头针治疗小儿脑性瘫痪

小儿脑瘫是由于出生前后或出生过程中多种原因造成脑部病变而引起的运动功能障碍,多伴神经精神改变,语言、视力、听力和智力障碍,属祖国医学“五迟”“五软”“五硬”范畴。在临床治疗过程中,发现头皮针对小儿脑瘫确有较明显疗效。现将头皮针治疗脑瘫18例总结如下。一般资料     

头脊针治疗小儿脑性瘫痪

头脊针治疗小儿脑性瘫痪刘媛黄委会黄河中心医院（４５０００３主题词中枢神经系统疾病／针灸疗法头针疗法小儿脑性瘫痪，简称“小儿脑瘫”，又称“脑性麻痹”。系指小儿脑部在发育完成之前，在胎儿期或婴儿早期因某种原因使尚未成熟的大脑受到损伤所留下来的后遗症。也可...     

头针治疗小儿脑性瘫痪文献述评

头针疗法在小儿脑性瘫痪临床上得到广泛应用，主要有焦氏头针、汤氏头针、靳氏头针以及林氏头针等流派。本文对近年来发表的文献进行整理，对各头针体系穴位构成的理论基础及其应用特点进行了探讨。发现：(1)穴区分布与构成所依据的理论有中医藏象，以及现代医学脑功能定位与神经生理学理论之差异。(2)不同流派配穴理论、进针层次、行针手法、留针时间等各有特点。(3)在头针体系的选择方面，总体表现出以某一流派为主的特点，但也有将两种或两种以上的方法组合应用的情况。为提高小儿脑性瘫痪领域头针临床水平，使其应用更趋规范，在临床研究中亟需通过严格的科研设计，对不同头针体系的组合应用模式、施术方案等进行比较观察。     

头针治疗小儿脑性瘫痪疗效观察

采用头针治疗小儿脑性瘫痪,能够减轻患儿的运动障碍,纠正患儿的异常运动模式,缓解肌肉痉挛,提高患儿的智力水平,取得了满意的疗效。     

头针益智康复疗法治疗小儿脑性瘫痪的临床研究

目的:探讨头针益智康复疗法治疗小儿脑性瘫痪的临床疗效。方法:将100例小儿脑性瘫痪患儿随机分为观察组及对照组,每组50例。对照组仅给予综合治疗,主要包括口服益智中药、头部重点穴区推拿、言语训练及智力训练,观察组在对照组的基础上另给予头针益智康复疗法治疗。治疗后,评价两组构音障碍疗效、语言发育疗效及智商发育疗效。治疗前后,分别对两组患儿中医症状评分进行观察,主要观察指标包括立迟、行迟、语迟、手软、足软及口软。治疗前后,分别对两组患儿发育商评分进行观察,主要观察指标包括语言能力、动作能力、应人能力、应物能力等。结果:构音障碍疗效、语言发育疗效及智商发育疗效中,观察组治疗后有效率均明显高于对照组(P0.05)。治疗后,观察组立迟、行迟、语迟、手软、足软及口软评分均明显低于对照组(P0.05)。治疗后,观察组语言能力、动作能力、应人能力、应物能力评分均明显高于对照组(P0.05)。结论:头针益智康复疗法治疗小儿脑性瘫痪疗效确切,值得进行深入研究。     

针刺治疗小儿脑性瘫痪临床观察

本研究４０例收到满意疗效，其中痊愈３例（７．５％），显效２１例（５２．５％），好转１３例（３２．５％），无效３例（７．５％），总有效率为９２．５％。本法针刺大脑皮层功能定位在头皮上划分出相应的投射区，能调节大脑皮层功能，改善和促进脑细胞的代偿作用，从而使临床症状、体征得到改善，配合体针促进肢体局部代谢，改善肢体血液供应，以调节肌张力，解决诸如失足、内收肌紧张等，提高疗效。     

