热补针法结合Bobath疗法的个性化治疗方案对脑瘫患儿运动发育功能的影响:随机对照研究

目的:探讨热补针法结合康复训练对脑瘫患儿运动发育功能的影响。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Bobath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Bobath康复手法训练。体针治疗辨证取穴结合局部取穴神门、华佗夹脊、肩髃、曲池、合谷、阳陵泉、阴陵泉、绝骨、足三里、三阴交、承山、太冲、太溪,其中在曲池、合谷、阳陵泉、阴陵泉、足三里、三阴交、承山等穴施热补针法,不留针,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,留针60min,隔日治疗1次。均3个月为一疗程,共治疗2个疗程。治疗前、治疗3个月及6个月采用Peabody运动发育评定量表(PDMS-2)对脑瘫患儿进行评估。结果:两组总有效率分别为70.00%(21/30)和60.00%(18/30),热补针法结合康复组显著优于康复组(P0.05)。热补针法结合康复组患儿治疗6个月姿势、移动、实物操作、抓握评分分别与治疗前及治疗3个月比较,均显著升高(P0.05),视觉-运动整合评分与治疗前比较明显升高(P0.05);康复组患儿治疗6个月姿势、移动、抓握评分与治疗前比较均升高(P0.05),实物操作评分与治疗前及治疗3个月比较显著升高(P0.05);针刺结合康复组患儿治疗6个月姿势、移动、实物操作、抓握评分与康复组比较均明显升高(P0.05)。结论:热补针法结合现代Bobath疗法对脑瘫患儿粗大运动功能和精细运动能力均有明显改善作用。

Randomized Controlled Clinical Trials of Individualized Treatment of Cerebral Palsy Children by Warm-reinforcing Needling Combined with Bobath Rehabilitation Training

Objective To observe the effect of warm-reinforcing needling combined with modern rehabilitation training on motor function of cerebral palsy(CP)children.Methods Sixty cases of CP children were randomly divided into acupuncture combined with rehabilitation(Acu+Rehab,n=30)group and Rehab(n=30)group.Patients of the Acu+Rehab group were treated by warm-reinforcing needling stimulation of Jiaji(EX-B 2),Jianyu(LI 15),Quchi(LI 11),Hegu(LI 4),Zusanli(ST 36),Yinlingquan(GB 34),Sanyinjiao(SP 6),Juegu(GB 39),Yanglingquan(GB 34),etc.,combined with Bobath rehabilitation therapy,and those of the Rehab group treated by Bobath rehabilitation(stimulating key control points in the body,triggering reflexes that provide head and body control).The treatment was conducted every day,with three months being a therapeutic course,two courses in all.The Peabody Developmental Motor Scales 2(PDMS-2)was used to evaluate the CP children's motor function1)gross motor:posture(straightness ratio),locomotion and object manipulation;2)fine motor:grasping and visual-Motor integration].Results After the treatment,of the 30 and 30cases in the Acu+Rehab and Rehab groups,1(3.33%)and 0(0%)were cured,20(66.67%)and 18(60.00%)experienced marked improvement,9(30.00%)and 12(40.00%)were invalid,with the effective rates being 70.00%and 60.00%respectively.The therapeutic effect of the Acu+ Rehab group was markedly superior to that of the Rehab group(P<0.05).After 6months' treatment,the scores of posture,locomotor,object manipulation and grasping,and visual-movement integration were significantly increased in comparison with pre-treatment in the same one group(P<0.05),and the effects of the Acu+Rehab group were obviously superior to those of Rehab group in increasing the scores of posture,locomotor,object manipulation and grasping after 6months' treatment(P<0.05).Conclusion Warm-reinforcing needling combined with Bobath rehabilitation has a better therapeutic effect in improving gross motor and fine motor functions of CP children.