目的

探讨通督针刺法联合核心稳定性训练对痉挛型脑性瘫痪患儿站立位及行走能力的影响。

方法

选取2013 年2 月10日至2014 年2 月20日在广州中医药大学附属南海妇产儿童医院康复科就诊的痉挛型脑性瘫痪患儿103 例， 按随机数字表法将患儿分两组， 其中对照组51 例， 治疗组52 例。 对照组按常规康复训练进行治疗， 治疗组在常规康复训练的基础上联合通督针刺法与核心稳定性训练技术。 20 d为1 个疗程， 期间休息15 d 后再进行下一个疗程， 共完成3 个疗程。 在康复治疗前及疗程结束后， 运用粗大运动功能评估量表-88项（GMFM-88） 对患儿进行评估， 统计D、 E区的得分情况。 采用SPSS13.0软件对数据进行统计学分析， 两组患儿GMFM得分为计量资料， 采用均数±标准差（±s） 进行统计学描述， 组内治疗前后比较采用配对样本t 检验， 组间比较采用两独立样本t 检验。 计数资料以例数或百分率表示， 采用χ² 检验。 以P＜0.05 为差异有统计学意义。

结果

两组患儿的GMFM-88量表评分D区（站位） 、 E区（走、 跑、 跳）数值治疗前的评分有可比性（D区： t=0.897， P＞0.05， E 区： t=0.980， P＞0.05） ； 经治疗后对照组D区、 E区的GMFM-88评分分别为（30±12， 39±12） 分， 明显高于治疗前（26±7， 33±13） 分， 差异具有统计学意义（t=2.097，P=0.045； t=2.570， P=0.042） ； 治疗后观察组D区、 E区的GMFM-88评分为（34±12）分和（45±12）分， 明显高于治疗前的（26±7） 分和（33±13） 分， 差异具有统计学意义（t=3.850， P=0.008；t=5.13， P=0.007） ； 经治疗后两组的D、 E 区数值较治疗前均有提高（D 区： t=4.741， P＜0.01； E 区：t=5.136， P＜0.01） ， 表明观察组在D、 E区的得分明显优于对照组。

结论

通督针刺法联合核心稳定性训练能有效地提高痉挛型脑瘫患儿立位姿势控制的能力及行走能力。

Objective

To explore the effectiveness of the Tong-du acupuncture treatment combined with core stability training on standing postural controlling and walking abilities in children with spastic cerebral palsy.

Methods

A total of 103 children with spastic cerebral palsy who accepting the treatment in Nanhai Hospital of Women and Children Affiliated to Guangzhou University of Chinese Medicine during from February 10， 2013 to February 20， 2014 were divided into two groups by table of random number： the control group （n=51） and the treated group（n=52）.The control group received basic rehabilitation therapy， and the treatment group received the basic rehabilitation and Tong-du acupuncture treatment combined with core stability training.Twenty-day treatment was for one course of treatment，15-day rest was after one course，and a total of three courses.The gross motor function measure（GMFM）-88 was used to assess in two groups before and after three-course treatment. The scores in D and E domains were recorded and analyzed. SPSS 13.0 software was used for statistical analysis. （±s）was used for statistical description.The paired samples t-test was used to compare data before and after treatment.The two independent samples t-test was used for data between groups. Count data were expressed in percentage or number of cases， and analyzed byχ² examination.P＜0.05 was considered statistically significant.

Results

The GMFM scores of D and E domains were significantly improved after treatment in control group ［（30±12）and（39±12） ］compared with those before treatment ［（26±7）and（33±13）， （P＞0.05）］ .The GMFM scores of D and E domains were significantly increased after treatment in treatment group ［ （34±12）and（45±12） ］ than those before treatment ［ （26±7）and（33±13），t=3.850， P=0.008 and t=5.130， P=0.007）］ .The GMFM scores of D and E domains were significantly increased after treatment in two groups（D domain：t=4.741，P＜0.01； E domain： t=5.136，P＜0.01）， the scores were more significantly higher in treatment group.

Conclusion

Tongdu acupuncture treatment combined with core stability training is effective in improving standing postural controlling and walking abilities in children with spastic cerebral palsy.