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针刺与推拿治疗痉挛型脑瘫患儿粗大运动功能:一项单中心临床研究

Acupuncture and Tuina Treatment for Gross Motor Function in Children with Spastic Cerebral Palsy: A Monocentric Clinical Study.

作者信息

Wang Xing, Teh Siew Hoon, Du Xiao-Gang, Wang Xing-Hua

机构信息

M. Kandiah Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang, SGR, Malaysia.

Famous TCM Expert Heritage Studio, Xi'an Encephalopathy Hospital Affiliated to Shaanxi University of Chinese Medicine, Xi'an, Shaanxi, People's Republic of China.

出版信息

Neuropsychiatr Dis Treat. 2023 Aug 30;19:1875-1886. doi: 10.2147/NDT.S424102. eCollection 2023.

Abstract

OBJECTIVE

Cerebral palsy (CP) is a condition characterized by abnormal pronunciation, posture, and movement, particularly spastic CP, which involves Gross motor dysfunction due to increased muscle tone and stiffness. This monocentric clinical study aims to evaluate the effectiveness of acupuncture and tuina (AT) in improving gross motor function and alleviating associated symptoms in children diagnosed with spastic CP.

METHODS

A total of 83 eligible patients received AT treatment, while 85 patients received conventional rehabilitation treatment. Both groups underwent a 12-week treatment period following the research protocol. Pre- and post-treatment assessments included the Modified Ashworth Muscle Tension Scale (MAS), Gross Motor Function Measure (GMFM-D and GMFM-E), 6-min walking distance measurement (6MWD), and Modified Children's Functional Independence Rating Scale (WeeFIM).

RESULTS

After 12 weeks of treatment, when compared with baseline, the scores of MAS in both AT group and control group are decreased (<0.01, <0.01), the scores of GMFM-D, GMFME, 6MWD, WeeFIM in both group are increased (<0.01 in all indicators). When compared with control group, AT group had significantly lower MAS scores compared to the control group (<0.01), indicating reduced muscle tension. Moreover, AT group showed significantly higher scores in GMFM-D, GMFM-E, 6MWD, and WeeFIM compared to the control group (<0.01 in all indicators), indicating improved gross motor function and functional independence. The study also revealed an inverse correlation between the children's age and treatment efficacy (r= -0.496, <0.01 in AT group, r=-0.540, <0.01 in control group), highlighting the importance of early intervention in the management of CP in children.

CONCLUSION

These findings suggest that AT may effectively enhance gross motor function and alleviate associated symptoms in children diagnosed with spastic CP. Moreover, early initiation of treatment is crucial to maximize therapeutic efficacy in children with spastic CP.

TRIAL REGISTRATION

Chinese Clinical Trial Registry, ChiCTR2200059823. Registered on 12 May 2022.

摘要

目的

脑瘫(CP)是一种以发音、姿势和运动异常为特征的疾病,尤其是痉挛型脑瘫,它因肌张力增加和僵硬而导致粗大运动功能障碍。这项单中心临床研究旨在评估针灸推拿(AT)对改善痉挛型脑瘫患儿粗大运动功能及缓解相关症状的有效性。

方法

共有83例符合条件的患者接受AT治疗,85例患者接受传统康复治疗。两组均按照研究方案进行为期12周的治疗。治疗前后的评估包括改良Ashworth肌张力量表(MAS)、粗大运动功能测量(GMFM-D和GMFM-E)、6分钟步行距离测量(6MWD)以及改良儿童功能独立性评定量表(WeeFIM)。

结果

治疗12周后,与基线相比,AT组和对照组的MAS评分均降低(<0.01,<0.01),两组的GMFM-D、GMFM-E、6MWD、WeeFIM评分均升高(所有指标均<0.01)。与对照组相比,AT组的MAS评分显著更低(<0.01),表明肌张力降低。此外,与对照组相比,AT组在GMFM-D、GMFM-E、6MWD和WeeFIM方面的评分显著更高(所有指标均<0.01),表明粗大运动功能和功能独立性得到改善。研究还揭示了儿童年龄与治疗效果之间呈负相关(AT组r = -0.496,<0.01;对照组r = -0.540,<0.01),突出了早期干预在儿童脑瘫管理中的重要性。

结论

这些发现表明,AT可能有效增强痉挛型脑瘫患儿的粗大运动功能并缓解相关症状。此外,早期开始治疗对于使痉挛型脑瘫患儿的治疗效果最大化至关重要。

试验注册

中国临床试验注册中心,ChiCTR2200059823。于2022年5月12日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f59/10475301/2a91befe3790/NDT-19-1875-g0001.jpg

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