中药熏洗对痉挛型脑瘫患儿踝关节活动度影响临床观察

目的：观察中药熏洗对痉挛型脑瘫患儿踝关节活动度的改善情况。方法：本研究采用分层随机对照研究方法。选择2009年6月——2010年12月辽宁中医药大学附属医院小儿脑瘫康复中心进行康复治疗的痉挛型脑瘫患儿,符合纳入标准的随机分为治疗组与对照组,治疗组采用中药熏洗配合基础治疗（推拿＋运动疗法）,对照组采用中药稀释液熏洗配合基础治疗（推拿＋运动疗法）。每周6次,1个月为1疗程。以踝关节活动度为主要观察指标,在患儿入组时、每个治疗周的1、3、5天治疗前后及出组时记录患儿踝关节活动度。结果 ：关节活动度显效率治疗组95.83%,对照组65.22%,两组比较具有统计学差异（P〈0.05）;治疗组治疗前后在踝背屈、踝跖屈的活动度即时疗效要优于对照组,具有统计学差异（P〈0.05）。结论：中药熏洗治疗痉挛型脑瘫患儿踝关节活动度疗效明显优于对照组;中药熏洗具有较好的即刻疗效,主要表现为治疗前后踝关节活动度的即时效应改善明显,因此在推拿及功能训练之前进行熏洗治疗,可以有效放松痉挛的肌肉、肌腱,对于异常姿势的纠正更有利,同时可以减少患儿的疼痛,增强患儿的康复配合度,提高康复疗效。

Clinical Observation on Chinese Medicine Fumigation to Improve Range of Ankle Joint Situation of Children with Spastic Cerebral Palsy

Objective:To observe the range of ankle joint improved situation of children with cerebral palsy before and after Chinese medicine fumigation.Methods:In this study,the stratified random control study was adopted.The children with CP from June 2009 to December 2010 in pediatrics of Affiliated Hospital of Liaoning University of Traditional Chinese Medicine were chosen.The children fit the criteria were divided into the treatment group and control group,the treatment group used herbal fumigation treatment with foundation(massage+exercise therapy),the control group used Chinese medicine with diluted fumigation based therapy(massage+exercise therapy),six times a week,a month for one period of treatment.With ankle mobility as the main outcome,ankle mobilities at 1,3,5 days before and after treatment were recorded.Results:The range of motion significant efficiencies in treatment group and control group were 95.83% and 65.22%,two groups had a statistical difference(P<0.05);before and after treatment,the curative effects of ankle flexion and ankle plantar flexion in treatment group should be better than those in control group,which had statistical difference(P<0.05).Conclusion:Herbal fumigation treatment for children with cerebral palsy ankle mobility type spasm has better effects than control group.Herbal fumigation has good curative effect immediately,ankle mobility is improved after treatment,so massage and functional training before fumigation treatment can effectively relax muscles and tendons,at the same time could relieve the patients’ pain and enhance the recovery of the children with degrees,improving rehabilitation curative effect.