头部水针疗法联合常规康复改善小儿脑性瘫痪智力障碍的临床研究

关键词：小儿脑瘫  智力障碍  水针疗法  常规康复疗法  脑血流

Keywords:infants cerebral palsy  mental retardation  acupoint injection  rehabilitation therapy  cerebral blood flow

摘要：

      摘要 目的：评价头部水针穴位注射疗法对小儿脑性瘫痪（以下简称脑瘫）智力障碍的临床疗效并探讨其作用机制。 方法：将90例脑瘫患儿按照随机数字表法平均分为水针疗法组、肌肉注射组和常规康复组，每组30例，收集同龄健康儿童30例为健康对照组；对常规康复组进行常规康复训练疗法，水针疗法组和肌肉注射组在此基础上分别进行头部穴位注射GM1和肌肉药物注射GM1治疗。分别于治疗前和每个疗程结束后测定每位患儿智力发育指数(MDI)和心理发育指数(PDI)，并检测大脑动脉血流动力学参数：收缩期峰值速度(Vs)、舒张末期速度(Vd)、平均血流速度(Vm)及血管阻力指数(RI)，同期检测血清NSE和T-SOD的水平。 结果：3疗程结束后，三组脑瘫患儿MDI和PDI均较治疗前提高(P<0.05)，水针疗法组相对于其他组效果更为明显(P<0.05)；与治疗前相比，水针疗法组血流动力学参数Vs、Vm、Vd明显升高，RI显著降低(P<0.05)，肌肉注射组与常规康复组的血流动力学参数变化不明显(P>0.05)。治疗后，水针疗法组NSE降低，T-SOD升高，其余两组无变化。 结论：水针疗法结合常规康复治疗可以有效地改善脑瘫患儿的脑部血流动力学状况，提高脑瘫患儿的智力发育。

Abstract:

      Abstract Objective: To study the clinical effect and preliminary mechanism of acupoint injection therapy on mental retardation for children with cerebral palsy. Method: 90 children with cerebral palsy were randomly and equally divided into three groups: the acupoint injection group, the intramuscular injection group and the conventional rehabilitation group, with 30 even-aged healthy children as the health control. Children in the conventional rehabilitation group only received conventional rehabilitation therapy, while children in the acupoint injection group or intramuscular injection group received conventional rehabilitation therapy combined with GM1 acupoint injection therapy or GM1 intramuscular injection therapy respectively. MDI, PDI and the hemodynamic parameters, Vs, Vm, Vd and RI in cerebral arteries of all groups were measured before and after every treatment and the level of NSE and T-SOD were detected at the same time. Result: After 3 courses of treatment, MDI and PDI of 3 groups increased, especially significant effects in acupoint injection group (P<0.05). Vs, Vm, Vd elevated and RI decreased after 3 courses of treatment in acupoint injection group, with statistical significance (P<0.05).However,there were no significant changes in the intramuscular injection group and the control group(P>0.05). The levels of NSE decreased and T-SOD increased in acupoint injection group after the treatments and there was no difference in other groups before and after treatment(P>0.05). Conclusion: Acupoint injection therapy combined with conventional rehabilitation therapy effectively improved the cerebral hemodynamic conditions and improved the mental development of children with cerebral palsy.