头针治疗对脑瘫儿童粗大运动功能的影响

目的观察基于脑功能定位和中医规范化辨证的个性化针刺治疗方案对脑瘫儿童粗大运动功能的影响,探索针刺与康复治疗技术有机结合的新途径。方法将74例脑瘫儿童,随机分为治疗组37例和对照组37例。治疗组采用个性化针刺治疗方案结合康复训练,对照组采用靳氏（益脑十六穴）针刺治疗方案结合康复训练。两组针刺治疗隔日1次,康复训练每日1次,共观察3个月。并运用粗大运动-66项（GMFM-66）对治疗前、治疗后（每治疗1个月）粗大运动功能动态改变以评分法进行测评。结果两组患者组内治疗前后GMFM积分均有明显提高（P〈0.01）;两组患者治疗前后GMFM积分增长幅度比较,差异无统计学意义（P〉0.05）,治疗方案与时间无交互作用（P〉0.05）;痉挛型脑瘫儿童GMFM积分改善,治疗组优于对照组（P〈0.05）。结论头针治疗结合康复训练对脑瘫儿童粗大运动功能产生积极的影响;个性化针刺治疗对痉挛型脑瘫儿童粗大运动功能的改善优于益脑十六穴。

Clinical Observations on the Effect of Scalp Acupuncture on Gross Motor Function in Cerebral Palsy Children

Objective To investigate the effect of an individual acupuncture protocol,based on brain function location and standardized syndrome differentiation in traditional Chinese medicine,on gross motor function in cerebral palsy children and seek a new organic way of combining acupuncture and rehabilitation techniques.Methods Seventy-four cerebral palsy children were randomly allocated to a treatment group of 37 cases and a control group of 37 cases.The treatment group received an individual acupuncture protocol plus rehabilitation training and the control group,Jin’（sixteen brain-reinforcing points） acupuncture protocol plus rehabilitation training.Acupuncture and rehabilitation training were given once every other day and once daily,respectively,for three months in both groups.Gross motor function was assessed using the GMFM-66 score before and after（each month） treatment to examine the dynamic change.Results The GMFM-66 score increased significantly in both groups of patients after treatment（P〈 0.01）.There was no statistically significant difference in post-treatment GMFM score increment between the two groups（P〉0.05）.There was no interaction between the therapeutic protocol and time（P〉0.05）.The GMFM score increased more in spastic cerebral palsy children of the treatment group than in those of the control group（P〈0.05）.Conclusion Scalp acupuncture treatment plus rehabilitation training produces a positive effect on gross motor function in cerebral palsy children.Individual acupuncture treatment is superior to sixteen brain-reinforcing points in improving gross motor function in children with spastic cerebral palsy.