调神通督针法联合点穴推拿治疗小儿脑瘫肝肾不足证30例临床观察

Clinical observation on 30 cases of pediatric cerebral palsy with liver and kidney deficiency syndrome treated with Tiaoshen Tongdu acupuncture combined with acupoint tuina

目的观察调神通督针法联合点穴推拿治疗小儿脑瘫肝肾不足证的临床疗效。方法选取2020年7月至2022年7月江山市人民医院康复科和江山第四人民医院康复科收治的脑瘫肝肾不足证患儿60例,采用随机数字表法分为治疗组和对照组,各30例。对照组给予鼠神经生长因子和单唾液酸四己糖神经节苷脂钠注射液肌肉注射,治疗组给予调神通督针法联合点穴推拿治疗。2组均以1个月为1个疗程,共治疗3个疗程后统计临床疗效。结果治疗组总有效率为96.67%(29/30),对照组为83.33%(25/30),2组比较,差异有统计学意义(P<0.05)。治疗前2组智力发育量表(CDCC)评分、发育商(DQ)比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组CDCC评分、DQ值均显著升高,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组升高更显著(P<0.05)。治疗前2组粗大运动功能量表(GMFM)、精细运动功能量表(FMFM)评分比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组GMFM、FMFM评分均显著升高,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组升高更显著(P<0.05)。治疗前2组大脑前动脉(ACA)、大脑中动脉(MDA)、椎动脉(VA)、基底动脉(BA)以及血管搏动指数(PI)值比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组ACA、MDA、VA、BA、PI值均显著升高,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组升高更显著(P<0.05)。结论调神通督针法联合点穴推拿治疗小儿脑瘫肝肾不足证疗效显著,有利于提高患儿的智力水平和运动功能,改善脑血流灌注,值得临床推广应用。

Objective e To observe the clinical efficacy of the combination of Tiaoshen Tongdu acupuncture and acupoint tuina in the treatment of cerebral palsy in children with liver and kidney deficiency syndrome.Methods Sixty cases of cerebral palsy in children with liver and kidney deficiency syndrome admitted to the Rehabilitation Department of Jiangshan People's Hospital and the Rehabilitation Department of Jiangshan Fourth People's Hospital from July 2020 to July 2022 were selected.They were randomly divided into a treatment group and a control group,with 30 cases in each group,using a random number table method.The control group was given intramuscular injection of rat nerve growth factor and monosialotetrahexosylganglioside sodium injection,while the treatment group was given the combination of Tiaoshen Tongdu acupuncture and acupoint tuina therapy.Both groups were treated for one month as a course of treatment,and the clinical efficacy was calculated after a total of three courses of treatment.Results The total clinical effective rate of the treatment group was 96.67%(29/30),while that of the control group was 83.33%(25/30).The difference between the two groups was statistically significant(P<0.05).There was no statistically significant difference(P>0.05)in the CDCC scores and developmental quotient(DQ)between the two groups before treatment,indicating comparability.After treatment,the CDCC score and DQ value of both groups significantly increased,with statistical significance(P<0.05)compared to before treatment in the same group,and the treatment group showed a more significant increase(P<0.05).There was no statistically significant difference(P>0.05)in the scores of the gross motor function scale(GMFM)and fine motor function scale(FM-FM)between the two groups before treatment,indicating comparability.After treatment,the GMFM and FMFM scores in both groups significantly increased,with statistical significance(P<0.05)compared to before treatment in the same group,and the treatment group showed a more significant increase(P<0.05).Before treatment,the two groups of anterior cerebral artery(ACA),middle cerebral artery(MDA),vertebral artery(VA),and basilar artery(BA)were compared,and the pulsatile index(PI)values were calculated.The difference was not statistically significant(P>O.05),indicating comparability.After treatment,the values of ACA,MDA,VA,BA,and PI in both groups significantly increased.Compared with the same group before treatment,the difference was statistically significant(P<0.05),and the treatment group showed a more significant increase(P<0.05).Conclusion The combination of Tiaoshen Tongdu acupuncture and acupoint tuina has a significant therapeutic effect on the liver and kidney deficiency syndrome in children with cerebral palsy.It is beneficial for improving the intellectual level and motor function of children,improving cerebral blood flow perfusion,and is worthy of clinical promotion and application.