Objective: To observe the efficacy of acupuncture combined with Heixiaoyao powder for children with cerebral palsy (liver-qi stagnation, spleen-kidney deficiency syndrome) and its effect on serum immune indexes and nerve growth related protein.
Methods: A total of 180 children with cerebral palsy were randomly divided into a combined group (60 cases, 2 cases dropped off), an acupuncture group (60 cases, 4 cases dropped off) and a Chinese medication group (60 cases, 5 cases dropped off). On the basis of conventional treatment, the children in the combined group were treated with acupuncture [Baihui (GV 20), Sishencong (EX-HN 1), Shenting (GV 24), Benshen (GB 13), 30 min each time, twice a day] and Heixiaoyao powder; the children in the acupuncture group were treated with acupuncture, and the children in the Chinese medication group were treated with Heixiaoyao powder, the treatment was same with the combined group. All the children were treated for 6 consecutive days and rest for 1 day, totaling for 8 weeks. The Gesell developmental schedules (GDS) and TCM symptom scores were recorded before treatment, after treatment and at 3-month, 6-month and 12-month follow-up visit; the serum immune indexes (IgA, IgG and IgM) and nerve growth related protein [myelin basic protein (MBP), high mobility group box-1 (HMGB1), neuronspecific enolase (NSE)] were detected before and after treatment. The clinical efficacy of each group was evaluated.
Results: The total effective rate was 91.4% (53/58) in the combined group, which was higher than 80.4% (45/56) in the acupuncture group and 78.2% (43/55) in the Chinese medication group (P<0.05). Compared before treatment, the GDS scores in the three groups were increased and the TCM symptom scores were reduced after treatment and at 3-month, 6-month and 12-month follow-up visit (P<0.05). The GDS score in the combined group was higher than that in the acupuncture group and the Chinese medication group, and the TCM symptom score was lower than that in the acupuncture group and Chinese medication group (P<0.05). After treatment, the serum levels of IgA, IgG and IgM in the combined group were increased (P<0.05), and the serum levels of MBP, HMGBl and NSE were decreased (P<0.05), and the improvements were superior to those in the acupuncture group and the Chinese medication group (P<0.05).
Conclusion: Acupuncture combined with Heixiaoyao powder could effectively improve the development quotient in children with cerebral palsy (liver-qi stagnation, spleen-kidney deficiency syndrome), regulate the serum immune indexes and nerve growth related protein levels.
目的：观察针刺联合黑逍遥散治疗小儿脑瘫（肝郁气滞、脾肾亏虚证）的疗效及对血清免疫指标和神经生长相关蛋白水平的影响。方法：180例脑瘫患儿随机分为联合组（60例，脱落2例）、针刺组（60例，脱落 4例）和中药组（60例，脱落5例）。在常规治疗基础上，联合组给予针刺（穴取百会、四神聪、神庭、本神等，每次30 min，每日2次）联合中药黑逍遥散治疗；针刺组给予针刺治疗，中药组给予黑逍遥散治疗，方法同联合组。均连续治疗6 d，休息1 d，共治疗8周。治疗前后及随访3、6、12个月分别观察各组患儿Gesell发育商量表（GDS）和中医症状评分；治疗前后检测各组患儿血清免疫指标（IgA、IgG和IgM）和神经生长相关蛋白[髓鞘碱性蛋白（MBP）、高迁移率族蛋白B1（HMGBl）、神经元特异性烯醇化酶（NSE）]水平；并比较各组临床疗效。结果：联合组总有效率为91.4%（53/58），高于针刺组的80.4%（45/56）和中药组的78.2%（43/55）（P<0.05)。治疗后及随访3、6、12个月，3组患儿GDS评分较治疗前升高、中医症状评分降低（P<0.05)；且联合组患儿GDS评分高于针刺组和中药组、中医症状评分低于针刺组和中药组（P<0.05)。治疗后，联合组患儿血清IgA、IgG、IgM含量升高（P<0.05），血清MBP、HMGBl、NSE蛋白水平显著降低（P<0.05），且改善优于针刺组和中药组（P<0.05）。结论：针刺联合黑逍遥散可有效改善脑瘫（肝郁气滞、脾肾亏虚证）患儿的发育商，调节血清免疫指标和神经生长相关蛋白水平。.
Keywords: Heixiaoyao powder; acupuncture; cerebral palsy, liver-qi stagnation, spleen-kidney deficiency syndrome; development quotient; immune index.