痉瘫康胶囊治疗痉挛型脑瘫的临床效果及microRNA研究

目的观察痉瘫康胶囊治疗痉挛型脑瘫的临床效果及其差异表达microRNA。方法将60例痉挛型脑瘫患儿根据随机数字表法分为对照组和研究组,每组30例。对照组给予常规康复治疗,研究组在对照组基础上给予口服痉瘫康胶囊治疗。比较两组患儿治疗前、后的腓肠肌肌电值及下肢肌张力。筛取研究组中疗效指标差值最大的5例患儿,分别抽取患儿外周静脉血5 mL,用TRIzol法提取总RNA后采用Human Genome Array表达谱芯片筛选差异表达基因,利用DAVID生物软件对差异表达基因进行GO富集和KEGG通路分析。结果治疗后,研究组的腓肠肌静息状态肌电值低于治疗前及对照组,腓肠肌主动收缩状态肌电值高于治疗前及对照组(P<0.05)。研究组患儿治疗后的MAS分级优于对照组(P<0.05)。共筛选出12个特异性差异表达基因(miR-1246、miR-3074、miR-5009、miR-4522、miR-146a、miR-1306-3p、miR-200b-3P、miR-548ar-3p、miR-4536、miR-136、miR-548aa、miR-618),这些microRNA靶基因主要参与了免疫、细胞分化、肌肉张力及蛋白翻译合成等调节。结论痉瘫康胶囊能有效降低痉挛型脑瘫患儿的肌张力,免疫调控通路和能量代谢可能为其作用的靶点,这些基因可能是痉挛型脑瘫表型发生、发展的关键病机之一。

基于真实世界的痉瘫康胶囊治疗小儿痉挛性脑瘫研究

目的 :研究观察痉瘫康胶囊治疗小儿痉挛性脑瘫的临床疗效。方法 :应用真实世界研究方法 ,将凡是应用痉瘫康胶囊治疗的小儿痉挛性脑瘫患者均作为入选对象,所纳入病例必须连续入选,研究不设排除标准,采用自然分组法以不同性别或是否合并使用鼠神经生长因子为标准进行分组,依据医生临床经验和痉瘫康胶囊说明书用药并如实记录合并用药信息,每4周评估1次疗效,12周为一疗程,评估粗大运动功能(GMF)、综合功能、肌力、肌张力压变化情况等指标。结果:每组病例治疗前后GMFM评分、综合功能、肌力、肌张力的变化比较差异有统计学意义(P<0.05),不同性别患者治疗前后各观测指标相互比较差异无统计学意义(P>0.05),是否合并使用鼠神经生长因子对患儿疗效的影响差异无统计学意义(P>0.05)。结论:痉瘫康胶囊能有效缓解小儿痉挛性脑瘫的临床症状。

痉瘫康湿敷结合蜡疗对痉挛型脑瘫膝关节屈曲活动度与粗大运动功能的影响

目的探讨痉瘫康湿敷结合蜡疗对痉挛型脑瘫膝关节屈曲活动度与粗大运动功能的影响。方法选取60例痉挛型脑瘫患儿为研究对象,随机分为试验组和对照组,每组30例,试验组采用常规运动加痉瘫康湿敷结合蜡疗,对照组采用常规运动疗法。治疗周期为3个月,比较治疗前、后两组膝关节活动度及粗大运动功能评分。结果治疗后,两组患儿关节活动度、粗大运动功能评分均显著高于治疗前,且试验组显著高于对照组,差异有统计学意义(P<0.05)。结论痉瘫康湿敷结合蜡疗可以显著改善痉挛型脑瘫患儿的膝关节屈曲活动度和粗大运动功能,值得临床推广应用。

抑肝扶脾法治疗痉挛型脑性瘫痪30例

目的:观察抑肝扶脾法治疗痉挛型脑性瘫痪的临床疗效。方法:采用随机对照单盲法,将60例患者随机分成治疗组和对照组,治疗组30例采用抑肝扶脾法联合神经发育治疗法(Bobath)治疗,对照组采用神经发育治疗法(Bobath)治疗。连续治疗3个月,采用改良Ashworth(MAS)量表(Modified Ashworth Scale)进行疗效判定。结果:治疗组有效率为86.7%,对照组有效率为66.7%,两组比较有统计学意义。结论:抑肝扶脾法治疗痉挛型脑性瘫痪疗效显著。

