宋忠阳 秦晓光 方晓丽 陈玉婵

摘要：目的 觀察郑氏“金鸡啄米”针法治疗小儿痉挛型脑性瘫痪后运动功能障碍的临床疗效。方法 采用随机数字表法将90例患儿分为金鸡啄米组和平补平泻组各45例。2组均进行Bobath康复训练，每次30～60 min；体针取风池、肝俞、肾俞、命门、太溪、孔最、曲池、合谷、阳陵泉、三阴交、环跳、梁丘、绝骨、太冲；头针取顶中线、顶颞前斜线、顶旁1线及顶旁2线。金鸡啄米组体针行“金鸡啄米”针法，头针行平补平泻法；平补平泻组体针、头针均行平补平泻法。2组针刺与Bobath康复训练交替进行，每周各3次，12次为1个疗程，连续3个疗程。观察2组治疗前后脑性瘫痪粗大运动功能分级系统（GMFCS）分级、粗大运动功能测量量表（GMFM）-88评分情况，评价临床疗效。结果 2组患儿治疗前后GMFCS分级比较，差异有统计学意义（P<0.05）。与本组治疗前比较，2组GMFM-88评分均升高（P<0.05）；金鸡啄米组治疗后GMFM-88评分明显高于平补平泻组（P<0.05）。金鸡啄米组临床疗效总有效率为95.6%（43/45），平补平泻组为88.9%（40/45），2组比较差异有统计学意义（P<0.05）。结论 郑氏“金鸡啄米”针法治疗小儿痉挛型脑性瘫痪后运动功能障碍疗效显著，可明显改善脑瘫患儿的运动功能。

关键词：金鸡啄米针法；平补平泻；小儿脑性瘫痪；运动功能障碍

DOI：10.3969/j.issn.1005-5304.2018.01.006

中图分类号：R259.422 文献标识码：A 文章编号：1005-5304（2018）01-0023-05

Clinical Study on Motor Dysfunction of Infantile Spastic Cerebral Palsy Treated

by Zhengs “Golden Chicken Pecking Rice” Acupuncture

SONG Zhong-yang1， QIN Xiao-guang1， FANG Xiao-li1， CHEN Yu-chan2

1. School of Acupuncture and Massage， Gansu University of Chinese Medicine， Lanzhou 730000， China；

2. School of Integrated Traditional Chinese and Western Medicine，

Gansu University of Chinese Medicine， Lanzhou 730000， China

Abstract： Objective To compare the clinical efficacy of “golden chicken pecking rice” and flat tonifying diarrhea in the treatment of pediatric spastic cerebral palsy. Methods Totally 90 cases of children with pediatric spastic cerebral palsy diagnosis standard were divided into golden chicken pecking rice group and flat tonifying diarrhea group by random number table method， with 45 cases in each group. Bobath rehabilitation training was used for both groups， 30–60 min each time. Body acupoints were Fengchi， Ganshu， Shenshu， Mingmen， Taixi， Kongzui， Quchi， Hegu， Yanglingquan， Sanyinjiao， Huantiao， Liangqiu， Juegu， and Taichong. Head acupoints were taken from the top midline， top temporal lobe， the top side of line 1， and the top side of line 2. Golden chicken pecking rice group was given “golden chicken pecking rice” needling， and head acupoints were given flat tonifying diarrhea method； flat tonifying diarrhea group was given flat tonifying diarrhea method. Acupuncture and Bobath rehabilitation training were given alternatively， three time per week， 12 times as a course， for 3 courses. GMFCS and GMFM-88 of the two groups before and after treatment were observed. Clinical efficacy was evaluated. Results The GMFCS of both groups were higher after treatment， with statistical significance （P<0.05）. GMFM-88 scores in both groups increased

基金项目：国家中医药管理局甘肃郑氏针法学术流派传承工作室项目（2305135901）

通讯作者：秦晓光，E-mail：lzhqxg@163.com

after treatment （P<0.05）. GMFM-88 score of the golden chicken pecking rice group was significantly higher than that of the flat tonifying diarrhea group， with statistical significance （P<0.05）. The total effective rate was 95.6% （43/45） in golden chicken pecking rice group and 88.9% （40/45） in flat tonifying diarrhea group， with statistical significance （P<0.05）. Conclusion Zhengs “golden chicken pecking rice” acupuncture on the treatment of children spastic cerebral palsy with motor dysfunction is with confirmed efficacy， which can obviously improve the motor function of children with cerebral palsy.

Keywords： “golden chicken peck the rice” acupuncture； flat tonifying diarrhea method； children cerebral palsy； motor dysfunction

小兒脑性瘫痪，指胎儿及婴幼儿时期发育过程中出现的非进行性脑损伤及缺陷，造成患儿运动功能障碍及姿势异常的一系列综合征，临床主要以运动功能障碍及姿势异常为主，可伴有智力、语言、听力、行为、感觉等异常[1]。痉挛型脑性瘫痪占脑性瘫痪患儿的60%～70%[2]，主要表现为运动功能障碍或肢体行为异常。该病严重影响小儿的正常发育，若治疗不及时，将造成患儿永久性残疾。我国小儿脑性瘫痪发病率较高，约为1.2%～2.7%[3]，目前，国外治疗本病以康复训练为主，缺乏特效疗法。……