补肾健脑针法治疗肝肾不足型小儿脑瘫的临床疗效评价

【作者】 鲍超；

【导师】 吴旭；

【作者基本信息】 南京中医药大学 ， 中医针灸学， 2005， 博士

【摘要】 [研究目的] 根据脑在脑瘫发病中的作用，认为肝肾不足，脑失所养为小儿脑瘫的主要病机，提出了补肾健脑针刺法治疗小儿脑瘫。通过对补肾健脑针刺法、传统针刺法及不针刺三种方法之间的临床疗效比较，对补肾健脑针法疗效及优势进行探讨。同时进行治疗方法的优选，进一步拓展临床治疗思路，提高中医在治疗小儿脑瘫中的作用和地位。 [研究方法] 将患儿分为补肾健脑针法组、传统针法组(前两组又合称治疗组)和对照组。补肾健脑针法组31例，体针、头针和穴位注射同用，体针选用督脉经为主，头针取用四神针、智三针、颞三针、脑三针(“一四”“三三三”)，并配合丽珠赛乐5ml在大椎、肾俞、足三里穴穴位注射。传统针法组30例，体针、头针同用，体针选穴同上，头针选用运动区、感觉区和足运感区等。对照组25例，不进行针刺治疗。两针刺组每周3次针刺，三个月为一疗程，共观察两个疗程。分别于治疗前、治疗一疗程后、治疗两疗程后对患儿总有效率、脑瘫儿童的综合功能评定表评分、日常生活活动能力评定表、婴儿—初中学生社会生活能力量表、疗程与有效率的关系、年龄与有效率的关系、病情与有效率的关系进行观察。 [研究结果] 治疗两疗程后两治疗组与对照组有效率均有显著性差异。脑瘫儿童的综合功能评定表评分中两治疗组与对照组比较均有显著差异；补肾健脑针法组与传统针法组比较有显著差异。脑瘫儿童的综合功能评定表各因子分评分中，两治疗组与对照组比较均有显著差异；补肾健脑针法组与传统针法组在认知功能、运动能力、自理动作因子分中有显著差异。在疗程与疗效关系的观察中，治疗组不同疗程的有效率及综合功能评定表评分均有显著性差异。在年龄与疗效关系的观察中，治疗组在不同年龄的有效率有显著性差异。在病情与疗效关系的观察中，治疗组不同病情中度、轻度与边缘三组显效率两两相比显效率有显著性差异。 [结论] 可见，在小儿脑瘫的治疗中，两种针刺方法总体疗效均优于不针刺者。对患更多还原

【Abstract】 [Purpose]According to the importance of brain, the main pathogeny and pathology of children cerebral palsy is the deficiency of liver and kidney and that lead to the disfunction of brain. The theory of acupuncture treatment is put forward that nourishing kidney and regulating brain in the type of liver and kidney deficiency. With the comparison of curative effects of three acupuncture treatment (nourishing kidney and regulating brain method, traditional method and no acupuncture method), discusses the curative effects and merits of the first acupuncture method. At the same time, select the better one from the two acupuncture treatment methods to broad the treatment methods and improve the position of Traditional Chinese Medicine in the treatment of this disease.[methods]The children were divided into 3 groups. Group 1 (nourishing kidney and regulating brain method): 31 cases were treated with body and scalp acupuncture and point injection. Body points were mainly in Du meridian. Scalp points were Four-shen Points, Three-zhi points, Three-nie points, Three-nao points(That were named ’one-four’ and ’three-three’.). Dazhui, Shenshu and Zusanli were selected in point injection with 5ml Lizhusaile injection altogether. Group 2(traditional method): 30 cases were treated with body and scalp acupuncture. Body points were the same as that in group 1. Scalp points included motor area, sensation area and foot-yungan area. Group 3 (contrast group): 25 cases with no acupuncture treatment. Group 1 and 2 were also named therapeutic groups, and group 3 was named contrast group. The patients of therapeutic groups were treated 3 times a week and a duration included 3 months. The treatment included 2 durations and 1 week’s interval between these 2 durations. The observed time was before treatment, after 1 and 2 durations’ treatment. The total curative effect rate, the scores of Infant-Middle School Student Social Functional Ability Scale, Activities of Daily Life(ADL) , Comprehensive Function Assessment for Cerebral Palsy, the relation of effect rate to duration, to age and to更多还原