调神通督针法联合认知功能训练治疗小儿脑瘫认知功能障碍的临床研究

发布时间：2018-04-13 21:26

本文选题：脑瘫 + 认知功能障碍　；参考：《湖北中医药大学》2016年硕士论文

【摘要】：目的脑瘫是当今儿童致残的主要病因之一,脑瘫患儿的康复治疗越来越受到广泛重视。本研究针对脑瘫儿童认知功能的障碍,创新性提出了调神通督针法,通过探讨调神通督针法联合认知功能训练治疗脑瘫儿童认知功能障碍的临床疗效,从而探寻一种临床上治疗脑瘫儿童认知功能障碍的有效途径,并为今后脑瘫儿童的康复治疗提供思路及参考。方法将符合小儿脑瘫合并认知功能障碍诊断标准的60例患儿完善脑血流图检测,并由专业人员进行Gesell诊断发育量表评估及日常生活活动能力(ADL)评估,先根据患儿年龄、性别、智力发育程度进行分层,再随机分为调神通督针刺组、认知功能训练组、联合组各20名。三组均以药物治疗及综合康复训练(物理治疗、作业治疗、言语治疗等)为基础治疗。在药物及综合康复训练基础上,针刺组:加用调神通督针刺法治疗,选用四神聪、神庭、百会、大椎、至阳、腰阳关、肺俞、心俞、肝俞、脾俞、肾俞,头针留针30min,体针采用速刺法,每日针刺1次,2个月为1疗程,共治疗2个疗程。训练组:由具有丰富临床经验的康复治疗师对患儿进行认知功能训练,每次训练30min,每日1次,2个月为1疗程,持续治疗2个疗程。联合组:加用调神通督针法联合认知功能训练治疗,具体操作方法同前两组。三组均经过2个疗程治疗结束后,再次进行脑血流图检查、发育商DQ及日常生活活动能力(ADL)评定,应用统计学方法,分别对治疗前、治疗后患儿的脑血流图改变、发育商DQ及ADL评分变化进行分析。结果临床研究显示应用调神通督针法联合认知功能训练治疗脑瘫患儿认知功能障碍在改善脑血流量方面优于单纯针刺组及训练组,差异有统计学意义(p0.05)。联合组在提高智力方面亦优于单纯针刺组及训练组,差异有显著统计学意义(p0.01)。三组均能改善患儿的日常生活活动能力,三组组间比较差异无统计学意义(p0.05)。结论调神通督针法治疗小儿脑性瘫痪合并认知功能障碍有确切疗效。调神通督针法联合认知功能训练治疗小儿脑性瘫痪在改善脑血流量、提高智力方面均明显优于单纯针刺组及单纯功能训练组,值得临床推广。
[Abstract]:Objective Cerebral palsy is one of the main causes of disability in children.Aiming at the cognitive dysfunction of children with cerebral palsy, this study put forward the method of regulating Shentong and regulating acupuncture, and discussed the clinical effect of regulating Shentong and regulating acupuncture combined with cognitive function training in the treatment of cognitive dysfunction in children with cerebral palsy.To explore an effective approach for the treatment of cognitive dysfunction in children with cerebral palsy, and to provide ideas and references for the rehabilitation of children with cerebral palsy in the future.Methods 60 children with cerebral palsy complicated with cognitive dysfunction were assessed by Gesell diagnostic development scale and ADL according to their age and sex.The intelligence development was stratified and randomly divided into three groups: the acupuncture group of regulating Shentong and the training group of cognitive function, and the combined group of 20 persons in each group.All the three groups were treated on the basis of drug therapy and comprehensive rehabilitation training (physical therapy, occupational therapy, speech therapy, etc.).On the basis of medicine and comprehensive rehabilitation training, the acupuncture group was treated with the acupuncture method of regulating Shentong governor, including Sishen Cong, Shenting, Baihui, Dazhui, Jiyang, Yaoyang pass, Fei Yu, Xin Yu, Gan Yu, spleen Yu, Shen Yu,The scalp acupuncture was kept for 30 mins, and the body acupuncture was used for 2 courses of treatment, once a day, 2 months as a course of treatment.Training group: the children were trained by rehabilitation therapists with rich clinical experience for cognitive function training for 30 mins, once a day, 2 months as a course of treatment and 2 courses of continuous treatment.Combined group: combined therapy of regulating Shentong and du acupuncture combined with cognitive function training, the specific operation method was the same as the former two groups.After two courses of treatment, the three groups were examined again with cerebral blood flow imaging (CBF), DQ and ADL (ADL). The changes of CBF before and after treatment were analyzed by statistical method.Development quotient (DQ) and ADL score were analyzed.Results Clinical studies showed that the treatment of cognitive dysfunction in children with cerebral palsy by regulating Shen Tong and du acupuncture combined with cognitive function training was better than that of acupuncture group and training group in improving cerebral blood flow. The difference was statistically significant (P 0.05).The intelligence of the combined group was better than that of the acupuncture group and the training group, and the difference was statistically significant.All the three groups could improve the activities of daily life of the children, and there was no significant difference between the three groups (P 0.05).Conclusion the method of regulating Shentong and du acupuncture is effective in the treatment of children cerebral palsy with cognitive dysfunction.The treatment of cerebral palsy in children with cerebral palsy by regulating Shen Tong and du acupuncture combined with cognitive function training is obviously superior to that of simple acupuncture group and simple functional training group in improving cerebral blood flow and improving intelligence. It is worth popularizing in clinic.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.6

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