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温针补法结合Bobath康复训练个体化治疗小儿脑性瘫痪的随机对照临床试验

[Randomized controlled clinical trials of individualized treatment of cerebral palsy children by warm-reinforcing needling combined with Bobath rehabilitation training].

作者信息

Zhang Ning-Xia, Wang Xiang-Yu, Liu Gui-Zhen, Li Yun-Bo, Zhang Hong-Ying

出版信息

Zhen Ci Yan Jiu. 2014 Aug;39(4):318-23.

Abstract

OBJECTIVE

To observe the effect of warm-reinforcing needling combined with modern rehabilitation training on motor function of cerebral palsy (CP) children.

METHODS

Sixty cases of CP children were randomly divided into acupuncture combined with rehabilitation (Acu + Rehab, n = 30) group and Rehab (n = 30) group. Patients of the Acu + Rehab group were treated by warm-reinforcing needling stimulation of Jiaji (EX-B 2), Jianyu (LI 15), Quchi (LI 11), Hegu (LI 4), Zusanli (ST 36), Yinlingquan (GB 34), Sanyinjiao (SP 6), Juegu (GB 39), Yanglingquan (GB 34), etc., combined with Bobath rehabilitation therapy, and those of the Rehab group treated by Bobath rehabilitation (stimulating key control points in the body, triggering reflexes that provide head and body control). The treatment was conducted every day,with three months being a therapeutic course,two courses in all. The Peabody Developmental Motor Scales 2 (PDMS-2) was used to evaluate the CP children's motor function [1) gross motor: posture (straightness ratio), locomotion and object manipulation; 2) fine motor: grasping and visual-Motor integration].

RESULTS

After the treatment, of the 30 and 30 cases in the Acu+ Rehab and Rehab groups, 1 (3.33%) and 0 (0%) were cured, 20 (66.67%) and 18 (60.00%) experienced marked improvement, 9 (30.00%) and 12 (40.00%) were invalid, with the effective rates being 70.00% and 60.00% respectively. The therapeutic effect of the Acu + Rehab group was markedly superior to that of the Rehab group (P < 0.05). After 6 months ' treatment, the scores of posture, locomotor, object manipulation and grasping, and visual-movement integration were significantly increased in comparison with pre-treatment in the same one group (P < 0.05), and the effects of the Acu + Rehab group were obviously superior to those of Rehab group in increasing the scores of posture, locomotor, object manipulation and grasping after 6 months' treatment (P < 0.05).

CONCLUSION

Warm-reinforcing needling combined with Bobath rehabilitation has a better therapeutic effect in improving gross motor and fine motor functions of CP children.

摘要

目的

观察温针补法联合现代康复训练对脑瘫(CP)患儿运动功能的影响。

方法

将60例CP患儿随机分为针康组(Acu + Rehab,n = 30)和康复组(n = 30)。针康组患儿采用温针补法针刺夹脊(EX - B 2)、肩髃(LI 15)、曲池(LI 11)、合谷(LI 4)、足三里(ST 36)、阴陵泉(GB 34)、三阴交(SP 6)、绝骨(GB 39)、阳陵泉(GB 34)等穴位,并结合Bobath康复疗法;康复组患儿仅采用Bobath康复疗法(刺激身体关键控制点,引发提供头部和身体控制的反射)。每日进行治疗,3个月为1个疗程,共治疗2个疗程。采用Peabody儿童运动发育量表第2版(PDMS - 2)评估CP患儿的运动功能[1)大运动:姿势(挺直率)、移动和物体操控;2)精细运动:抓握和视觉 - 运动整合]。

结果

治疗后,针康组30例与康复组30例中,治愈分别为1例(3.33%)和0例(0%),显效分别为20例(66.67%)和18例(60.00%),无效分别为9例(30.00%)和12例(40.00%),有效率分别为70.00%和60.00%。针康组的治疗效果明显优于康复组(P < 0.05)。治疗6个月后,同一组内与治疗前相比,姿势、移动、物体操控、抓握及视觉 - 运动整合得分均显著提高(P < 0.05);治疗6个月后,针康组在提高姿势、移动、物体操控及抓握得分方面的效果明显优于康复组(P < 0.05)。

结论

温针补法联合Bobath康复疗法在改善CP患儿大运动和精细运动功能方面具有较好的治疗效果。

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