目的：观察针刺顶区头穴线联合痉挛三针治疗痉挛型脑瘫患儿的临床疗效。方法：选择痉挛型脑 瘫患儿104 例，按随机数字表法分为对照组和观察组各52 例。对照组给予常规康复训练联合重复经颅电刺激 治疗，观察组在对照组基础上给予针刺治疗。2 组均治疗2 个月。评价2 组临床疗效，比较2 组治疗前后临床 痉挛指数及运动功能，检测内收肌、腓肠肌的表面肌电信号，检测血清脑源性神经营养因子（BDNF）、血清神 经生长因子（NGF） 水平。结果：观察组总有效率为88.46%，高于对照组71.15%（P＜0.05）。治疗后，2 组 粗大运动功能评估量表（GMFM）、精细运动能力测试量表（FMFM） 各项评分均较治疗前升高（P＜0.05）；且 观察组GMFM、FMFM 各项评分均高于对照组（P＜0.05）。治疗后，2 组腱反射评分、肌张力评分、阵挛评分 及痉挛指数总分均较治疗前降低（P＜0.05）；且观察组各项评分均低于对照组（P＜0.05）。治疗后，2 组内收 肌、腓肠肌表面肌电信号均方根值均较治疗前降低（P＜0.05），且观察组内收肌、腓肠肌表面肌电信号均方根 值均低于对照组（P＜0.05）。治疗后，2 组血清BDNF、NGF 水平均较治疗前升高（P＜0.05）；且观察组血清 BDNF、NGF 水平高于对照组（P＜0.05）。结论：针刺顶区头穴线联合痉挛三针治疗痉挛型脑瘫患儿临床疗效 显著，可以改善患儿运动功能，降低肌张力及痉挛指数，营养脑神经。
Abstract：Objective：To observe the clinical effect of acupuncture at scalp point line in nuchal region combined with three- spasm- needle therapy for children with spastic cerebral palsy. Methods：A total of 104 cases of children with spastic cerebral palsy were selected and divided into the control group and the observation group according to the random number table method，with 52 cases in each group. The control group was treated with routine rehabilitation training and repetitive transcranial magnetic stimulation，and the observation group was additionally treated with acupuncture based on the treatment of the control group. Both groups were treated for 2 months. Clinical effects were evaluated in the two groups. The clinical spasticity indexes and motor function were compared between the two groups before and after treatment. The surface electromyographic signals of the adductor and gastrocnemius muscles and the levels of serum brain- derived neurotrophic factor (BDNF) and serum nerve growth factor (NGF) were detected. Results： The total effective rate was 88.46% in the observation group， higher than that of 71.15% in the control group (P＜0.05). After treatment，the scores of the Gross Motor Function Measure (GMFM) and the Fine Motor Function Measure (FMFM) in the two groups were increased when compared with those before treatment (P＜0.05)，and the score of each item in GMFM and FMFM in the observation group was higher than that in the control group (P＜0.05). After treatment，the scores of tendon reflex，muscle tension，and clonus，and the total scores of spasticity indexes in the two groups were decreased when compared with those before treatment (P＜0.05)， and each score in the observation group was lower than that in the control group (P＜0.05). After treatment， the values of root mean square of surface electromyography signal of the adductor and gastrocnemius muscles in the two groups were decreased when compared with those before treatment (P＜0.05)， and the values in the observation group were lower than those in the control group (P＜0.05). After treatment， the levels of BDNF and NGF in serum in the two groups were increased when compared with those before treatment (P＜0.05)， and the two levels in the observation group were higher than those in the control group (P＜0.05). Conclusion：Acupuncture at scalp point line in nuchal region combined with three-spasm-needle therapy has a significant clinical effect in the treatment of children with spastic cerebral palsy and can improve their motor function， reduce muscle tone and spasticity indexes，and nourish brain nerves.