“靳三针”联合早期介入丹佛模式在全面发育迟缓伴孤独症患儿中的临床应用

Clinical application of"Jin San Needle"combined with early start Denver model in children with comprehensive developmental delay and autism

目的探讨“靳三针”联合早期介入丹佛模式(ESDM)应用于全面发育迟缓(GDD)伴孤独症(ASD)患儿中的临床疗效。方法选取2023年4月至8月赣州市妇幼保健院收治的123例GDD伴ASD患儿作为研究对象,按随机数字表法分为常规康复组、ESDM组、“靳三针”+ESDM组,各41例。比较三组临床疗效、Gesell发育诊断量表(GDDS)评分、孤独症行为评定量表(ABC)评分、儿童孤独症评定量表(CARS)评分及不良反应情况。结果“靳三针”+ESDM组的GDD伴ASD的临床总有效率高于ESDM组和常规康复组,差异有统计学意义(P<0.017)。治疗后,“靳三针”+ESDM组粗大运动、适应性、精细运动、个人-社交、语言评分及GDDS总分高于ESDM组和常规康复组,差异有统计学意义(P<0.05);ESDM组AD、PS评分及GDDS总分高于常规康复组,差异有统计学意义(P<0.05)。治疗后,“靳三针”+ESDM组ABC、CARS总分低于ESDM组和常规康复组,差异有统计学意义(P<0.05);ESDM组ABC、CARS总分低于常规康复组,差异有统计学意义(P<0.05)。ESDM组、常规康复组均无不良反应发生,仅“靳三针”+ESDM组发生针刺部位出血2例,三组不良反应发生率比较,差异无统计学意义(P>0.05)。结论“靳三针”联合ESDM治疗GDD伴ASD的总体效果较佳,能有效促进患儿发育迟缓及ASD行为症状的改善,减轻病情严重程度,提高整体发育水平,且安全性较高。

Objective To explore the clinical efficacy of the"Jin San Needle"combined with early start Denver model(ESDM)in children with global developmental delay(GDD)and autistic spectrum disorder(ASD).Methods A total of 123 children with GDD and ASD treated in Ganzhou Maternal and Child Health Hospital from April to August 2023 were selected as the study objects,and they were divided into routine rehabilitation group,ESDM group and"Jin San Needle"+ESDM group according to random number table method,with 41 cases each.The clinical efficacy,Gesell development diagnosis scale(GDDS)score,autism behavior checklist(ABC)score,childhood autism rating scale(CARS)score and adverse reactions of the three groups were compared.Results The total clinical effective rate of GDD with ASD in"Jin San Needle"+ESDM group was higher than that in ESDM group and conventional rehabilitation group,the difference was statistically significant(P<0.017).After treatment,the scores of gross motor,adaptation,fine motor,personal-social,language and GDDS in"Jin San Needle"+ESDM group were higher than those in ESDM group and conventional rehabilitation group,and the differences were statistically significant(P<0.05).The AD,PS scores and GDDS scores in ESDM group were higher than those in conventional rehabilitation group,and the differences were statistically significant(P<0.05).After treatment,the total scores of ABC and CARS in"Jin San Needle"+ESDM group were lower than those in ESDM group and conventional rehabilitation group,and the differences were statistically significant(P<0.05).The total scores of ABC and CARS in ESDM group were lower than those in conventional rehabilitation group,and the differences were statistically significant(P<0.05).There were no adverse reactions in the ESDM group and the conventional rehabilitation group,and only two cases of bleeding at the acupuncture site occurred in the"Jin San Needle"+ESDM group,there was no statistical significance in the incidence of adverse reactions among the three groups(P>0.017).Conclusion"Jin San Needle"combined with ESDM in the treatment of GDD with ASD has a good overall effect,which can effectively promote the improvement of developmental delay and ASD behavioral symptoms in children,reduce the severity of the disease,and improve the overall development level,with high safety.