目的 观察靳三针联合早期目标-活动-运动环境训练对脑性瘫痪高危儿的临床疗效，为治疗脑性瘫痪高危儿提供新的治疗思路。方法 本研究为随机对照试验。选取西安市人民医院儿童保健科2021年5月至2023年1月期间收治的80例脑性瘫痪高危儿，按照随机数字表法分为观察组(40例)和对照组(40例)。观察组男19例，女21例，月龄(4。09±0。89)个月;对照组男22例，女18例，月龄(4。25±0。74)个月。对照组患儿接受基础康复和早期目标-活动-运动环境治疗，基础康复是以神经发育学治疗为主的Rood疗法和Bobath疗法，每次40 min，1次/d，5次/周，共6个月;观察组在对照组治疗基础上采用靳三针治疗，每隔1日针刺1次，每周针刺3次，每3个月为1个疗程，治疗2个疗程后观察疗效。观察两组干预前后粗大运动功能评估量表(Gross Motor Function Measure，GMFM)、精细运动功能评估量表(Fine Motor Function Measure，FMFM)、Gesell 发育诊断量表(Gesell Developmental Diagnosis Scale，GDDS)得分的差异，常规随访观察患儿的发育状况。行t检验、x2检验。结果 治疗前，两组患儿的GMFM、FMFM、适应性行为、语言评分比较，差异均无统计学意义(均P＞0。05)。治疗3、6个月后，观察组的 GMFM 和 FMFM 评分分别为(39。29±3。90)分、(49。79±3。16)分、(16。83±3。57)分、(25。59±4。11)分，高于对照组的(34。25±4。08)分、(45。69±3。17)分、(13。73±3。44)分、(19。34±3。54)分，差异均有统计学意义(t=5。648、5。793、3。955、7。287，均P＜0。001);观察组的适应性行为和语言得分分别为(57。33±3。90)分、(69。72±4。76)分、(62。86±4。38)分、(68。19±3。89)分，高于对照组的(55。22±4。08)分、(65。21±4。17)分、(58。44±4。74)分、(63。84±3。56分)，差异均有统计学意义(t=2。364、4。507、4。331、5。217，均P＜0。05)。在校正胎龄为12月龄时，观察组和对照组发育正常比例分别为85。00％(34/40)、60。00％(24/40)，两组比较差异有统计学意义(x2=6。270，P=0。012)。结论 靳三针联合早期目标-活动-运动环境训练对提高脑性瘫痪高危儿的运动和认知能力有明显的促进作用，对改善其生长发育具有重要意义。
Application of Jin's three-needle combined with goal-activity-exercise environment training in infants with high-risk of cerebral palsy
Objective To observe the clinical effect of Jin's three-needle combined with early goal-activity-exercise environment training on infants with high-risk of cerebral palsy,and to provide new treatment ideas for the treatment of infants with high-risk of cerebral palsy.Methods This study was a randomized controlled trial.A total of 80 infants with high-risk of cerebral palsy admitted to the Children's Health Department of Xi'an People's Hospital from May 2021 to January 2023 were divided into an observation group(40 cases)and a control group(40 cases)according to the random number table method.In the observation group,there were 19 boys and 21 girls,aged(4.09±0.89)months.In the control group,there were 22 boys and 18 girls,aged(4.25±0.74)months.The control group received basic rehabilitation and early goal-activity-exercise environment treatment.Basic rehabilitation was Rood therapy and Bobath therapy,which were mainly neurodevelopmental treatment,40 min each time,once a day,5 times a week,for 6 months.The observation group was treated with Jin's three-needle therapy on the basis of the control group,acupuncture once every 2 days,3 times a week,3 months as a course of treatment,and the curative effect was observed after 2 courses of treatment.The changes of scores of Gross Motor Function Measure(GMFM),Fine Motor Function Measure(FMFM),and Gesell Developmental Diagnosis Scale(GDDS)were observed before and after intervention in the two groups,and the infants'development status was observed by routine follow-up.t test and x2 test were performed.Results Before treatment,there were no statistically significant differences in the scores of GMFM,FMFM,adaptive behavior,or language between the two groups(all P＞0.05).After 3 and 6 months of treatment,the GMFM and FMFM scores in the observation group were(39.29±3.90)points,(49.79±3.16)points,(16.83±3.57)points,and(25.59±4.11)points,respectively,which were higher than those in the control group[(34.25±4.08)points,(45.69±3.17)points,(13.73±3.44)points,and(19.34±3.54)points],with statistically significant differences(t=5.648,5.793,3.955,and 7.287,all P＜0.001).After 3 and 6 months of treatment,the scores of adaptive behavior and language in the observation group were(57.33±3.90)points,(69.72±4.76)points,(62.86±4.38)points,and(68.19±3.89)points,respectively,which were higher than those in the control group[(55.22±4.08)points,(65.21±4.17)points,(58.44±4.74)points,and(63.84±3.56)points],with statistically significant differences(t=2.364,4.507,4.331,and 5.217,all P＜0.05).On the basis of corrected gestational age of 12 months,the proportion of normal development was 85.00％(34/40)in the observation group and 60.00％(24/40)in the control group,respectively,with a statistically significant difference between the two groups(x2=6.270,P=0.012).Conclusion Jin's three-needle combined with early goal-activity-exercise environment training has a significant effect on improving the motor and cognitive ability in infants with high-risk of cerebral palsy,and is of great significance for improving their growth and development.
Cerebral palsyHigh-risk infantsJin's three-needleEarly goal-activity-exercise environment training
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维普
