本文選題：“補(bǔ)腎健腦針法” + 康復(fù)訓(xùn)練��； 參考：《南京中醫(yī)藥大學(xué)》2012年碩士論文

【摘要】：目的：觀察治療前后痙攣型腦癱患兒修改的Ashworth痙攣量表(MAS)和腦癱患兒日常生活能力評(píng)價(jià)表(ADL)積分的變化情況,探索“補(bǔ)腎健腦針法”結(jié)合康復(fù)訓(xùn)練治療肝腎不足型痙攣型腦癱患兒的有效性及起效時(shí)間規(guī)律。 研究方法：采用隨機(jī)化方法。借助SAS統(tǒng)計(jì)分析系統(tǒng)產(chǎn)生60例受試者接受處理的隨機(jī)安排,即列出流水號(hào)為01-60所對(duì)應(yīng)的治療分配。分為治療組30例、對(duì)照組30例,其中治療組脫落1例,納入統(tǒng)計(jì)的病例治療組29例,對(duì)照組30例。治療組為“補(bǔ)腎健腦針法”結(jié)合康復(fù)訓(xùn)練,對(duì)照組單純采用康復(fù)訓(xùn)練,康復(fù)治療方法同治療組。分別于治療前、1個(gè)月后、2個(gè)月后、3個(gè)月后運(yùn)用修改的Ashworth痙攣評(píng)定量表及日常生活能力評(píng)價(jià)表(ADL),觀察兩組患兒痙攣狀態(tài)和日常生活能力改善的差異以及起效時(shí)間規(guī)律。 結(jié)果：(1)根據(jù)治療前后MAS積分變化,治療組與對(duì)照組有顯著性差異(P0.01)；治療組治療前與2個(gè)月后比較無顯著差異(P0.05)；治療前與3個(gè)月比較,有顯著差異(P0.01),對(duì)照組治療前與2個(gè)月及3個(gè)月后比較均無顯著差異(P0.05)。說明“補(bǔ)腎健腦針法”結(jié)合康復(fù)訓(xùn)練能改善腦癱患兒的痙攣狀態(tài),比單純康復(fù)訓(xùn)練更早更為有效。 (2)在日常生活能力方面,根據(jù)ADL量表積分變化,兩組治療均能改善腦癱患兒的日常生活活動(dòng)能力,但治療組明顯優(yōu)于對(duì)照組(P0.01),能夠明顯改善腦癱患兒的日常生活活動(dòng)能力(P0.01),而且治療組在第1個(gè)月積分即顯示出統(tǒng)計(jì)學(xué)意義(P0.05),3個(gè)月后與2個(gè)月后積分具有明顯差異(P0.05)。說明治療組起效時(shí)間早于對(duì)照組,第3個(gè)月起效幅度較大。而且療程越長,患兒的日常生活活動(dòng)能力的改善效果越明顯(P0.01)。根據(jù)兩組之間每個(gè)月ADL各因子評(píng)分比較看,經(jīng)2個(gè)月治療后,治療組對(duì)粗大運(yùn)動(dòng)的改善與對(duì)照組比較有顯著性差異(P0.05),經(jīng)3個(gè)月治療后,治療組對(duì)粗大運(yùn)動(dòng)、附加功能的改善與對(duì)照組比較有顯著性差異(P0.01),說明治療組對(duì)粗大運(yùn)動(dòng)治療效果較好。 (3)兩組臨床療效比較,治療組總有效率為100%,總顯效率是72.41%；對(duì)照組總有效率為83.33%,總顯效率是43.33%。兩組比較總有效率和總顯效率均有顯著性差異(P0.05)；說明“補(bǔ)腎健腦針法”結(jié)合康復(fù)訓(xùn)練比單純康復(fù)訓(xùn)練更有效。兩組總起效情況比較,與對(duì)照組相比,治療組起效時(shí)間較早,大多數(shù)在第1個(gè)月起效；粗大運(yùn)動(dòng)及附加功能起效時(shí)間早于對(duì)照組(P0.05),多數(shù)在第1個(gè)月起效；治療組在站、步行、上下臺(tái)階、理解、步行能力及站立平衡起效月份早于對(duì)照組,站、步行、上下臺(tái)階多為第1個(gè)月開始起效；理解、步行能力及站立平衡多在2、3月后起效。治療3個(gè)月后治療組ADL單項(xiàng)評(píng)分因子(爬、站、轉(zhuǎn)移、步行、理解、表達(dá)、步行能力)方面治愈率優(yōu)于對(duì)照組。 結(jié)論：“補(bǔ)腎健腦針法”結(jié)合康復(fù)訓(xùn)練對(duì)于痙攣性腦癱患兒的治療臨床療效肯定,能顯著較早的地改善患兒的痙攣狀態(tài),提高患兒的日常生活能力,尤其是粗大運(yùn)動(dòng)能力,從而提高患兒的生活質(zhì)量,減輕家長的負(fù)擔(dān)�！把a(bǔ)腎健腦針法”結(jié)合康復(fù)訓(xùn)練對(duì)痙攣型腦癱患兒的痙攣狀態(tài)和日常生活活動(dòng)能力的改善具有起效早,療效顯著、安全等優(yōu)勢。避免了藥物的副作用,價(jià)格相對(duì)便宜,故值得臨床推廣。
[Abstract]:Objective: To observe the changes of the modified Ashworth spasmodic scale (MAS) and the daily living ability assessment table (ADL) score of children with spastic cerebral palsy before and after treatment, and to explore the effectiveness and the onset time of the "tonifying kidney and brain acupuncture" combined with rehabilitation training for children with spastic cerebral palsy with deficiency of liver and kidney type.
Study method: using the randomization method, with the help of the SAS statistical analysis system, 60 subjects were treated randomly, that is to list the treatment allocation corresponding to the flow number 01-60, divided into 30 cases in the treatment group and 30 cases in the control group, including 1 cases of the treatment group, 29 cases in the statistical case treatment group and 30 in the control group. Combined with rehabilitation training, the control group was treated with rehabilitation training, rehabilitation therapy and treatment group. Before treatment, 1 months later, 2 months later, 3 months later, the modified Ashworth spasticity assessment scale and daily living ability assessment table (ADL) were used to observe the difference of spastic state and improvement of daily living ability in the two groups. The law of the starting time.
