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目的:探讨热补针法结合Bobath康复训练对脑瘫患儿粗大运动(GMFM)功能的影响。方法:将60例脑瘫患儿随机分为康复组和热补针法结合康复组,每组30例。康复组患儿只接受康复手法训练,热补针法结合康复组患儿在采用热补针法治疗的同时结合康复手法训练。热补针法治疗取穴夹脊穴、肩髃、曲池、合谷、阳陵泉、阴陵泉、悬钟、足三里、三阴交、承山、太冲、太溪、神门,每日治疗1次,头针取穴百会、四神聪、智三针、脑三针、颞三针、运动区,不提插捻转,隔日治疗1次,3个月为一疗程,共治疗2个疗程。同时在治疗前、治疗3个月及6个月后采用GMFM运动功能评定量表评定,对脑瘫患儿进行评估。结果:热补针法结合康复组总有效率为70.00%(21/30),康复组总有效率为60.00%(24/30),热补针法结合康复组的疗效优于康复组(P<0.05)。热补针法结合康复组患儿治疗6个月后GMFM卧位和翻身、爬和跪、坐位、站位及走跑跳评分分别与治疗前及治疗3个月比较均有明显改善(均P<0.05);康复组患儿治疗6个月后GMFM卧位和翻身、爬和跪评分、坐位评分、站位、走跑跳评分与治疗前比较均有明显改善(均P<0.05),治疗6个月后站位评分与治疗3个月后比较有明显改善(P<0.05);热补针法结合康复组患儿治疗6个月后GMFM爬和跪、坐位、站位及走跑跳评分与康复组患儿比较均有明显改善(P<0.05)。结论:热补针法结合Bobath康复训练对脑瘫患儿GMFM爬和跪、坐位、站位、走跑跳评分的影响明显优于单纯康复训练,说明热补针法与Bobath现代康复理念的有机结合,可提高脑瘫患儿粗大运动功能。
Objective: To investigate the effects of hot-fill acupuncture combined with Bobath training on gross motor function (GMFM) in children with cerebral palsy. Methods: Sixty children with cerebral palsy were randomly divided into rehabilitation group and hot-fill combined with rehabilitation group, 30 cases in each group. Children in rehabilitation group were only trained in rehabilitation methods, while those in rehabilitation group were combined with rehabilitation therapy while those in rehabilitation group were treated with hot needle replacement therapy. Hot acupuncture treatment of acupuncture Jiaji points, shoulder 髃, Quchi, Hegu, Yanglingquan, Yinlingquan, hanging bell, Zusanli, Sanyinjiao, Chengshan, Taichong, too Creek, God door, daily treatment 1 times, acupuncture points Baihui, Sishencong, wisdom three needles, three brain acupuncture, temporal three-needle, exercise area, do not mention inserted twirling, the next day treatment 1, 3 months for a course of treatment, a total of 2 A course of treatment. At the same time before treatment, 3 months and 6 months after treatment with GMFM motor function assessment scale assessment, evaluation of children with cerebral palsy. Results: The total effective rate was 70.00% (21/30) in the combination therapy of hot stapling and rehabilitation, 60.00% (24/30) in the rehabilitation group, and the therapeutic effect was better than that of the rehabilitation group (P <0.05). Combined hot-fill method and rehabilitation group 6 months after treatment GMFM supine position and stand up, climb and kneel, sitting, standing and walking jump scores were significantly improved compared with before treatment and 3 months of treatment (both P <0.05). After 6 months of treatment, the GMFM supine position, stand-up and climb-kneeling scores, sitting position score and run-off score of the rehabilitation group were significantly improved (all P <0.05) After 6 months, the site score was significantly improved after 3 months of treatment (P <0.05). After 6 months’ treatment, the GMFM climbing and kneeling, sitting position, standing position and running jump Score and rehabilitation group were significantly improved children (P <0.05). Conclusion: The effect of hot-fill acupuncture combined with Bobath training on climbing and kneeling, sitting, standing and running-jumping score of children with cerebral palsy is obviously better than that of pure rehabilitation training, indicating the organic combination of hot-fill and Bobath’s modern rehabilitation concept , Can improve children with cerebral palsy coarse motor function.