發(fā)布時(shí)間：2018-01-19 10:38

  本文關(guān)鍵詞： 捏脊療法 肌張力低下 腦性癱瘓 粗大運(yùn)動(dòng)功能 甲襞微循環(huán)　出處：《長春中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:觀察捏脊療法在促進(jìn)肌張力低下型腦癱患兒運(yùn)動(dòng)功能康復(fù)中的臨床療效及對(duì)微循環(huán)的影響作用關(guān)系。探索具有中醫(yī)特色的綜合康復(fù)手段。方法:(1)臨床對(duì)照觀察:將符合納入標(biāo)準(zhǔn)的60例患兒,運(yùn)用隨機(jī)數(shù)字表法分為治療組和對(duì)照組,每組各30例。根據(jù)患兒的運(yùn)動(dòng)功能制定康復(fù)計(jì)劃,治療組加用捏脊療法;對(duì)照組采用單純康復(fù)訓(xùn)練。各項(xiàng)治療每日1次,每周治療6次,30次為1療程,治療3個(gè)療程。于治療3個(gè)療程后對(duì)兩組患兒的運(yùn)動(dòng)功能及肌力進(jìn)行評(píng)定。(2)臨床試驗(yàn):納入張力低下型腦性癱瘓患兒40例,采用數(shù)字表法隨機(jī)分為四組,每組10例。分別進(jìn)行捏脊3遍、5遍、7遍、9遍操作。采用田牛氏微循環(huán)加權(quán)積分法對(duì)各組捏脊前5min和捏脊后1min、5min、10min、20min、30min的甲襞微循環(huán)狀態(tài)進(jìn)行綜合定量分析。結(jié)果:(1)粗大運(yùn)動(dòng)功能改善:兩組治療后粗大運(yùn)動(dòng)功能積分均有顯著提高且治療組的積分差值大于對(duì)照組(p0.05)。(2)肌力增長:兩組治療后患兒的肌力均有增長且治療組明顯優(yōu)于對(duì)照組(p0.05),表明捏脊療法對(duì)促進(jìn)肌張力低下型腦癱患兒肌力增長具有優(yōu)勢(shì)作用。(3)臨床療效:治療組共計(jì)30例,其中有效28例,無效2例,總有效率為93.3%;對(duì)照組共計(jì)30例,其中有效22例,無效8例,總有效率73.3%。(4)各組捏脊后患兒甲襞微循環(huán)積分均顯著下降,隨時(shí)間積累,效果逐漸減弱,但較捏脊前仍有改善。捏脊7遍與9遍組的微循環(huán)改善的影響持續(xù)時(shí)間優(yōu)于捏脊3遍與5遍組。結(jié)論:捏脊療法對(duì)改善肌張力低下型腦癱患兒的微循環(huán)灌注狀態(tài)具有即時(shí)和延時(shí)作用;一定范圍內(nèi)治療量的增加對(duì)微循環(huán)的延時(shí)效應(yīng)具有提高作用。該療法對(duì)增加患兒肌力、促進(jìn)粗大運(yùn)動(dòng)功能發(fā)育均有較明顯且確切的療效,是提高本病臨床療效的行之有效的治療方法。
[Abstract]:Objective: to observe the clinical effect of chiropractic therapy in the rehabilitation of motor function in children with hypotonia and its influence on microcirculation. Clinical controlled observation: 60 children who met the inclusion criteria were selected. The treatment group and control group were divided into treatment group and control group with 30 cases in each group. According to the motor function of the children, the rehabilitation plan was formulated, and the treatment group was treated with chiropractic therapy. The control group was treated with simple rehabilitation training. Each treatment was treated once a day and 30 times a week as a course of treatment. After 3 courses of treatment, 40 children with hypotonic cerebral palsy were included in the clinical trial. The patients were randomly divided into four groups with 10 cases in each group. Nine times of operation were performed. Five minutes before and one minute after chiropractic pinching and 10 minutes and 20 minutes after chiropractic pinching in each group were performed by using Tian Niu's microcirculation weighted integration method. The microcirculation status of nailfold in 30 min was analyzed quantitatively. Results: 1). Improvement of coarse motor function: after treatment, the scores of gross motor function in both groups were significantly improved, and the difference of scores in the treatment group was higher than that in the control group (p 0.05. Muscle strength increase: after treatment, the muscle strength of the two groups increased and the treatment group was significantly better than the control group (P 0.05). The results showed that chiropractic therapy had superior effect on promoting muscle strength growth in children with hypotonia cerebral palsy.) there were 30 cases in the treatment group, among which 28 cases were effective and 2 cases were ineffective. The total effective rate was 93. 3%. In the control group, 22 cases were effective, 8 cases were ineffective. The total effective rate was 73.3%. The duration of microcirculation improvement was better in the group of 7 times and 9 times than that in the group of 3 times and 5 times. Conclusion:. Chiropractic therapy has an immediate and delayed effect on improving microcirculation perfusion in children with hypotonia cerebral palsy. In a certain range, the increase of the amount of treatment on the delay effect of microcirculation has an enhanced effect. This therapy has obvious and definite effect on increasing muscle strength and promoting the development of coarse motor function in children. It is an effective method to improve the clinical effect of this disease.
【學(xué)位授予單位】：長春中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R244.1

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