中医穴位按摩治疗小儿发育迟滞临床研究

目的：观察中医穴位按摩在小儿发育迟滞康复治疗中的应用效果。方法：选取2 000 例发育迟滞患儿，按随机数字表法分为研究组及常规组各1 000 例。研究组治疗期间脱落48 例，最终纳入952 例患儿；常规组治疗期间脱落51 例，最终纳入949 例患儿。常规组给予常规康复治疗，研究组在常规组基础上联合中医穴位按摩。比较2 组智商发育、语言功能[Gesell 发育量表（GDS） ]、运动功能[Peabody 精细运动发育量表（PDM-FM）、粗大运动功能评估量表（GMFM） ]、日常生活能力[日常生活能力量表（ADL） ]、脑神经损伤相关指标[S100β 蛋白、髓鞘碱性蛋白（MBP）、神经元特异性烯醇化酶（NSE） ]值的变化。结果：治疗3 个月、6 个月后，2 组语言商、操作商、全智商分数均较治疗前上升，研究组上述3 项分数均高于常规组（P＜0.05）；治疗6 个月后，2 组语言商、操作商、全智商分数均较治疗3 个月升高（P＜0.05）。治疗3 个月、6 个月后，2 组抓握能区、视觉运动统合能区、GMFM、GDS 评分均较治疗前上升，研究组上述4 项评分均高于常规组（P＜0.05）；治疗6 个月后，2 组抓握能区、视觉运动统合能区、GMFM、GDS 评分均较治疗3 个月上升（P＜0.05）。治疗3 个月、6 个月后，2 组生活自理量表、工具性日常生活能力量表评分及ADL 总分均较治疗前下降，研究组上述3 项评分均低于常规组（P＜0.05）；治疗6 个月后，2 组生活自理量表、工具性日常生活能力量表评分及ADL 总分均较治疗3 个月下降（P＜0.05）。治疗3 个月、6 个月后，2 组S100β 蛋白、MBP、NSE 水平均较治疗前下降（P＜0.05），研究组上述3 项水平均低于常规组（P＜0.05）。治疗6 个月后，2 组S100β 蛋白、MBP、NSE 水平均较治疗3 个月下降（P＜0.05）。结论：中医穴位按摩在治疗小儿发育迟滞康复中效果显著，可减轻患儿脑神经损伤，促进患儿智力发育，改善患儿语言、运动功能，提升日常生活能力。

Clinical Study on Chinese Medicine Point Massage for Developmental Retardation inChildren

Abstract： Objective： To observe the effect of Chinese medicine point massage on developmentalretardation in children. Methods：A total of 2 000 children with developmental retardation were selected anddivided into the study group and the routine group according to the random number table method， with1 000 cases in each group. In the study group， 48 cases fell off during treatment， and 952 cases werefinally included. In the routine group， 51 cases fell off during treatment， and 949 cases were finallyincluded. The routine group was given routine rehabilitation treatment，and the study group was additionally treated with Chinese medicine point massage based on the treatment of the control group. The changes inIQ development，language function [Gesell Development Schedule (GDS)]，motor function [Peabody FineMotor Development Motor Scale (PDM- FM)， and Gross Motor Function Measure (GMFM)]， activity ofdaily living (ADL)，and brain nerve injury-related indexes [S100β protein，myelin basic protein (MBP)，andneuron-specific enolization (NSE)] were compared between the two groups. Results：After 3 and 6 monthsof treatment，the scores of language quotient，operation quotient and total intelligence quotient in the twogroups were increased when compared with those before treatment， and the above three scores in thestudy group were higher than those in the routine group (P＜0.05). After 6 months of treatment，the scoresof language quotient，operation quotient and total intelligence quotient in the two groups were increasedwhen compared with those after 3 months of treatment (P＜0.05). After 3 and 6 months of treatment，thescores of grasping energy range， visual motor integration energy range， GMFM， and GDS in the twogroups were increased when compared with those before treatment， and the above four scores in thestudy group were higher than those in the routine group (P＜0.05). After 6 months of treatment，the scoresof grasping energy range， visual motor integration energy range， GMFM， and GDS in the two groupswere increased when compared with those after 3 months of treatment (P＜0.05). After 3 and 6 months oftreatment，the scores of Physical Self-Maintenance Scale，Instrumental Activities of Daily Living Scale andthe total scores of ADL in the two groups were decreased when compared with those before treatment，and the above three scores in the study group were lower than those in the routine group (P＜0.05). After6 months of treatment， the scores of Physical Self- Maintenance Scale， Instrumental Activities of DailyLiving Scale and the total scores of ADL in the two groups were decreased when compared with those after3 months of treatment (P＜0.05)，and the above three scores in the study group were lower than those inthe routine group. After 3 and 6 months of treatment，the levels of S100β protein，MBP and NSE in thetwo groups were decreased when compared with those before treatment (P＜0.05)，and the above threelevels in the study group were lower than those in the routine group (P＜0.05). After 6 months oftreatment， the levels of S100 β protein ， MBP and NSE in the two groups were decreased whencompared with those after 3 months of treatment (P＜0.05). Conclusion： Chinese medicine pointmassage has a significant effect in the treatment and rehabilitation of children with developmentalretardation， which can relieve the brain nerve injury， promote the intellectual development of children，improve the language and motor function of children，and enhance their activities of daily living.