CAJ | 학술논문

背景:寻找有效改善小儿脑性瘫痪(脑瘫)患儿独立步行能力的方法,提高患儿的生活质量是目前脑瘫治疗的热点题目.目的:观察针刺治疗小儿脑瘫对运动功能改善的效果.设计:自身前后对照的研究.单位:中山市博爱医院康复科.对象:中山市博爱医院收治的92例脑瘫患儿.方法:92例患儿随机分为针刺组72例,予针刺治疗,对照组20例,口服脑复康,1粒/次,3次/d,3个月为1个疗程,疗程结束后评定疗效.主要观察指标:①两组患儿显效率的比较.②治疗后两组患儿主要运动功能改善情况. 结果:对92例脑瘫患儿研究结果表明:针刺组有效率79%,对照组有效率55%,针刺组疗效优于对照组,两组比较差异有显著性意义(x2=4.74,P＜0.05);3岁以下患儿,针刺组有效率为84%,对照组有效率54%,两组比较差异有显著性意义(x2=5.12,P＜0.05);大于3岁年龄,针刺组有效率57%,对照组有效率56%,两组比较差异无显著性意义(x2=0.005,P＞0.05).针刺后患儿79%可翻身,62%可独坐,47%可膝爬,33%可独站,7%可独走.与针刺前比较,差异有非常显著性意义(x2=14.5,11.1,16.2,10.2,5.17,P＜0.05或P＜0.01).针刺组与对照组比较除独走项无差异外,差异均有显著性意义(x2=4.74,4.81,4.78,4.33,1.46,P＜0.05).结论:年龄越小,疗效越好,3岁前是脑瘫患儿针刺的最佳治疗时机;CT异常的脑瘫患儿其运动障碍明显高于CT无异常者,运动障碍多见于中央型萎缩,智力障碍和语言障碍多见于皮质型萎缩;针刺可尽早建立脑瘫患儿的主要运动功能,为脑瘫患儿独立行走打好基础.
배경:심조유효개선소인뇌성탄탄(뇌탄)환인독립보행능력적방법,제고환인적생활질량시목전뇌탄치료적열점제목.목적:관찰침자치료소인뇌탄대운동공능개선적효과.설계:자신전후대조적연구.단위:중산시박애의원강복과.대상:중산시박애의원수치적92례뇌탄환인.방법:92례환인수궤분위침자조72례,여침자치료,대조조20례,구복뇌복강,1립/차,3차/d,3개월위1개료정,료정결속후평정료효.주요관찰지표:①량조환인현효솔적비교.②치료후량조환인주요운동공능개선정황. 결과:대92례뇌탄환인연구결과표명:침자조유효솔79%,대조조유효솔55%,침자조료효우우대조조,량조비교차이유현저성의의(x2=4.74,P＜0.05);3세이하환인,침자조유효솔위84%,대조조유효솔54%,량조비교차이유현저성의의(x2=5.12,P＜0.05);대우3세년령,침자조유효솔57%,대조조유효솔56%,량조비교차이무현저성의의(x2=0.005,P＞0.05).침자후환인79%가번신,62%가독좌,47%가슬파,33%가독참,7%가독주.여침자전비교,차이유비상현저성의의(x2=14.5,11.1,16.2,10.2,5.17,P＜0.05혹P＜0.01).침자조여대조조비교제독주항무차이외,차이균유현저성의의(x2=4.74,4.81,4.78,4.33,1.46,P＜0.05).결론:년령월소,료효월호,3세전시뇌탄환인침자적최가치료시궤;CT이상적뇌탄환인기운동장애명현고우CT무이상자,운동장애다견우중앙형위축,지력장애화어언장애다견우피질형위축;침자가진조건립뇌탄환인적주요운동공능,위뇌탄환인독립행주타호기출.
BACKGROUND: To search for the effective method to promote the independent walking ability of children with cerebral paralysis so as to improve their living quality, which is the hot topic in the treatment of cerebral paralysis at present.OBJECTIVE: To observe the effects of acupuncture on the improvement of motor functions in infantile cerebral paralysis.DESIGN: Self-controlled study.SETTING: Rehabilitation Department of Bo' ai Hospital in Zhongshan City.PARTICIPANTS: Totally 92 children with cerebral paralysis treated in Bo' ai Hospital in Zhongshan City.INTERVENTIONS: Totally 92 cases of cerebral paralysis were randomized into acupuncture group, including 72 cases treated with acupuncture, and control group, including 20 cases treated by oral taking Piracetan, 1 pill/time,3 times daily and 3 months made 1 course. The therapeutic effects were evaluated at the end of the course.children in two groups after treatments.RESULTS: It was indicated from the results of the research on 92 cases of cerebral paralysis in children that: the effective rate was 79% in acupuncture group, 55% in the control, the therapeutic effect of acupuncture group was superior to that of the control, reflecting significant difference(x2 = 4.74, P ＜ 0. 05); for the children younger than 3 years old, the effective rate was 84% in acupuncture group, 54% in the control, reflecting significant difference(x2 =5.12, P ＜ 0.05); for the children elder than 3 years old, the effective rate was 57% in acupuncture group, 56% in the control, reflecting no significant difference(x2 = 0. 005, P ＞ 0. 05) . After acupuncture, 79% children were able to turning the body, 62% to sit up independently, 47% to climb on knees, 33% to stand up independently, and 7% to walk independently. After acupuncture, the differences were very significant compared with the results before acupuncture(x2 = 14. 5, 11.1, 16.2, 10.2,5.17, P ＜ 0.05 or P ＜ 0.01 ) . By the comparison between acupuncture group and the control, except independent walking that had no difference in two group, (x2 =4.74, 4. 81,4.78, 4.33, 1.46, P ＜0.05).CONCLUSION: The younger the children are, the better therapeutic effects will be. The treatment starting before 3 years is the best opportunity of acupuncture for cerebral paralysis of children. The motor disturbance of children with cerebral paralysis with abnormal CT results is obviously severe than that without CT abnormal. Motor disturbance is commonly seen in central atrophy, intelligent disturbance and aphasis are commonly in cortical atrophy. Acupuncture can possibly establish the main motor functions for children with cerebral paralysis earlier so as to lay a good foundation for walking independently in the children with cerebral paralysis.