头针治疗小儿脑性瘫痪104例疗效分析

1999年 8月— 2 0 0 2年 8月笔者对 10 4例脑性瘫痪 (CP)患儿行头针治疗 ,并进行了对比观察 ,现报道如下。1　临床资料1 1　一般资料　本组 16 6例均为门诊与住院CP患儿 ,诊断与分型符合第 1届CP座谈会制定的标准[1] ,治疗均在 3个月以上 ,男 132例 ,女 34例 ,随机分为 2组。治疗组 10 4例 ,予头针加功能训练 ;对照组 6 2例 ,采用功能训练。其中痉挛型14 5例 ,手足徐动型 9例 ,混合型 12例。CP的高危因素中缺氧窒息 116例 ,早产 35例 ,新生儿颅内出血 8例 ,核黄疸 2例 ,不明原因 5例 ;年龄 4～ 6个月 12例 ,～ 1岁 5 7例 ,～ 3岁75例 ,…     

头针结合鲍巴斯疗法治疗小儿脑性瘫痪80例临床观察

头针结合Bobath疗法治疗小儿脑性瘫痪 80例 ,疗程 2个月。结果 :显效 5 3例 ,占66 2 5 % ;有效 1 5例 ,占 1 8 75 % ;总有效率 85 % ;1～ 5岁脑瘫患儿总有效率显著高于 5 +～ 1 4岁 (P <0 .0 1 )表明脑性瘫痪患者年龄越小 ,治疗效果越好。头针结合Bobath疗法可以提高康复疗效 ,促进神经功能恢复。     

Clinical observation of infantile cerebral palsy mainly treated by scalp acupuncture

Purpose: The clinical effects of scalp acupuncture in treating infantile cerebral palsy were observed.Methods: Forty-five patients were treated by scalp acupuncture, functional exercise, intravenous drip, and parents' instructive training.Results: Basic recovery occurred in 4 cases, marked effectiveness in 21 cases and effectiveness in 15 cases. The total effective rate was 88.9%. The shorter duration and the longer course were, the better curative effects got.Conclusion: A combined treatment of scalp acupuncture, physiotherapy and intravenous drip can markedly improve clinical symptoms, signs, and intelligence in children with cerebral palsy. Author: REN Yi-zhong (1965-), male, attending physician Translator: XIAO Yuan-chun     

头针结合现代康复治疗小儿脑瘫临床研究

目的观察头针与现代康复疗法在治疗小儿脑瘫中的协同作用.方法90例脑瘫患儿随机分为3组,Ⅰ组采用头针疗法、Ⅱ组采用现代康复疗法和Ⅲ组采用头针结合现代康复疗法,治疗前后进行日常生活能力(ADL)、运动功能评定.结果经60天治疗后,3个组ADL评分明显高于治疗前(P<0.01),Ⅲ组的ADL评分、运动功能评分明显优于Ⅰ、Ⅱ组(P<0.01),Ⅰ、Ⅱ组相比则差异无显著性意义.结论头针与现代康复疗法在治疗小儿脑瘫中有协同作用.     

Clinical study on 28 cases of acute cerebral hemorrhage treated by scalp acupuncture plus rehabilitation therapy

目的:评价头穴透刺结合康复对急性脑出血患者的临床疗效.方法:采用计算器随机法随机分为头穴透刺结合康复组(A)、康复组(B)、西药对照组(C).结果:A组总有效率为92.9%,愈显率为75.0%,B组为84.6%和69.2%,C组为75.9%和37.9%,A组、B组与C组比较有显著性差异(P＜0.01,P＜0.05),A组和B组无显著性差异(P＞0.05).但A组总有效率明显高于B组.结论:头穴透刺结合康复能明显提高脑出血临床疗效,降低急性脑出血后的神经功能缺损症状,提高日常生活活动能力.     

Clinical observation on acupuncture plus occupation therapy for fine motor functions in children with spastic cerebral palsy

Objective

To observe the clinical effect of acupuncture plus occupation therapy for fine motor functions in children with spastic cerebral palsy.

