Objective To compare the therapeutic effects of acupoint injection of ganglioside sodium alone and Deproteinised Calf Blood Serum Injection alone and combined usage of two drugs in the treatment of children with cerebral palsy (CP).Methods One hundred and eighty-three cases of children with CP admitted to Taihe Hospital of Shiyan City from February 2015 to July 2016 were randomly divided into ganglion sodium group (group A),calf serum group (group B) and combined group (group C).All 3 groups were received routine rehabilitation training and acupuncture therapy;group A was added with acupoint injection of sodium ganglion,group B was added with Deproteinised Calf Blood Serum Injection,intravenous drip,group C was given the two drugs above,all 3 groups were treated for 21 days.The activities of venous blood acetylcholine (Ach),acetylcholinesterase (AchE),plasma norepinephrine (NE) and brain de rived neurotrophic factor (BDNF) of children with CP before treatment and after treatment for 1,2,3 courses were detected.The local cerebral blood flow (RCBF),the occurrence times of pathological spike wave and amplitude of electroencephalogram (EEG) were recorded,and the efficacy was evaluated by gross motor function measurement scale-88 (GMFM-88).Results At the third course of treatment,the contents of venous blood Ach and NE in CP group were decreased,and the activities of AChE and BDNF were enhanced,which had statistically significant differences compared with those before treatment and those of group B (P ＜ 0.05);the RCBF was increased,which had statistically significant difference compared with that of group A (P ＜ 0.05);the occurrence times of pathological spike wave and amplitude of EEG were reduced,which had statistically significant differences compared with that of group B (P ＜0.05);the scores of GMFM-88 at the second and third courses were improved,and the total effective rate was 90.16％,which had statistically significant differences compared with those of group B and A (P ＜ 0.05).Conclusion Application of scalp acupuncture and body acupuncture in CP patients can clear the meridian and relax the cerebral vascular smooth muscle;intravenous drip of Deproteinised Calf Blood Serum Injection may increase RCBF and improve microcirculation;acupoint injection of ganglioside sodium can improve activities of AchE and BDNF,and inhibit the sympathetic and parasympathetic synaptic releasing neurotransmitter NE and Ach.Comprehensive treatment can improve the clinical efficacy of CP.%目的 比较单用神经节苷脂钠穴位注射和小牛血清去蛋白注射液静脉滴注及两药联用治疗小儿脑性瘫痪(CP)的效果.方法 将2015年2月～2016年7月湖北省十堰市太和医院康复科收治的183例CP患儿随机分为神经节苷脂钠组(A组)、小牛血清组(B组)和联合治疗组(C组).三组均给予常规康复训练和针灸等基础治疗,A组加穴位注射神经节苷脂钠,B组加用小牛血清去蛋白注射液静脉滴注,C组为两组治疗方法并用,均治疗21 d.检测CP患儿治疗前及第1、2、3个疗程时静脉血乙酰胆碱(Ach)、乙酰胆碱脂酶(AchE)、血浆去甲肾上腺素(NE)及脑源性神经生长因子(BDNF)活性,记录局部脑血流(RCBF)、脑电图(EEG)病理性棘波出现次数和振幅,并采用儿童粗大运动功能测试量表-88(GMFM-88)评估疗效.结果 治疗第3个疗程时,C组CP患儿静脉血Ach及NE含量降低,AchE及BDNF活性增强,与同组治疗前及B组比较,差异有统计学意义(P＜0.05);RCBF增高,与A组比较,差异有统计学意义(P＜ 0.05);EEG病理性棘波出现次数和波幅明显降低,与B组比较,差异有统计学意义(P＜0.05);第2、3个疗程时GMFM-88评分明显提高,临床总有效率为90.16％,与B组和A组比较,差异有统计学意义(P＜0.05).结论 采用头针和体针针刺治疗CP可疏通患儿经络,松弛脑血管平滑肌,小牛血清去蛋白注射液静脉滴注可增加RCBF,改善微循环,神经节苷脂钠穴位注射吸收后可提高AchE和BDNF活性,抑制交感和副交感神经突触释放神经递质NE和Ach.综合治疗可提高CP临床疗效.
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