中成药微生物限度检查方法验证

目的:建立9种中成药的微生物限度检查方法。方法:按照2010年版《中国药典》一部(附录)微生物限度检查法,进行细菌、霉菌及酵母菌计数方法验证和控制菌检查方法验证。结果:9种药品均可采用常规法进行霉菌和酵母菌数测定,1种药品可采用常规法进行细菌数测定,5种药品需采用培养基稀释法进行细菌数测定,3种药品需采用薄膜过滤法进行细菌数测定。8种药品可采用常规法进行控制菌检查,只有1种药品需采用薄膜过滤法进行控制菌检查。结论:中成药可以运用薄膜过滤法和离心沉淀法或超声洗菌法联用等方法来消除某些中成药中的抑菌作用,方法简便易行、准确可靠、重现性好。

Clinical Observation on Acupuncture Treatment for Post-stroke Spastic Hemiplegia

Objective:To observe the clinical effect of contralateral needling plus rehabilitation for post-stroke spastic hemiplegia. Methods:Thirty-six patients with post-stroke spastic hemiplegia were randomly divided into a treatment group and a control group, 18 cases in each group. The two groups were all given rehabilitation training. The contralateral needling was adopted in the treatment group on the acupoints group of brain-refreshing and orifice-opening needling method. The routine acupuncture was applied in the control group on the same acupoints. Respectively before and after the treatment, the modified Ashworth scale (MAS) and clinical spasticity index (CSI) were used to assess the therapeutic effects. Results:The total effective rate was 94.4% in the treatment group and 67.7% in the control group, with a statistical difference in comparison of the two groups (P<0.05). In comparison of MAS and CSI scores after the treatment between the treatment group and control group, the differences were statistically significant (P<0.05). Conclusion:The contralateral needling plus rehabilitation training is an effective method for the treatment of post-stroke spastic hemiplegia.

Applying tuina to exterior-interiorly connected meridians for post-stroke upper limb spasticity

Objective： To observe the effect of applying tuina to exterior-interiorly connected meridians for post-stroke upper limb spasticity. Methods： A total of 150 patients with post-stroke upper limb spasticity were randomly allocated into a treatment group （n=75） and a control group （n=75） by the random number table. Patients in the treatment group received tuina on exterior-interiorly connected meridians, whereas patients in the control group received standard rehabilitation therapy. The therapeutic efficacies in both groups were observed after 3 weeks of treatment. Results： The total effective rate in the treatment group was 89.3%, versus 61.3% in the control group, showing a statistically significant difference （P〈0.05）. After the treatment, the muscle tones by the modified Ashworth scale （MAS） were significantly improved in both groups （both P〈0.05）; and the improvement of muscle tone was more significant in the treatment group than that in the control group （P〈0.05）. Conclusion： Applying tuina to exterior-interiorly connected meridians can obtain an exact efficacy for post-stroke upper limb spasticity.

Effect of acupuncture and tuina plus rehabilitative therapy on lower limb motor dysfunction in infants with spastic cerebral palsy

Objective： To observe the effect of acupuncture, tuina plus rehabilitative therapy on lower limb motor dysfunction in infants with spastic cerebral palsy. Methods： A total of 60 infants with spastic cerebral palsy were randomly divided into a treatment group and a control group by random digital table, 30 cases in each group. The treatment group was treated with acupuncture, tuina therapy plus rehabilitative therapy of Western medicine. The control group was simply treated with rehabilitative therapy of Western medicine, as same as that for the treatment group. The assessment was respectively given to the sick infants before the treatment and after the treatment of six months, to evaluate lying and rolling scores in dimension A, to evaluate sitting score in dimension B, to evaluate crawling and kneeling scores in dimension C, and evaluate standing score in dimension D in the gross motor functions and determine the muscle tone of the gastrocnemius muscle by modified Ashworth scale （MAS）. Results： The differences were not statistically significant in comparison of the gross motor functions and the muscle tone of the gastrocnemius muscle between the two groups of sick infants before the treatment （P〉O.OS）; after the treatment of six months, the above items were obviously improved in the two groups （P〈O.01）, better in the treatment group than in the control group, with the statistical significance in the differences between the groups （P〈O.01）. Conclusion： Acupuncture, tuina plus rehabilitative therapy of Western medicine are remarkable in the therapeutic effects in the treatment of motor disorders of the lower limbs in the sick infants with spastic cerebral palsy. This therapeutic method is safe, simple and convenient and needs to be clinically popularized and applied.

