腹募穴揿针改善孤独症谱系障碍患儿异常行为疗效观察

Thumbtack needle at front-mu points for abnormal behavior in children with autism spectrum disorders

目的:比较腹募穴揿针联合常规康复训练与单纯常规康复训练治疗孤独症谱系障碍(ASD)的临床疗效。方法:将40例ASD患儿随机分为联合组(20例,脱落3例)和常规康复组(20例,脱落3例)。常规康复组予常规康复训练,包括语言认知训练和综合教育训练,每日1次,每周5d。联合组在常规康复组基础上,于中脘和双侧天枢、关元行揿针治疗,每次留针3 d,每次治疗间隔3 d,每月5次。两组均治疗1个月为一疗程,每个疗程间休息10 d,共治疗3个疗程。分别于治疗前后观察两组孤独症行为量表(ABC)、儿童期孤独症评定量表(CARS)、Achenbach儿童行为量表(CBCL)评分及中医脾胃疾病症状积分,并检测患儿血清谷氨酸(Glu)/γ-氨基丁酸(GABA)比值。结果:治疗后,两组患儿ABC、CARS及CBCL评分均较治疗前降低(P<0.05,P<0.01),联合组患儿中医脾胃疾病症状积分较治疗前降低(P<0.05);联合组患儿ABC评分、CARS评分、中医脾胃疾病症状积分、CBCL评分及血清Glu/GABA降低幅度大于常规康复组(P<0.05,P<0.01)。结论:腹募穴揿针联合常规康复训练及单纯常规康复训练均可有效治疗ASD,联合疗法可更好地改善患儿异常行为、脾胃症状及神经兴奋/抑制平衡。

Objective To compare the clinical effect of thumbtack needle at front-mu points combined with conventional rehabilitation training and simple conventional rehabilitation training in the treatment of autism spectrum disorders(ASD).Methods A total of 40 children with ASD were randomly divided into a combination group(20 cases, 3 cases dropped out)and a conventional rehabilitation group(20 cases, 3 cases dropped out). Conventional rehabilitation training i.e.language-cognition training and comprehensive education training was adopted in the conventional rehabilitation group, once a day, 5 days a week. On the basis of the treatment in the conventional rehabilitation group, thumbtack needle was applied at Zhongwan(CV 12), bilateral Tianshu(ST 25) and Guanyuan(CV 4) in the combination group, the needles were retained for 3 days each time, 3-day interval was taken between each treatment, for 5 times per month. One-month treatment was as one course and a total of 3 courses were required in both groups, with 10-day break between each course. Before and after treatment, the scores of autism behavior checklist(ABC), childhood autism rating scale(CARS), TCM spleen-stomach symptoms and Achenbach child behavior checklist(CBCL) were observed, and the serum ratio of glutamate and gamma-aminobutyric acid(Glu/GABA) was measured. Results After treatment, the scores of ABC, CARS and CBCL were decreased compared with those before treatment(P<0.05, P<0.01) in both groups, the TCM spleen-stomach symptoms score was decreased compared with that before treatment(P<0.05) in the combination group;the changes in the scores of ABC, CARS, TCM spleen-stomach symptoms and CBCL, as well as the serum Glu/GABA in the combination group were lager than those in the conventional rehabilitation group(P<0.05, P<0.01). Conclusion Both thumbtack needle at front-mu points combined with conventional rehabilitation training and simple conventional rehabilitation training can effectively treat ASD, the combination treatment has superior effect on improving the abnormal behavior, spleen-stomach symptoms and balance of nerve impulse and inhibition.