任雪松,蔡志军,周厚勤,等.互动式头针联合强制性诱导疗法对痉挛型偏瘫脑瘫儿童上肢功能的影响[J].中华物理医学与康复杂志,2025,47(1):41-45
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| 互动式头针联合强制性诱导疗法对痉挛型偏瘫脑瘫儿童上肢功能的影响 |
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| DOI：10.3760/cma.j.cn421666-20240202-00107 |
| 中文关键词: 脑性瘫痪 互动式头针 强制性诱导疗法 上肢功能 |
| 英文关键词: Cerebral palsy Interactive scalp acupuncture Constraint-induced movement therapy Upper extremity function |
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| 中文摘要: |
| 目的 观察互动式头针联合强制性诱导疗法对痉挛型偏瘫脑瘫儿童上肢功能的影响。 方法 选取痉挛型偏瘫脑瘫患儿57例，按随机数字表法分为对照组28例和观察组29例。对照组在常规康复治疗的基础上给予CIMT，观察组在常规康复治疗的基础上给予互动式头针联合CIMT进行治疗。互动式头针联合CIMT治疗每日1次，每次留针的同时采用CIMT先训练30 min，然后取针，再由康复治疗师指导患儿家属行简单康复训练2.5 h，每周训练5 d，3周为1个疗程，共训练3个疗程。于治疗前、治疗后1个月和3个月采用墨尔本单侧上肢功能评估量表2（MA2）和Peabody精细运动发育量表（PDMS-FM）评估2组患儿的上肢功能，同时采用改良Ashworth量表（MAS）对患儿偏瘫侧上肢屈肘肌的肌张力进行评估。 结果 治疗1、3个月后，2组患儿的MA2评分均显著优于组内治疗前（P<0.05），且观察组治疗1、3个月后的MA2评分分别为（50.28±8.38）分和（56.76±7.85）分，均显著优于对照组同时间点，差异均有统计学意义（P<0.05）。治疗1、3个月后，2组患儿PDMS-FM的视觉-运动整合评分、抓握能力评分和总分均显著优于组内治疗前（P<0.05），且观察组治疗1、3个月后PDMS-FM的视觉-运动整合评分、抓握能力评分和总分均显著优于对照组同时间点，差异均有统计学意义（P<0.05）。治疗1、3个月后，2组患儿的MAS评分均显著优于组内治疗前（P<0.05），但2组患儿治疗1、3个月后的MAS评分组间同时间点比较，差异均无统计学意义（P>0.05）。 结论 互动式头针联合强制性诱导疗法可显著改善痉挛型偏瘫脑瘫儿童的上肢运动功能，提高其精细运动能力。 |
| 英文摘要: |
| Objective To observe any effect of combining interactive scalp acupuncture with constraint-induced movement therapy (CIMT) in treating the upper extremity motor function of children with spastic hemiplegic cerebral palsy. Methods Fifty-seven children with spastic hemiplegic cerebral palsy were randomly divided into a control group of 28 and an observation group of 29. The control group was given conventional rehabilitation and routine CIMT, while the observation group was additionally provided with interactive scalp acupuncture. In the observation group the CIMT lasted for 30 minutes while the needles were retained. Then, after the needles were removed, the family administered simple rehabilitation training for 2.5 hours guided by a rehabilitation therapist. The treatments were administered 5 days per week for 3 weeks as a session, and the whole treatment consisted of 3 sessions. Before, as well as 1 month and 3 months after the treatment, upper extremity motor function in both groups was evaluated using the Melbourne assessment scale 2 (MA2) and the fine motor Peabody developmental motor scales. Muscle tone in the children′s elbow flexors was assessed using the modified Ashworth scale (MAS). Results After both 1 and 3 months of treatment, the average MA2 scores of both groups were significantly better than those before treatment, with those of the observation group significantly superior to the control group′s averages. After both 1 and 3 months, both groups′ visual-motor integration scores, grasping ability scores and total scores had improved significantly, with those of the observation group significantly better than in the control group, on average. The MAS scores of both groups were also significantly better than before the treatment, but with no significant differences between the two groups at either time point. Conclusions Interactive scalp acupuncture combined with constraint-induced movement therapy can significantly improve the upper extremity motor functioning and fine motor ability of children with spastic hemiplegic cerebral palsy. |
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