热补针法结合Bobath疗法个性化治疗方案对脑瘫患儿粗大运动功能的影响:随机对照研究(英文)

目的:探讨热补针法结合Bobath康复训练对脑瘫患儿粗大运动(GMFM)功能的影响。方法:将60例脑瘫患儿随机分为康复组和热补针法结合康复组,每组30例。康复组患儿只接受康复手法训练,热补针法结合康复组患儿在采用热补针法治疗的同时结合康复手法训练。热补针法治疗取穴夹脊穴、肩髃、曲池、合谷、阳陵泉、阴陵泉、悬钟、足三里、三阴交、承山、太冲、太溪、神门,每日治疗1次,头针取穴百会、四神聪、智三针、脑三针、颞三针、运动区,不提插捻转,隔日治疗1次,3个月为一疗程,共治疗2个疗程。同时在治疗前、治疗3个月及6个月后采用GMFM运动功能评定量表评定,对脑瘫患儿进行评估。结果:热补针法结合康复组总有效率为70.00%(21/30),康复组总有效率为60.00%(24/30),热补针法结合康复组的疗效优于康复组(P0.05)。热补针法结合康复组患儿治疗6个月后GMFM卧位和翻身、爬和跪、坐位、站位及走跑跳评分分别与治疗前及治疗3个月比较均有明显改善(均P0.05);康复组患儿治疗6个月后GMFM卧位和翻身、爬和跪评分、坐位评分、站位、走跑跳评分与治疗前比较均有明显改善(均P0.05),治疗6个月后站位评分与治疗3个月后比较有明显改善(P0.05);热补针法结合康复组患儿治疗6个月后GMFM爬和跪、坐位、站位及走跑跳评分与康复组患儿比较均有明显改善(P0.05)。结论:热补针法结合Bobath康复训练对脑瘫患儿GMFM爬和跪、坐位、站位、走跑跳评分的影响明显优于单纯康复训练,说明热补针法与Bobath现代康复理念的有机结合,可提高脑瘫患儿粗大运动功能。

Effects of individualized therapeutic porgram with heatreinforcing needling in combination with Bobath therapy on gross motor dysfunction in children with cerebral palsy：a randomized controlled trial

Objective To explore the effect of heat-reinforcing acupuncture combined with Bobath rehabilita on training for the gross motor func on measurement（GMFM） in children with cerebral palsy. Methods Sixty cases of cerebral palsy were randomized into a heat-reinforcing acupuncture combined with rehabilitation training group（group A） and a rehabilitation group（group B）,30 cases in each group. Rehabilitation training was applied in group B and heat-reinforcing acupuncture was added in group A. Jiāji（夹脊 EX-B 2）,Jiānyú（肩髃 LI 15）,Qūchí（曲池 LI 11）,Hégi（合谷 LI 4）,Yánglíngquán（阳陵泉 GB 34）,Yīnlíngquán（阴陵泉 SP 9）,Xuánzhōng（悬钟 GB 39）,Zúsānli（足三里 ST 36）,Sānyīnjiāo（三阴交 SP 6）,Chéngshān（承山 BL 57）,Tài chōng（太冲 LR 3）,Tàixī（太溪 KI 3） and Shénmén（神门 HT 4） were chosen in group A and the heat-reinforcing acupuncture was applied once a day. For scalp acupuncture,Biihuì（百会 GV 20）,Sìshéncōng（四神聪 EX-HN 1）,Zhìsānzhēn（智三针）,Nǎosānzhēn（脑三针）,Nièsānzhēn（颞三针） and motor area（运动区） were punctured without any manipulation,once every other day,3 months as a treatment course and 2 courses were needed. GMFM were selected to assess the children with cerebral palsy before treatment,a er 3 months treatment and a er 6 months treatment. Results The total eff ec ve rate in group A was 70.00%（21/30）,which is superior to that of 60.00%（24/30） in group B（P0.05）. In group A,the GMFM scores of decubitus position and turn-over of body,creeping and kneeling,sitting,standing,walking,running and jumping after6 months treatment were significantly improved compared with that before treatment and after 3 months treatment（all P0.05）. In group B,above indices a er 6 months treatment were significantly improved compared with those before treatment,the standing score after 6 months treatment was significantly improved compared with that a er 3 months treatment（P0.05）; the GMFM scores of creeping,kneeling,sitting,standing,walking,running and jumping after 6 months treatment in group A were more significantly improved than that in group B（all P0.05）. Conclusion The heat-reinforcing acupuncture combined with Bobath rehabilita on training has a be er eff ect than rehabilitation training on the GMFM scores of creeping and kneeling,si ng,standing,walking,running and jumping of children with cerebral palsy. It can be shown that the combination of heat-reinforcing acupuncture and Bobath rehabilita on training can improve the gross motor func on of children with cerebral palsy.