Methods

A total of 80 cerebral palsy kids with fine motor dysfunction were allocated into two groups by envelop, 40 cases in each group. Cases in the control group were treated with occupation therapy. Based on the therapy given to the control group, cases in the treatment group were supplemented with acupuncture at the points of the three yang meridians of hand. The treatment was done every other day and 10 times for a course. There was a 15-day interval between two courses, and 3 courses in total. The therapeutic efficacies were evaluated using Peabody developmental motor scale 2 (PDMS-2) and modified Ashworth scale (MAS) before and after treatment.

Results

After treatment, the standard score for grasping (Grs), standard score for visual-motor integration (Vis), fine motor quotient (FMQ) and modified Ashworth scale (MAS) were significantly improved in both groups (P<0.05). The improvement in the treatment group was more obvious than that in the control group (P<0.01).

Conclusion

Acupuncture plus occupation therapy can achieve better effect than occupation therapy alone in improving fine motor functions of upper limbs in cerebral palsy kids.

     

针刺治疗脑性瘫痪儿童语言障碍临床观察

目的:观察针刺方法对脑性瘫痪儿童语言障碍的疗效,改善患儿预后.方法:将98例脑性瘫痪儿童语言障碍患儿随机分为针刺组(76例)和对照组(22例)进行临床观察,针刺组取四神针、颞三针、脑三针、智三针、舌三针、风池、哑门为主;对照组口服脑复新0.1～0.2 g,γ-氨酪酸0.25～0.5 g,每日3次;肌肉注射神经生长因子2 mL,每日1次.两组均治疗4个月.结果:针刺组总有效率86.8%,对照组总有效率59.1%,差异有极显著性意义(P<0.001);同时治疗组结果显示早期治疗效果较好.结论:针刺对脑性瘫痪儿童语言障碍有明显的改善作用.     

Clinical observation on Governor Vessel-unblocking and brain-refreshing scalp acupuncture for cerebral palsy complicated with intellectual disabilities

Objective

To observe the clinical efficacy of Governor Vessel-unblocking and brain-refreshing scalp acupuncture for cerebral palsy (CP) complicated with intellectual disabilities.

Methods

A total of 300 CP cases aged between 1 and 5 years were randomly allocated into a treatment group (n=150) and a control group (n=150). Patients in the treatment group were treated with Governor Vessel-unblocking and brainrefreshing scalp acupuncture combined with rehabilitation training, whereas patients in the control group received rehabilitation training alone. The Beijing Gesell developmental (Gesell) scale and gross motor function measure (GMFM) scale were used to assess the motor and intellectual development before and 3 months after the treatment. In addition, the head CT/MRI examination was applied to assess the brain nerve repair before and after the treatment.

Results

After the treatment, the total effective rate in the treatment group was 78.0%, versus 42.7% in the control group, showing a statistical significance (P<0.05). As for scores of five subscales in the Gesell scale, there were significant intra-group differences in the treatment group (all P<0.05); and the scores in the treatment group were significantly better than those in the control group (all P<0.05). As for scores of five dimensions in GMFM scale, there were significant intra-group differences in the treatment group (all P<0.05); and the scores in the treatment group were significantly better than those in the control group (all P<0.05). According to the head CT/MRI findings, the total effective rate was 73.3% in the treatment group, versus 62.0% in the control group, showing a statistical significance (P<0.05).

Conclusion

When used in combination with rehabilitative training, Governor Vessel-unblocking and brain-refreshing scalp acupuncture can significantly improve the clinical efficacy for cerebral palsy complicated with intellectual disabilities. It can also improve the patients’ motor function, intelligence and language ability.

