针刺治疗小儿脑病患者的手功能障碍

背景手功能障碍是小儿各种脑病中最常见的合并症,也是妨碍小儿正常生长发育的重要因素.穴位注射既能发挥针刺刺激作用,又能发挥药物的作用原理,同时配合作业疗法,可能会提高治疗效果.设计以患者为研究对象的回顾性病例分析.单位一所大学医院的康复中心.目的探讨治疗小儿脑病手功能障碍的有效方法.对象2001-11/2002-10本院门诊收治的31例脑病患儿.纳入标准①符合脑性瘫痪及精神发育迟滞的诊断标准.②年龄＜5岁.③治疗前后均用婴幼儿精细运动发育量表进行评估.排除标准①治疗不满一个疗程.②进行性疾病所致的中枢瘫痪,及各种脑炎、脑病所致的瘫痪.③正常小儿一过性运动发育落后.其中男19例,女12例;年龄最小4月,最大5岁.3岁以内占94%.足月20例,早产11例.方法对31例患儿以穴位注射为主,配合作业疗法进行治疗,并以婴幼儿精细运动发育量表作为评估指标.主要观察指标主要结局为观察脑病患儿手功能改善情况.次要结局为采用婴幼儿精细运动发育量表作为评估指标,观察精细运动治疗前后发育商的变化.结果治疗后精细运动发育商提高21例,占68%;抓握能力指数提高27例,占87%;视觉感知能力指数提高31例.结论针刺配合作业疗法治疗小儿脑病手功能障碍确有明显效果.

Acupuncture for fine motor function impairment in children with encephalopathy

BACKGROUND: Fine motor function impairment is the most common complication in various eneephalopathy in children and is the key factor to hinder the normal development. Acupuncture injection brings not only the stimulation of needling but also the pharmaceutical action into play. In combination with occupational therapy,it improves probably the therapeutic effects.DESIGN: Retrospective analysis based on the patients.SETTING: Rehabilitation center of a university-affiliated hospital.OBJECTIVE: To probe into the effective method for the treatment of fine motor function impairment of children with encephalopathy.PARTICIPANTS: Totally 31 children with encephalopathy were admitted in clinic of the hospital from November 2001 to October 2002. Inclusion criteria: ① To conform to the diagnostic criteria on cerebral palsy and metal retardation. ② Age<5 years old. ③ Having be assessed with peabody developmental motor scale-fine motor(PDMS-FM) before and after treatment.Exclusion criteria: ① To be less than one session treatment. ② To suffer from progressive disorders and palsy caused by various encephalitis and encephalopathy. ③ Transient delayed motor development . Of those patients,19 cases were male,12 cases female,aged varied from 4 months to 5years. 94% of patients were younger than 3 years old. Twenty cases were in full-term delivery. Eleven cases were born prematurely.METHODS: Thirty-one patients were treated primarily with acupunc ture injection in combination with occupational therapy. Assessment was carried on with PDMS-FM.MAIN OUTCOME MEASURES: Primary results: To observe the motor improvement in children with encephalopathy. Secondary results: To observe the changes in fine motor quotient (FMQ) before and after treatment.RESULTS: FMQ was increased in 21 cases(68%),grasp capacity index was elevated in 27 cases(87%) and capacity index of visual perception was improved in 31 cases.CONCLUSION: Acupuncture has firmly achieved remarkable therapeutic effects on fine motor function impairment in children with encephalopatby in combination with occupational therapy.