CAJ | 학술논문

目的：探讨通督醒神针刺法对脑瘫患儿运动、智力及脑神经功能恢复的作用。方法对参与研究的1～5岁300例脑瘫患儿采用通督醒神针刺法，并配合物理治疗、作业治疗、语言治疗等疗法，于治疗前及治疗后3个月，使用北京盖什尔（Gesell）神经发育评定量表及美国粗大运动功能量表（GMFM）评定患儿在智力及运动方面的变化情况，并应用头颅CT/MRI评估患儿治疗前后脑神经修复情况。采用SPSS 13.0统计软件进行资料处理，治疗前后Gesell各能区评分及GMFM（A、B、C）行正态检验，符合正态分布用x±s表示，GMFM（D，E）不符合正态分布，采用中位数±四分位数（M±Q）进行统计描述，以P＜0.05为差异有统计学意义。结果临床康复疗效方面，显效42例（14%），有效148例（49.3%），无效110例（36.7%），总有效率63.3%（190/300）。治疗后Gesell治疗前后神经发育评定量表中社会适应发育商（DQ）、大运动DQ、语言DQ、精细动作DQ、个人社交DQ的评分比较差异均有显著性统计学意义（t=11.53、6.73、9.69、9.43，均P＜0.05）。治疗后GMFM评定量表中A、B、C、D四个能区评分较前均有显著提高（t=17.09、12.73、5.20，Z=4.50，均P＜0.05），E能区评分较前无统计学意义（Z=1.81， P＞0.05）。治疗前后头颅影像学检查比较，治疗后头颅CT/MRI病变恢复至正常者22例（8.2%），好转159例（59.1%），无明显变化者88例（32.7%），有效率达67.2%（181/269）。结论通督醒神针刺疗法能促进脑瘫患儿运动、智力的发育，且可促进患儿脑神经修复。
목적：탐토통독성신침자법대뇌탄환인운동、지력급뇌신경공능회복적작용。방법대삼여연구적1～5세300례뇌탄환인채용통독성신침자법，병배합물리치료、작업치료、어언치료등요법，우치료전급치료후3개월，사용북경개십이（Gesell）신경발육평정량표급미국조대운동공능량표（GMFM）평정환인재지력급운동방면적변화정황，병응용두로CT/MRI평고환인치료전후뇌신경수복정황。채용SPSS 13.0통계연건진행자료처리，치료전후Gesell각능구평분급GMFM（A、B、C）행정태검험，부합정태분포용x±s표시，GMFM（D，E）불부합정태분포，채용중위수±사분위수（M±Q）진행통계묘술，이P＜0.05위차이유통계학의의。결과림상강복료효방면，현효42례（14%），유효148례（49.3%），무효110례（36.7%），총유효솔63.3%（190/300）。치료후Gesell치료전후신경발육평정량표중사회괄응발육상（DQ）、대운동DQ、어언DQ、정세동작DQ、개인사교DQ적평분비교차이균유현저성통계학의의（t=11.53、6.73、9.69、9.43，균P＜0.05）。치료후GMFM평정량표중A、B、C、D사개능구평분교전균유현저제고（t=17.09、12.73、5.20，Z=4.50，균P＜0.05），E능구평분교전무통계학의의（Z=1.81， P＞0.05）。치료전후두로영상학검사비교，치료후두로CT/MRI병변회복지정상자22례（8.2%），호전159례（59.1%），무명현변화자88례（32.7%），유효솔체67.2%（181/269）。결론통독성신침자요법능촉진뇌탄환인운동、지력적발육，차가촉진환인뇌신경수복。
Objective The aim of this study was to discuss effects of acupuncture on movement, intelligence and cranial nerve functional recovery in children with cerebral palsy. Methods A total of 300 cases of children (aged 1~5 years) with cerebral palsy were treated using acupuncture,and with physical therapy,occupational therapy,speech therapy and other therapies. Gesell's Developmental Scale and the Gross Motor Function Measure (GMFM) were used to assess mental and physical activities in patients before and 3-month after treatment. The situation of children with brain repair was detected by cranial CT/MRI before and after treatment. SPSS 13.0 statistical software was used for data processing. Scores of Gesell and GMFM line(A,B,C) before and after the treatment were analyzed by normality test. The normal distribution was represented by x±s. The median plus or minus quartile statistical description of(M±Q) was used for GMFM (D,E). P<0.05 was considered statistically significant. Results The curative effect of clinical rehabilitation,42 cases were markedly improved (14%),148 cases (49.3%) improved,110 cases (36.7%) invalid,and the total effective rate was 63.3%(190/300). There were significant differences in the scores of Gesell including Developmental Quotient(DQ),gross motor DQ,language DQ,fine motor DQ and personal social DQ,before and after treatment in patients (t=11.53,6.73 and 9.69,9.43,P<0.05). After treatment GMFM rating scales of A,B,C and D were significantly increased compared with the previous (t=17.09,12.73 and 5.2,Z=4.50,P<0.05). There was no significant difference in E score before and after treatment (Z=1.81,P>0.05). Results of cranial CT/MRI showed that lesions returned to normal in 22 cases (8.2%),improvement in 159 cases (59.1%) and no obvious changes in 88 cases (32.7%). The effective rate was 67.2%(181/269). Conclusion Acupuncture can promote movement and intellectual development of cerebral palsy,and can help cranial nerve repair in children with cerebral palsy.