目的 探讨悬吊技术结合针刺治疗对痉挛型脑瘫患儿粗大运动功能(GMF)和日常生活活动能力(ADL)的影响,为临床应用提供理论依据。方法 对2018年1月-2019年12月期间在安徽省儿童医院收治的476例痉挛性脑瘫患儿中随机选取84例作为研究对象,采用随机数字法分为对照组28例、针刺组28例和实验组28例。对照组给予常规康复训练,针刺组在此基础上配合针刺治疗,实验组在针刺组基础上予以悬吊技术治疗。治疗前和治疗后分别采用粗大运动功能评估量表(GMFM-88)中C区、D区、E区及脑瘫儿童日常生活活动能力(ADL)评估量表对3组患儿粗大运动功能和日常生活活动能力进行评定。结果 三组治疗前后组内比较,每组指标均优于治疗前(P<0.05);治疗后,三组间GMFM-C、GMFM-D、GMFM-E、ADL评分组间比较,差异均有统计学意义(H=14.044、16.874、13.246、14.590,P<0.05),且实验组各项评分均优于对照组和针刺组,效果显著(P<0.05)。结论 悬吊技术结合针刺治疗可以进一步促进痉挛型脑瘫患儿粗大运动功能水平及日常生活活动能力的提高。
Abstract
Objective To analyze the effect of suspension technique combined with acupuncture on gross motor function and activities of daily living (ADL) in children with spastic cerebral palsy,and to provide theoretical basis for clinical application. Methods A total of 84 children with spastic cerebral palsy were enrolled in this study from 476 children admitted to Anhui Children′s Hospital from January 2018 to December 2019.The random number method was used to divide the participants into control group(n=28), acupuncture group(n=28) and experimental group(n=28).The control group was given routine rehabilitation training, the acupuncture group received acupuncture treatment additionally, and the experimental group was given suspension technique treatment based on the acupuncture group.Before and after treatment, the gross motor function of the children was evaluated in C, D and E domains of the Gross Motor Function Measure (GMFM-88) scale, the cerebral palsy children′s Activities of Daily Living (ADL) scale was used to assess children′s ADL. Results The indicators of each group after treatment were better than those before treatment among three groups(P<0.05).The GMFM-C, GMFM-D, GMFM-E, ADL scores among the three groups were different after treatment(H=14.044, 16.874, 13.246, 14.590, P<0.05), and the scores of experimental group were better than those of the control group(P<0.05). Conclusion Suspension technique combined with acupuncture can further promote the improvement of gross motor function and activities of daily living in children with spastic cerebral palsy.
关键词
痉挛型脑瘫 /
悬吊技术 /
针刺治疗 /
粗大运动功能 /
日常生活活动能力
Key words
spastic cerebral palsy /
suspension technology /
acupuncture treatment /
gross motor function /
activities of daily living
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 中国脑性瘫痪康复指南编委会.中国脑性瘫痪康复指南(2015):第一部分[J].中国康复医学杂志,2015,30(7):747-754.
[2] 李晓捷.实用儿童康复医学[M].2版.北京:人民卫生出版社,2016:250.
[3] 刘源诚,李列旺.悬吊运动治疗在儿童康复中的应用现状与展望[J].中国临床新医学,2019,12(3):335-337.
[4] 赵勇,刘振寰,金炳旭.“健脾益肾通督”配穴针刺对痉挛型脑瘫患儿运动功能及日常生活能力的影响[J].中国针灸,2017,37(1):45-48.
[5] 安晓菲,李璟,黄馨云,等.针炙结合康复疗法治疗痉挛型脑瘫临床疗效Meta分析[J].陕西中医,2019,40(10):1477-1482.
[6] 高志萍,熊华春,肖宁,等.悬吊训练对脑瘫患儿姿势控制及平衡能力的影响[J].中华物理医学与康复杂志,2018,40(11):854-857.
[7] Gul Oznur Karabicak,Nilay Comuk Balci,Mustafa Gulsen,et al.The effect of postural control and balance on femoral anteversion in children with spastic cerebral palsy[J].Phys Ther Sci,2016,28(6):1697-700.
[8] 康贝贝,徐磊,卢明甲,等.儿童悬吊训练系统对脑瘫儿童躯干控制及粗大运动功能的影响[J].中国儿童保健杂志,2017,25(9):891-893.
[9] 张春涛,刘振寰,宋翠凤.悬吊训练系统对痉挛型脑性瘫痪患儿平衡和步行能力的影响[J].中国中西医结合儿科学,2018,10(5):376-379.
[10] 王军,郎永斌,杜江华,等.悬吊运动训练对痉挛型脑瘫患儿运动及平衡功能的影响[J].中国当代儿科杂志,2018,20(6):465-469.
[11] 叶志英,万文蓉.“靳三针”联合灸法治疗小儿脑瘫的临床疗效观察[J].针灸临床杂志,2017,33(4):19-22.
[12] 张鑫,车月苹,李海峰,等.针刺治疗婴幼儿期痉挛型脑性瘫痪疗效分析[J].中国针灸,2019,39(9):940-944.
[13] 谢克功,朱登纳,循径针刺综合康复疗法对于改善脑瘫患儿GMFM,ADL,FMA评分及发育情况的效果分析[J].陕西中医,2018,39(8):1115-1117,1121.
[14] 范桃林,周文颖,陈冬冬,等.悬吊疗法联合肌内效贴对痉挛型脑瘫儿童行走能力的疗效分析[J].中国儿童保健杂志,2019,27(6):652-655.
[15] 吴卫红.中国脑性瘫痪康复指南(2015)[J].中国康复医学杂志,2016,31(3):371-373.
[16] 范桃林,周文颖,陈冬冬,等.悬吊疗法联合肌内效贴对痉挛型脑瘫儿童行走能力的疗效分析[J].中国儿童保健杂志,2019,27(6):652-655.
[17] 钱月芳.针刺结合悬吊康复运动疗法对痉挛型脑瘫患儿髂腰肌痉挛临床研究[J].新中医,2016,48(11):135-136.