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党伟利,李 伟,马丙祥.针刺改善孤独症谱系障碍患儿核心症状的临床观察[J].中国康复医学杂志,2020,(5):527~532
针刺改善孤独症谱系障碍患儿核心症状的临床观察    点此下载全文
党伟利  李 伟  马丙祥
河北中医学院,河北省石家庄市,050091
基金项目:河南省中医药科学研究专项课题(2018JDZX086)
DOI:10.3969/j.issn.1001-1242.2020.05.004
摘要点击次数: 163
全文下载次数: 129
摘要:
      摘要 目的:探讨针刺改善儿童孤独症谱系障碍(ASD)核心症状的临床效果。 方法:选取2016年7月—2018年8月我院收治的86例ASD患儿,采取简单随机数字表法将其随机分成观察组(n=43)与对照组(n=43)。对照组采取常规康复训练,而观察组在对照组基础上加用针刺疗法治疗,所有患儿均治疗6个月。比较两组临床疗效,治疗前后分别对两组患儿进行孤独症儿童行为量表(ABC)、儿童孤独症评定量表(CARS)、孤独症疗效评估量表(ATEC)、孤独症儿童心理教育评核(第三版)(PEP-3)及韦氏学龄前及初小儿童智力量表(WPPSI)测评,并统计针刺相关副反应发生情况。 结果:观察组总有效率为88.37%(38/43),与对照组的67.44%(29/43)相比显著上升(P<0.05)。两组治疗后ABC和CARS评分均较治疗前显著降低(P<0.05),但观察组下降更显著(P<0.05);两组治疗后ATEC中各分量表(言语、感知觉、社交、行为)评分及其总分均较治疗前显著降低(P<0.05),但观察组下降更显著(P<0.05)。两组治疗后PEP-3中各部分包括认知(语言/语前)、语言理解、语言表达、小肌肉等10个部分评分均显著高于治疗前(P<0.05),且观察组升高更显著(P<0.05)。观察组治疗后WPPSI中各方面(言语理解、视觉空间、推理等)评分均较治疗前有显著增加(P<0.05),且显著高于对照组治疗后(P<0.05)。而对照组治疗后WPPSI中言语理解及总智商评分较治疗前有显著增高(P<0.05),但在视觉空间、推理、工作记忆、加工速度评分方面的改善效果均不明显(P>0.05)。同时观察组患儿因针刺所致的副作用较少且轻微。 结论:针刺治疗儿童ASD不仅能有效改善核心症状,而且能促进患儿语言、认知、行为功能障碍的恢复,提高其智力水平,且患儿耐受性较好。
关键词:针刺  核心症状  孤独症谱系障碍
Effects of acupuncture intervention on core symptoms in children with autism spectrum disorder    Download Fulltext
Hebei University of Chinese Medicine,050091
Fund Project:
Abstract:
      Abstract Objective: To investigate the clinical efficacy of acupuncture on children with autism spectrum disorder (ASD). Method: Eighty-six ASD children admitted in our hospital from July 2016 to August 2018, were divided into observation group (n=43) and control group (n=43) on the basis of random number table. Both groups were given conventional rehabilitation training, and at the same time, the observation group was also administrated with acupuncture intervention.All children were treated for 6 months. The clinical efficacy was compared between the two groups. Before and after treatment, Autism?Behavior?Checklist (ABC), Childhood autism rating scale (CARS), the Autism Treatment Evaluation Checklist (ATEC), Psycho-educational Profile version 3 (PEP-3) and Wechsler Preschool and Primary Scale of Intelligence (WPPSI) were adopted. And the occurrence of acupuncture-related side effect was recorded. Result: The overall effective rate of the observation group was 88.37% (38/43), much higher than 67.44% (29/43) of the control group (P<0.05). After treatment, both groups had remarkably lower ABC and CARS scores than those before treatment (P<0.05). After treatment, both groups had remarkably lower ATEC subscale scores (speech, sensory perception, social activities, behavior) and lower total scores than those before treatment (P<0.05), and the decrease in the observation group was more significant (P<0.05). After treatment, both groups exhibited a great increase in PEP-3 scores [10 components including cognition (speech / preverbal), language comprehension, language expression, small muscles, etc.] as compared with those before treatment, and the increase in the observation group was more significant (P<0.05). The scores in each WPPSI aspect (language comprehension, visual space, referencing, etc.) of the observation group after treatment raised obviously as compared with those before treatment (P<0.05), and the scores were much higher than those of the control group after treatment (P<0.05). After treatment, the control group had much higher WPPSI scores for language comprehension and full scale intelligence quotient than those before treatment (P<0.05), but there was no obvious improvement in visual space, referencing, working memory and working speed (P>0.05). Meanwhile side effect induced by acupuncture was seldom and mild in the observation group. Conclusion: In treating ASD children, the application of acupuncture not only can improve core symptoms but also can significantly promote the recovery of language, cognitive and behavioral function in the children, improve their intelligence level, and is well tolerated by children.
Keywords:acupuncture,  core symptoms  autism spectrum disorder
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