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多中心、随机对照试验按摩在小儿脑性瘫痪患儿:小儿按摩对痉挛型脑瘫患儿的疗效。

A multicenter, randomized controlled trial of massage in children with pediatric cerebral palsy: Efficacy of pediatric massage for children with spastic cerebral palsy.

机构信息

First Clinical Medical College, Nanjing University of Chinese Medicine, 282 Hanzhong Road, Gulou, Nanjing, Jiangsu.

Medical ethics committee of the second affiliated hospital of Yunnan University of Chinese Medicine.

出版信息

Medicine (Baltimore). 2021 Feb 5;100(5):e23469. doi: 10.1097/MD.0000000000023469.

Abstract

BACKGROUND

Cerebral palsy is 1 of the diseases critically affecting the health of children. The spasmodic type is the most common, characterized by the increased muscular tension. It often leads to lifelong disability, bringing a heavy economic burden to families and society. As a key treatment in traditional Chinese medicine, pediatric massage has a significant clinical effect on cerebral palsy in children; however, high-quality randomized controlled studies are lacking. The main objective of this study was to evaluate the efficacy of pediatric massage for children with spastic cerebral palsy.

METHODS/DESIGN: The study will be a multicenter, single-blinded, randomized-controlled pilot trial. During the period from June 2019 to December 2020, 182 children with spastic cerebral palsy will be randomly divided into experimental and control groups in a 1:1 ratio. The experimental group will undergo the modified selective spinal massage method combined with the basic rehabilitation treatment, while only the basic rehabilitation treatment would be performed for the control group. The intervention period of the study will last 12 weeks, 5 days weekly on weekdays. The primary outcomes include a modified Ashworth scale assessment and gross motor function test. The secondary outcomes include the 4-diagnostic scale of Chinese medicine and children's intelligence. The observation index will be measured during the complete 12 weeks duration after the treatment of the child, that is, before treatment, after 4 weeks of treatment, after 8 weeks, and after 12 weeks of treatment.

DISCUSSION

This study aims to evaluate the efficacy of pediatric massage on children with spastic cerebral palsy; if the outcome is positive, it can provide a reference for the further promotion and application of pediatric massage in the treatment of spastic cerebral palsy.

TRIAL REGISTRATION

Chinese ClinicalTrials.gov, ID: ChiCTR1900021666. Acupuncture-Moxibustion Clinical Trial Registry, AMCTR: (AMCTR-IPR-19000260) Registered on 04 March 2019.

摘要

背景

脑瘫是严重影响儿童健康的疾病之一。痉挛型是最常见的类型,其特征是肌肉张力增加。它常导致终身残疾,给家庭和社会带来沉重的经济负担。小儿推拿作为中医的一种重要治疗方法,对小儿脑瘫有显著的临床疗效,但高质量的随机对照研究较少。本研究的主要目的是评价小儿推拿治疗痉挛型脑瘫患儿的疗效。

方法/设计:本研究将采用多中心、单盲、随机对照的预试验。在 2019 年 6 月至 2020 年 12 月期间,将 182 例痉挛型脑瘫患儿按 1:1 比例随机分为实验组和对照组。实验组采用改良选择性脊推按摩法结合基础康复治疗,对照组仅进行基础康复治疗。研究的干预期为 12 周,每周 5 天,工作日进行。主要结局指标包括改良 Ashworth 量表评定和粗大运动功能测试。次要结局指标包括中医四诊和儿童智力。观察指标将在患儿治疗后完整的 12 周内进行测量,即治疗前、治疗 4 周后、治疗 8 周后和治疗 12 周后。

讨论

本研究旨在评价小儿推拿治疗痉挛型脑瘫患儿的疗效;如果结果为阳性,可为小儿推拿治疗痉挛型脑瘫的进一步推广应用提供参考。

试验注册

中国临床试验注册中心,编号:ChiCTR1900021666。针灸临床研究注册平台,编号:AMCTR-(AMCTR-IPR-19000260),注册于 2019 年 3 月 4 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f36a/7870189/5f5983682512/medi-100-e23469-g001.jpg

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