不同干预次序对脑瘫患儿腓肠肌肌电积分的影响

目的:观察针刺与运动疗法两种不同干预次序组合治疗对痉挛型脑瘫患儿腓肠肌即时肌电积分(IEMG)的影响。方法:将29例痉挛型脑瘫患儿随机分为先针刺后运动组(A组,15例)和先运动后针刺组(B组,14例)。A组先针刺委中、承山穴后采用Bobath运动疗法,B组先采用Bobath运动后针刺委中、承山穴,分别记录两种不同干预次序组合治疗后肌电积分的即刻变化情况。结果:(1)A组针刺后、针刺加运动后腓肠肌肌电积分明显增加(均P<0.05);针刺后与针刺加运动后肌电积分值比较差异无统计学意义(P>0.05)。(2)B组运动后、运动加针刺后肌电积分有升高趋势,但差异无统计学意义(均P>0.05)。(3)A、B两组组合治疗后肌电积分值比较,差异无统计学意义(P>0.05)。结论:针刺与运动疗法先后干预次序的不同对痉挛型脑瘫患儿腓肠肌即时肌电积分有显著影响,为避免治疗后引起患儿腓肠肌肌张力过度升高,以先运动后针刺组合为宜。

Impacts on IEMG of gastrocnemius muscle for children with cerebral palsy treated with different intervention order

Objective To observe the impacts on integrated electromyogram(IEMG) of gastrocnemius muscle of the children with spastic cerebral palsy treated with different intervention order of acupuncture and kinesitherapy.Methods Twenty-nine children with spastic cerebral palsy were randomly divided into group A(15 cases) in which the patients were treated with acupuncture before kinesitherapy,and group B(14 cases) in which the patients were treated with acupuncture after kinesitherapy.In group A,acupuncture was applied at Weizhong(BL 40) and Chengshan(BL 57).Afterward,Bobath kinesitherapy was adopted.In group B,Bobath kinesitherapy was adopted at first,and acupuncture was applied at Weizhong(BL 40) and Chengshan(BL 57) afterward.The instant changes of IEMG after treatment were recorded in each group.Results (1) Group A: after single acupuncture and the combined intervention in which acupuncture was applied together with kinesitherapy,IEMG increased apparently(both P<0.05).There was no significant difference statistically in IEMG after acupuncture as compared with that after the combined intervention of acupuncture and kinesitherapy(P>0.05).(2) Group B: after single kinesitherapy and the combined intervention in which acupuncture was applied together with kinesitherapy,IEMG increased in tendency,but no statistically significant difference indicated(both P>0.05).(3) In comparison of IEMG after treatment between two groups,there was no significant difference statistically(P>0.05).Conclusion The different intervention order of acupuncture and kinesitherapy impacts significantly IEMG of gastrocnemius muscle of the children with spastic cerebral palsy.In order to avoid hypermyotonia of gastrocnemius muscle after treatment,kinesitherapy should be applied before acupuncture in priority.