作　　者： (吴满红）; (梁利平）; (曾静）; (李容汉）; (罗鑫刚）; (梁伟燕）; (常燕群）;

机构地区： 广东省妇幼保健院神经康复科,广东广州市510010

出　　处： 《中国康复理论与实践》 2017年第8期942-945,共4页

摘　　要： 目的研究头针治疗对痉挛型脑瘫患儿脑血流和粗大运动功能的影响。方法 2016年1月至11月,将79例痉挛型脑瘫患儿随机分为常规组(n=40)和头针组(n=39)。常规组采用运动疗法、理疗等常规康复治疗,头针组在常规组治疗基础上加用头针治疗。两组总疗程均为5个月。采用彩色经颅多普勒超声技术(TCD)检测治疗前后患儿大脑前、中、后动脉(ACA、MCA、PCA)的收缩期峰值流速(Vs)、平均血流速度(Vm)以及血管阻力指数(RI);采用粗大运动功能分级系统(GMFCS)对患儿治疗前后的疗效进行评价。结果共脱落5例,其中常规组3例,头针组2例。治疗前,两组ACA、MCA、PCA的Vs、Vm、RI比较均无显著性差异(P>0.05);治疗后,两组ACA、MCA、PCA的Vs、Vm均较治疗前增加(t>2.051,P<0.05),常规组各血管RI无明显变化(t<1.1631,P>0.05),头针组各血管RI降低(t>2.659,P<0.05);头针组各血管Vs、Vm均高于常规组(t>2.098,P<0.05),头针组ACA的RI低于常规组(t=2.375,P<0.05),MCA和PCA的RI与常规组无显著性差异(t<1.637,P>0.05)。头针组总有效率高于常规组(χ~2=6.887,P<0.05)。结论头针有助于改善痉挛型脑瘫患儿的脑血流,降低颅内血管阻力,促进粗大运动功能的恢复。 Objective To investigate the effect of scalp acupuncture on cerebral blood flow and gross motor function in children with spastic cerebral palsy.Methods From January to November,2016,79 children with spastic cerebral palsy were randomly divided into conventional group（n=40） and scalp acupuncture group（n=39）.Both groups received conventional rehabilitation treatment,and the scalp acupuncture group was given scalp acupuncture in addition,for five months.The systolic blood flow velocity（Vs）,mean flow velocity of cerebral artery（Vm） and vascular resistance index（RI） of anterior cerebral artery（ACA）,middle cerebral artery（MCA） and posterior cerebral artery（PCA） before and after treatment were assessed with color transcranial Doppler ultrasound（TCD）.The clinical effect was evaluated with the Gross Motor Function Classification System（GMFCS）.Results Five cases dropped out during the follow-up,three cases in the conventional group and two cases in the scalp acupuncture group.There was no significant difference in all the indexes between two groups before treatment（P〈0.05）.After treatment,the Vs and Vm of ACA,MCA and PCA improved（t〉2.051,P〈0.05）,no improvement was found in the RI of ACA,MCA and PCA in the conventional group（t1.1631,P〈0.05）,and they decreased in the scalp acupuncture group（t〉2.659,P〈0.05）.After treatment,the Vs and Vm of ACA,MCA and PCA were higher in the scalp acupuncture group than in the conventional group（t〉2.098,P〈0.05）,the RI of ACA was lower in the scalp acupuncture group than in the conventional group（t=2.375,P〈0.05）,and no significant difference was found in the RI of MCA and PCA between two groups（t1.637,P〈0.05）.The total effective rate was higher in the scalp acupuncture group than in the conventional group（χ^2=6.887,P〈0.05）.Conclusion Scalp acupuncture facilitates to increase the cerebral blood flow,decrease the vascular resistance,and improve gross motor function in children with spastic cerebral pal

关 键 词： 痉挛型脑性瘫痪 头针 脑血流 经颅多普勒 粗大运动功能 粗大运动功能分级系统