsQL各项评分均明显高于对照A组,差异均具有统计学意义(P<0.05)。联合组总有效率为94.3%,显著高于对照A组的74.3%和对照B组的68.6%,差异均具有统计学意义(P<0.05)。结论揿针配合感觉统合训练治疗共济失调型脑性瘫痪疗效确切,可增强核心肌群稳定性,改善患者步态,提高粗大运动及平衡能力。

Objective To observe the clinical efficacy of thumbtack needle plus sensory integration training in treating ataxic cerebral palsy.Method A total of 105 patients with ataxic cerebral palsy were randomized into control group A,control group B,and a joint group,each comprising 35 cases.Control group A was treated with thumbtack needles,control group B was offered sensory integration training,and the joint group was treated with thumbtack needles plus sensory integration training.Before and after the treatment,the three groups were observed for changes in the dimension scores(dimensions A-E)of the gross motor function measure-88(GMFM-88),gait parameters(length,speed,and width of stride),balance control ability indicators(the anterior-posterior,left-right,and total standard deviations of the trunk),surface electromyographic signal parameters[integrated electromyography(IEMG)and root mean square(RMS)of the adductor and gastrocnemius muscles],and component scores(physical function,emotional function,and social function)of the pediatric quality of life inventory(PedsQL).The clinical efficacy was compared among the three groups.Result After the treatment,the three groups all had significant changes in all dimension scores of the GMFM-88,gait parameters,balance control ability indicators,surface electromyographic signal parameters,and PedsQL component scores(P<0.01).Compared with control groups A and B after the intervention,the joint group had higher GMFM-88 dimension scores,a longer stride length,and a faster stride speed,and the stride width and surface electromyographic signal parameters were smaller in the joint group,all showing statistical significance(P<0.05).After the treatment,the joint group and control group B had lower balance control ability indicators and higher PedsQL component scores compared to control group A,and the differences were statistically significant(P<0.05).The total effective rate was 94.3%in the joint group,significantly higher than 74.3%in group A and 68.6%in control group B(P<0.05).Conclusion Thumbtack needles plus sensory integration training can effectively treat ataxic cerebral palsy.This method can strengthen core muscle group stability,improve the patient’s gait,and enhance gross motor function and balance ability.