Results: (1) according to the changes of MAS scores before and after treatment, there was significant difference between the treatment group and the control group (P0.01); there was no significant difference between the treatment group before and after 2 months (P0.05); there was significant difference between before and 3 months (P0.01), and there was no significant difference between the control group before and after 2 months and 3 months (P0.05). Brain acupuncture combined with rehabilitation training can improve the spasticity of children with cerebral palsy, which is more effective than simple rehabilitation training earlier.
(2) in daily living ability, according to the ADL scale integral change, the two groups of treatment can improve the daily living ability of the children with cerebral palsy, but the treatment group is obviously better than the control group (P0.01). It can obviously improve the daily living ability of the children with cerebral palsy (P0.01), and the treatment group is statistically significant (P0.05) in first months' score (P0.05). There was a significant difference between 2 months after 2 months. It showed that the onset time of the treatment group was earlier than that of the control group, and the effect of the third months was greater. And the longer the course of treatment, the more obvious the improvement effect of the daily living ability of the children (P0.01). According to the comparison of the ADL factors of each month between the two groups, the treatment group was treated after 2 months of treatment. The improvement of gross exercise was significantly different from that of the control group (P0.05). After 3 months of treatment, the treatment group was significantly different from the control group (P0.01). The effect of the treatment group was better than that of the control group (P0.01).
(3) the total effective rate of the two groups was 100%, the total effective rate was 72.41%, the total effective rate of the control group was 83.33%, the total effective rate was significant difference between the 43.33%. two group and the total effective rate (P0.05). It showed that the "kidney tonifying brain acupuncture method" combined with the rehabilitation training was more effective than the simple rehabilitation training. The two groups had a total effect. Compared with the control group, the onset time of the treatment group was earlier than that of the control group, most of the effective time was first months. The onset time of the gross exercise and additional function was earlier than the control group (P0.05), most of which took effect in first months. The treatment group was standing, walking, walking up and down the steps, understanding, walking energy and standing balance were earlier than the control group, station, walking, up and down. More than first months began to start. Understanding, walking ability and standing balance were more effective after 2,3 months. After 3 months of treatment, the cure rate of the ADL single score factor (climbing, station, transfer, walking, understanding, expression, walking ability) in the treatment group was better than that of the control group.
Conclusion: the therapeutic effect of "invigorating kidney and invigorating the brain" combined with rehabilitation training in the treatment of children with spastic cerebral palsy is positive. It can significantly improve children's spasticity and improve the daily living ability of the children, especially the gross motor ability, so as to improve the quality of life and reduce the burden of the parents. Combined with rehabilitation training, the treatment of spastic cerebral palsy has the advantages of early effect, significant effect and safety. It avoids the side effects and the price is relatively cheap, so it is worthy of clinical promotion.

【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R246.6;R742.3

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本文編號(hào)：1821750