痉挛型脑瘫患儿采用针灸推拿结合黄芪桂枝五物汤治疗的效果

Effect of acupuncture and massage combined with Huangqi Guizhi Wuwu decoction on spastic cerebral palsy children

目的探讨痉挛型脑瘫患儿采用针灸推拿结合黄芪桂枝五物汤治疗的效果及其对粗大运动功能评估量表(Gross Motor Function Measure,GMFM)评分的改善情况。方法选取2021年1月至2023年12月西安中医脑病医院收治的痉挛型脑瘫患儿96例,按信封随机法分成试验组(48例)、对照组(48例)。对照组中,男25例,女23例,月龄(13.42±2.17)个月,病程(4.53±1.17)个月。试验组中,男27例,女21例,月龄(13.65±2.19)个月,病程(4.41±1.29)个月。对照组在常规治疗基础上行针灸推拿治疗(1次/d,6次/周),试验组在对照组基础上行黄芪桂枝五物汤治疗(200 ml药液分早晚2次服用),均连续治疗12周。对比两组疗效及治疗前后GMFM评分、脑血流速度、痉挛指数等。采用t检验、χ^(2)检验。结果试验组总有效率95.83%(46/48)高于对照组83.33%(40/48)(P<0.05)。治疗后,两组各项GMFM评分均升高,且试验组卧位和翻身、站立位、爬和跪位、行走和跑跳维度的评分均高于对照组(均P<0.05)。治疗后,两组大脑中动脉(MDA)和大脑前动脉(ACA)血流速度均升高,各项痉挛指数均下降;且试验组MDA与ACA血流速度均高于对照组,肌张力、腱反射和阵挛维度的痉挛指数均低于对照组(均P<0.05)。结论在痉挛型脑瘫患儿的治疗中,针灸推拿结合黄芪桂枝五物汤的疗效显著,有助于调节脑血流速度,改善运动功能,促进痉挛指数降低。

Objective To explore the value of acupuncture and massage combined with Huangqi Guizhi Wuwu decoction in the treatment of children with spastic cerebral palsy and the improvement of their Gross Motor Function Measure(GMFM)score.Methods Ninety-six children with spastic cerebral palsy admitted to Xi'an Traditional Chinese Medicine Brain Disease Hospital from January 2021 to December 2023 were selected and were divided into an experimental group(48 cases)and a control group(48 cases)using envelope randomization.In the control group,there were 25 boys and 23 girls,aged(13.42±2.17)months,and the course of disease was(4.53±1.17)months.In the experimental group,there were 27 boys and 21 girls,aged(13.65±2.19)months,and the course of disease was(4.41±1.29)months.The control group was treated with acupuncture and massage(once a day,6 times/week)on the basis of conventional treatment,and the experimental group was treated with Huangqi Guizhi Wuwu decoction(200 ml of liquid medicine was taken twice in the morning and evening)on the basis of the control group for 12 weeks.The efficacy and GMFM scores,cerebral blood flow velocities,and spasticity indexes before and after treatment were compared between the two groups.t test andχ^(2) test were used.Results The total effective rate of the experimental group was higher than that of the control group[95.83%(46/48)vs.83.33%(40/48)](P<0.05).After treatment,all GMFM scores of the two groups were increased,and the scores of lying and turning,standing,crawling and kneeling,and walking-running-jumping position dimensions of the experimental group were higher than those of the control group(all P<0.05).After treatment,the blood flow velocities of middle cerebral artery(MDA)and anterior cerebral artery(ACA)were increased and the spasticity index was decreased in both groups;the blood flow velocities of MDA and ACA in the experimental group were higher than those in the control group,and the spasticity indexes of muscle tone,tendon reflex,and clonus were lower than those in the control group(all P<0.05).Conclusion In the treatment of spastic cerebral palsy children,acupuncture and massage combined with Huangqi Guizhi Wuwu decoction has a remarkable effect,which helps to regulate the cerebral blood flow velocity,improve the motor function,and promote the reduction of spasticity index.