Clinical observation of tuina plus rehabilitation therapy for lower limb extensor spasticity in recovery stage of stroke

Objective: To observe the clinical efficacy of traditional tuina plus modern rehabilitation in the treatment of lower limb extensor spasticity during stroke recovery. Methods: A total of 93 stroke patients who met the inclusion criteria were randomly divided into an observation group and a control group. Forty-four patients in the observation group were treated with traditional tuina plus modern rehabilitation, and 49 patients in the control group were treated with modern rehabilitation. The modified Ashworth scale (MAS), the Fugl-Meyer assessment scale (FMA) and the modified Barthel index (MBI) were used to evaluate the knee extensors state, lower limb motor function and activities of daily living (ADL) of the two groups. Results: After treatment, the overall efficacy of the observation group was better than that of the control group, and the difference was statistically significant (P<0.05). After treatment, the MAS scores of both groups were significantly lower, FMA and MBI scores were significantly higher, and the differences were statistically significant in each group (P<0.01). After treatment, the MAS score of the observation group was lower than that of the control group, and the differenee between the groups was statistically significant (P<0.01). The MBI score of the observation group was higher than that of the control group, and the differenee between the two groups was statistically significant (P<0.05). There were significant differences in the post-treatment changes in MAS, FMA and MBI scores between the two groups (all P<0.05). Conclusion: Traditional tuina plus modern rehabilitation therapy can effectively alleviate or prevent lower limb extensor spasticity after stroke, and improve limb mobility and ADL. Hence, it is worthy of clinical promotion.

Clinical observation on acupuncture plus motor therapy for postapoplectic spastic hemiplegia

Objective： To observe the clinical efficacy of acupuncture plus motor therapy for postapoplectic spastic hemiplegia and provide reference for rehabilitation care of patients with spastic hemiplegia after stroke. Methods： A total of 87 cases with postapoplectic spastic hemiplegia were randomly allocated into a treatment group and a control group. Patients in both groups received basic treatments to control blood pressure, blood sugar, blood fat and improve circulation. The 43 cases in the treatment group received acupuncture combined with motor therapy, whereas the 44 cases in the control group received motor therapy alone（same as the treatment group）. The treatment was conducted once a day, for a total of 3 sessions. One session consisted of 10 times and there was a 1-day interval between two sessions. Then the changes in modified Ashworth scale（MAS） score and Fugl-Meyer assessment scale（FMA） score and clinical efficacy were observed. Results： After treatment, the MAS scores were significantly decreased in both groups, showing intra-group statistical differences（P〈0.01）. The MAS score in the treatment group was significantly lower than that in the control group, showing a between-group statistical difference（P〈0.01）. The total effective rate was 69.8% in the treatment group, versus 45.5% in the control group, showing a between-group statistical difference（P〈0.05）. After treatment, the FMA scores were significantly increased in both groups, showing intra-group statistical differences（P〈0.01）; and the FMA score in the treatment group was significantly higher than that in the control group, showing a between-group statistical difference（P〈0.05）. Conclusion： Acupuncture combined with motor therapy is better than motor therapy alone in alleviating postapoplectic limb spasticity, improving the limb motor function and increasing the activities of daily living（ADL）.

CONSORT and STRICTA evaluation of randomized controlled trials of acupuncture and rehabilitation for post-stroke limb spasm in recent 10 years in China

Objective： To evaluate the literature quality of randomized controlled trials of acupuncture plus rehabilitation for post-stroke limb spasm in the recent ten years in China.Methods： By searching four databases of China National Knowledge Internet（CNKI）, Wanfang Academic Journal Full-text Database（Wanfang）, Chongqing VIP Database（CQVIP） and Chinese Biomedical Literature Database（CBM）, randomized controlled trial（RCT） of acupuncture plus rehabilitation for the treatment of post-stroke limb spasm were screened and selected. In accordance with 2010 edition of the consolidated standards of reporting trials（CONSORT） and standards for reporting interventions in clinical trials of acupuncture（STRICTA）, the quality evaluation was processed for RCT documents. Results： Finally, 50 documents were selected. The issues of titles, sample size calculation, application of randomization and blind method, subject＇s procedure, conclusion and estimated value, explanation of trial limitation, auxiliary intervention measures and therapeutic plans, and background of therapists exist in most documents. Conclusion： Currently, RCT documents about acupuncture plus rehabilitation for the treatment of post-stroke limb spasm are generally of low quality. In the future, it is necessary to standardize the reports of the clinical trials based upon CONSORT and STRICTA, in order to enhance the document quality.