《中国康复理论与实践》

《中国康复理论与实践》 ›› 2017, Vol. 23 ›› Issue (8): 942-945.doi: 10.3969/j.issn.1006-9771.2017.08.015

• 临床研究 • 上一篇    下一篇

头针对痉挛型脑性瘫痪患儿脑血流和粗大运动功能的影响

吴满红，梁利平，曾静，李容汉，罗鑫刚，梁伟燕，常燕群   

  1. 广东省妇幼保健院神经康复科，广东广州市 510010。
  • 收稿日期:2017-04-19 修回日期:2017-07-01 出版日期:2017-08-25 发布日期:2017-08-24
  • 通讯作者: 常燕群。E-mail: cyq01@sina.com.cn。
  • 作者简介:吴满红(1981-)，女，汉族，湖南隆回县人，硕士研究生，主管技师，主要研究方向：婴幼儿神经损伤的后遗症治疗。
  • 基金资助:
    广东省中医药局科研项目(No.20162016)。　　

Effects of Scalp Acupuncture on Cerebral Blood Flow and Gross Motor Function in Children with Spastic Cerebral Palsy　

WU Man-hong, LIANG Li-ping, ZENG Jing, LI Rong-han, LUO Xin-gang, LIANG Wei-yan, CHANG Yan-qun   

  1. Neurological Rehabilitation Department of Guangdong Women and Children Hospital, Guangzhou, Guangdong 510010, China
  • Received:2017-04-19 Revised:2017-07-01 Published:2017-08-25 Online:2017-08-24
  • Contact: CHANG Yan-qun. E-mail: cyq01@sina.com.cn

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被引次数

1

摘要： 目的 研究头针治疗对痉挛型脑瘫患儿脑血流和粗大运动功能的影响。方法 2016年1月至11月，将79例痉挛型脑瘫患儿随机分为常规组(n=40)和头针组(n=39)。常规组采用运动疗法、理疗等常规康复治疗，头针组在常规组治疗基础上加用头针治疗。两组总疗程均为5个月。采用彩色经颅多普勒超声技术(TCD)检测治疗前后患儿大脑前、中、后动脉(ACA、MCA、PCA)的收缩期峰值流速(Vs)、平均血流速度(Vm)以及血管阻力指数(RI)；采用粗大运动功能分级系统(GMFCS)对患儿治疗前后的疗效进行评价。结果 共脱落5例，其中常规组3例，头针组2例。治疗前，两组ACA、MCA、PCA的Vs、Vm、RI比较均无显著性差异(P>0.05)；治疗后，两组ACA、MCA、PCA的Vs、Vm均较治疗前增加(t>2.051, P<0.05)，常规组各血管RI无明显变化(t<1.1631, P>0.05)，头针组各血管RI降低(t>2.659, P<0.05)；头针组各血管Vs、Vm均高于常规组(t>2.098, P<0.05)，头针组ACA的RI低于常规组(t=2.375, P<0.05)，MCA和PCA的RI与常规组无显著性差异(t<1.637, P>0.05)。头针组总有效率高于常规组(χ2=6.887, P<0.05)。结论 头针有助于改善痉挛型脑瘫患儿的脑血流，降低颅内血管阻力，促进粗大运动功能的恢复。

关键词: 痉挛型脑性瘫痪, 头针, 脑血流, 经颅多普勒, 粗大运动功能, 粗大运动功能分级系统

Abstract: Objective To investigate the effect of scalp acupuncture on cerebral blood flow and gross motor function in children with spastic cerebral palsy. Methods From January to November, 2016, 79 children with spastic cerebral palsy were randomly divided into conventional group (n=40) and scalp acupuncture group (n=39). Both groups received conventional rehabilitation treatment, and the scalp acupuncture group was given scalp acupuncture in addition, for five months. The systolic blood flow velocity (Vs), mean flow velocity of cerebral artery (Vm) and vascular resistance index (RI) of anterior cerebral artery (ACA), middle cerebral artery (MCA) and posterior cerebral artery (PCA) before and after treatment were assessed with color transcranial Doppler ultrasound (TCD). The clinical effect was evaluated with the Gross Motor Function Classification System (GMFCS). Results Five cases dropped out during the follow-up, three cases in the conventional group and two cases in the scalp acupuncture group. There was no significant difference in all the indexes between two groups before treatment (P>0.05). After treatment, the Vs and Vm of ACA, MCA and PCA improved (t>2.051, P<0.05), no improvement was found in the RI of ACA, MCA and PCA in the conventional group (t<1.1631, P>0.05), and they decreased in the scalp acupuncture group (t>2.659, P<0.05). After treatment, the Vs and Vm of ACA, MCA and PCA were higher in the scalp acupuncture group than in the conventional group (t>2.098, P<0.05), the RI of ACA was lower in the scalp acupuncture group than in the conventional group (t=2.375, P<0.05), and no significant difference was found in the RI of MCA and PCA between two groups (t<1.637, P>0.05). The total effective rate was higher in the scalp acupuncture group than in the conventional group (χ2=6.887, P<0.05). Conclusion Scalp acupuncture facilitates to increase the cerebral blood flow, decrease the vascular resistance, and improve gross motor function in children with spastic cerebral palsy.

Key words: spastic cerebral palsy, scalp acupuncture, cerebral blood flow, transcranial Doppler, gross motor function, Gross Motor Function Classification System

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