     

点穴加吞咽训练治疗脑瘫流涎的临床观察

流涎症是脑性瘫痪患儿常见的并发症,约占脑瘫的25％-35％,严重的影响脑瘫患儿的生活质量。笔者2005年8月--2008年6月,共对35例脑瘫合并流涎症的患儿,采取点穴按摩,配合吞咽训练,取得一定疗效,现报告如下：     

针刺治疗小儿脑瘫150例临床观察

150例小儿脑瘫分组治疗观察,舌针为主治疗115例,基本痊愈21例（18．26％）,显效44例（38．26％）,好转42例（36．52％）,无效8例（6．96％）,显效11例（31．43％）,好转9例（25．79％）,无效10例（28．57％）;总有效率93．04％。一般针刺治疗35例,无效10例（28．57％）,总有效率93．04％,一般针刺治疗35例,基本痊愈5例（14．29％,显效11例（31．43％）,好转9例（25．79％）无效10例28．57％）;总有效率71．43％。临床观察表明：舌针有助于改善患儿智力、语言功能等精神神经症状;舌针、头针、体针综合治疗,能提高针刺治疗脑瘫的疗效（P＜0．01）。     

Clinical observation on scalp acupuncture for diffusion tensor imaging in cerebral palsy children with periventricular leukomalacia

Objective

To observe the effect of Governor Vessel-unblocking and mind-refreshing needling technique on diffusion tensor imaging (DTI) in cerebral palsy (CP) children with periventricular leukomalacia (PVL) and investigate the underlying mechanism.

Methods

A total of 18 CP children with PVL received modern rehabilitation training and scalp acupuncture. The before-after study was conducted to compare the fractional anisotropy (FA) of the white matter fiber tracts, gross motor function measure (GMFM) score, Gesell developmental scale and changes in muscle tone.

Results

For the comparison before and after the first course of treatment, there were no statistical differences in DTI findings and FA values (both P>0.05); there were statistical differences in GMFM dimensions A and B (both P<0.05) and no statistical differences in dimensions C, D and E (all P>0.05); and there were statistical differences in six items of Gesell development test (P<0.01 or P<0.05). For the comparison before and after two courses of treatment, there were statistical differences in DTI findings and FA values in 8 cases between before and after 30 and 60 treatments (both P<0.05); there were statistical differences in GMFM dimensions A, B and C between before and after 30 and 60 treatments and between 30 and 60 treatments (all P<0.05); there were no statistical differences in GMFM dimensions D and E (all P>0.05); and there were statistical differences in six items of Gesell developmental test between before, after 30 and 60 treatments and between 30 and 60 treatments (P<0.05 or P<0.01).

Conclusion

The Governor Vessel-unblocking and mind-refreshing scalp acupuncture has no significant efficacy on the repair and regeneration of white matter fibers in children with PVL and CP in a short period of time; however, it gradually works along with the prolonged treatment time. In addition, it can improve the motor function and mental development and the efficacy is closely associated with the time of treatment.

     

Clinical observation on treatment of spastic cerebral palsy with tuina plus music therapy

目的：观察小儿推拿结合音乐疗法对改善痉挛型小儿脑性瘫痪患者踝关节活动度及下肢肌肉痉挛的作用。方法：对符合小儿脑性瘫痪诊断标准的286例痉挛型患儿,在背景音乐下进行通督循经点穴推拿、益肾健脾推拿、捏脊疗法、足底推拿、节段性推拿、促肌力恢复推拿及关节活动度推拿7种推拿治疗,每次25～30min,每日1～2次。30天为1个疗程。于治疗前后进行股内收肌角、足背屈角和综合痉挛量袁（Composite Spasticity Scale,CSS）评分,以评价疗效。结果：治疗前后足背屈角、股内收肌角、CSS评分统计学处理,差异有统计学意义（P〈O．01）。总体疗效为显效106例,有效172例,无效8例。结论：推拿结合音乐疗法治疗痉挛型小儿脑瘫,有滑利关节,松解肌腱挛缩,缓解肌肉痉挛作用,能改善剪刀步态和尖足步态。对患儿坐、跪、站、行大运动功能恢复有极积治疗作用。