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[皮内针治疗对脑性瘫痪患儿核心肌稳定性的影响:一项临床对照研究]

[Effects of intradermal needling on core muscle stability in children with cerebral palsy: a clinical comparative study].

作者信息

Qi Tengche, Wang Chunnan

机构信息

the Third Branch of Neurological Rehabilitation Department, Shenyang Children Hospital, Shenyang 110032, Liaoning Province, China.

出版信息

Zhongguo Zhen Jiu. 2018 Jun 12;38(6):597-601. doi: 10.13703/j.0255-2930.2018.06.007.

Abstract

OBJECTIVE

To observe the effects of rehabilitation training (RT) combined with intradermal needling, RT combined with acupuncture and RT alone on core muscle stability in children with cerebral palsy, and to explore the superior therapy to improve core muscle stability in children with cerebral palsy.

METHODS

A total of 120 children with cerebral palsy aged from 2 to 4 years old were randomly divided into a RT and intradermal needling group (group A), a RT and acupuncture group (group B) and a RT group (group C), 40 cases in each one. The patients in the group C were treated with kinesitherapy and core muscle stability training, once a day. Along with identical RT of group C, the patients in the group B were treated with acupuncture (once a day), while the patients in the group A were treated with intradermal needling at Yaoyangguan (GV 3), Mingmen (GV 4), Jiaji (EX-B 2, L-L), and 4-week treatment was taken as one course. The integrated electromyography (iEMG) of surface electromyography, root mean square (RMS) and mean power frequency (MPF) of erector spinae muscles, Berg balance scale as well as B area (siting), C area (climbing and kneeling), D area (standing) and E area (walking, running and jumping) of gross motor function measure (GMFM) were compared before and after 3-course treatment.

RESULTS

① Compared before treatment, the iEMG and RMS of erector spinae muscles in the group A and group B as well as MPF in the group A were all increased after treatment (all <0.05); after treatment, all the electromyography indexes in the group A were higher than those in the group B and group C (all <0.05); the RMS in the group B was higher than that in the group C (<0.05). ② Compared before treatment, the Berg balance scale was all increased after treatment in the three groups (all <0.05), and the scale in the group A was higher those that in the group B and group C (both <0.05). ③ Compared before treatment, the B area and C area of GMFM in the three groups as well as D area in the group A and group B were all improved after treatment (all <0.05); the B area, C area and D area in the group A and group B were higher than those in the group C (all <0.05); the B area and C area in the group A were higher than those in the group B (both <0.05).

CONCLUSION

Based on RT, the intradermal needling could better improve core muscle stability and balance-motor ability in children with cerebral palsy, which is superior to regular acupuncture and RT alone.

摘要

目的

观察康复训练(RT)联合皮内针、RT联合针刺及单纯RT对脑瘫患儿核心肌稳定性的影响,探讨改善脑瘫患儿核心肌稳定性的最佳治疗方法。

方法

将120例2~4岁脑瘫患儿随机分为RT联合皮内针组(A组)、RT联合针刺组(B组)和RT组(C组),每组40例。C组患儿采用运动疗法及核心肌稳定性训练,每天1次。B组患儿在进行与C组相同RT的基础上,加用针刺治疗(每天1次),A组患儿在进行与C组相同RT的基础上,于腰阳关(GV 3)、命门(GV 4)、夹脊(EX - B 2,L - L)行皮内针治疗,以4周治疗为1个疗程。比较3个疗程治疗前后表面肌电图的积分肌电图(iEMG)、竖脊肌均方根(RMS)和平均功率频率(MPF)、Berg平衡量表以及粗大运动功能测量(GMFM)的B区(坐位)、C区(爬和跪)、D区(站立)和E区(走、跑和跳)。

结果

①与治疗前比较,治疗后A组和B组竖脊肌的iEMG和RMS以及A组的MPF均升高(均P<0.05);治疗后,A组的各项肌电图指标均高于B组和C组(均P<0.05);B组的RMS高于C组(P<0.05)。②与治疗前比较,三组治疗后Berg平衡量表评分均升高(均P<0.05),且A组评分高于B组和C组(均P<0.05)。③与治疗前比较,三组GMFM的B区和C区以及A组和B组的D区治疗后均改善(均P<0.05);A组和B组的B区、C区和D区高于C组(均P<0.05);A组的B区和C区高于B组(均P<0.05)。

结论

在RT基础上,皮内针能更好地改善脑瘫患儿的核心肌稳定性及平衡运动能力,优于单纯针刺及单纯RT。

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