目的 观察针刺联合运动疗法治疗痉挛性双瘫型脑瘫患者的临床疗效.方法 将69例小儿脑瘫患者随机分成两组,治疗组35例给予针刺疗法联合运动疗法,对照组34例给予单纯运动疗法,治疗3个月后,观察两组患者双下肢腓肠肌肌张力缓解情况(改良Ashworth量表评分和足背屈角角度)、站立与行走、跑等功能改善(GMFM的D、E区分数变化)及日常生活能力改善情况(ADL评分).结果 两组治疗后双下肢腓肠肌肌张力较治疗前均降低,即Ashworth量表评分提高,足背屈角扩大活动度明显扩大,差异有统计学意义(P<0.05);两组治疗后分别在GMFM的D区、E区评分提高,差异具有统计学意义(P<0.05);两组治疗后ADL评分较治疗前明显提高,差异具有统计学意义(P<0.05).两组治疗后相比,治疗组Ashworth量表评分提高,足背屈角角度扩大,均优于对照组,两组比较差异均有统计学意义(P<0.05);治疗组GMFM的D、E区功能区评分均优于对照组,两组比较差异均有统计学意义(P<0.05);治疗组ADL评分明显优于对照组,两组比较差异均有统计学意义(P<0.05).结论 针刺疗法联合运动疗法治疗痉挛性双瘫型脑瘫患者疗效确切.%Objective To observe the clinical efficacy of acupuncture plus kinesiotherapy in treating spastic diplegia. Method Sixty-nine kids with cerebral palsy were randomized into two groups. Thirty-five cases in the treatment group were intervened by acupuncture plus kinesiotherapy, while 34 cases in the control group by kinesiotherapyalone. After 3-month treatment, the release of gastrocnemius muscle tension of lower limbs (modified Ashworth Scale and foot dorsiflexion angle), improvement of standing, walking and running function [D and E items of Gross Motor Function Measure (GMFM)],and activities of daily living (ADL) were observed in the two groups.Result After treatment, the gastrocnemius muscle tension of both lower limbs declined in both groups, manifested by the increase of Ashworth score and extension of foot dorsiflexion, with statistical significances (P<0.05); the D and E item scores of GMFM increased significantly after treatment in both groups (P<0.05); after treatment, the ADL scores increased significantly in both groups (P<0.05). After the treatment, the increase of Ashworth score and extension of foot dorsiflexion in the treatment group were more significant than those in the control group (P<0.05); the D and E item scores of GMFM in the treatment group were superior to those in the control group (P<0.05); the ADL score in the treatment group was superior to that in the control group (P<0.05).Conclusion Acupuncture plus kinesiotherapy is effective in treating spastic diplegia.
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