中文版Hammersmith婴儿神经学检查量表的信度和效度

目的 检验中文版Hammersmith 婴儿神经学检查量表(HINE)婴儿神经学检查量表的信度和效度。方法 将符合《中国脑性瘫痪康复指南(2015)》脑瘫高危儿诊断2月~1岁的59例患儿(胎龄32~36周和胎龄37~42周)和年龄相匹配的30例正常儿童进行中文版HINE评价。以三组间HINE总分和各因子评分比较确定区分效度;以脑瘫高危儿临床诊断为金标准,以ROC方法确定界限分及灵敏度、特异度;每组随机抽取10例由同一医师在首次检查后1周再次进行检查评估,以检测重测信度;每组随机抽取10例由两组评估医师同时进行HINE的检查和计分,以检测评分者信度。结果 早产脑瘫高危儿组、足月脑瘫高危儿组的量表总分和5个分项目评分均低于正常对照组,差异具有统计学意义(P＜0.01);早产脑瘫高危儿组ROC曲线的线下面积为0.95,界限分为21分时灵敏度0.97,特异度0.93;足月脑瘫高危儿组ROC曲线的线下面积为0.93,界限分为26分时灵敏度0.97,特异度0.95,两组的灵敏度、特异度均≥0.9;量表总分评分者信度组内相关系数(ICC)＞0.8,5个分项目评分者信度ICC＞0.7;该量表总分和5个分项目重测信度r＞0.8。结论 中文版HINE的效度、信度较好,灵敏度、特异度较高,可用于2月~1岁脑瘫高危儿的临床筛查。     

Clinical observation on acupuncture at thirteen ghost acupoints for children with autism spectrum disorder

Objective

To observe the clinical efficacy of needling thirteen ghost acupoints for children with autism spectrum disorder.

Methods

A total of 90 cases with autism spectrum disorder (ASD) aged between 2 and 6 years were randomly allocated into 2 groups by random number table. The control group (n=45) received routine rehabilitative training, and the treatment group (n=45) received acupuncture at thirteen ghost acupoints plus routine rehabilitative training. The Beijing Gesell developmental (Gesell) scale and autism behavior checklist (ABC) were used to assess the intellectual, language and behavior development before and 3 months after the treatment.

Results

After the treatment, the total effective rate in the treatment group was 82.2%, versus 55.6% in the control group, showing a statistical significance (P<0.05). As for the scores of social, emotional and language in Gesell scale, there were significant intra-group differences in the treatment group (all P<0.05), and all the five subscales in the Gesell scale in the treatment group were significantly better than those in the control group (all P<0.05). As for the scores of ABC, there were significant intra-group differences in the treatment group (P<0.05), and the scores in the treatment group were significantly better than those in the control group (all P<0.05).

Conclusion

Rehabilitation training plus acupuncture at thirteen ghost acupoints can significantly improve the intellectual, language and abnormal behavior in autism spectrum disorder children.