目的   观察超声引导下针刺蝶腭神经节治疗过敏性鼻炎的临床疗效。方法   将80例过敏性鼻炎患者随机分成干预组（40例）和对照组（40例），干预组采用超声引导针刺蝶腭神经节，对照组采用常规方法针刺蝶腭穴，每周2次，持续4周。结果   治疗4周后，干预组和对照组均显示出良好疗效。干预组的总有效率为92.50%，对照组的总有效率为82.50%，差异有统计学意义（P＜0.05）；干预组在鼻症状总分（TNSS）、非鼻症状总分（TNNSS）、视觉模拟量表（VAS）和鼻结膜炎生活质量问卷（RQLQ）等指标上的改善均优于对照组（P＜0.05）。结论   超声引导下针刺蝶腭神经节治疗过敏性鼻炎能有效改善患者的临床症状。

   Objective  To investigate the main clinical effect of acupuncture of pterygopalatine ganglion on patients with allergic rhinitis under the guidance of ultrasound．Methods  A total of 80 patients with allergic rhinitis were randomly divided into intervention group and control group．The intervention group was treated with ultrasound guided acupuncture of the sphenopalatine 

ganglion，the control group was treated with conventional acupuncture at sphenopalatine point．The clinical efficacy was determined after the course of treatment．Results  The total effective rate was 92.50% in the intervention group and 82.50% in the control group．The improvement of total nasal symptom score，total non-nasal symptom score，VAS and Arhinoconjunctivitis Quality of Life Questionnaire scores in the treatment group was significantly better the control group Conclusions  Ultrasound-guided acupuncture of the sphenopalatine ganglion can improves clinical symptoms of patients with allergic rhinitis．

目的 探讨与分析推拿联合补肾祛瘀针刺法治疗慢性腰肌劳损恢复期患者对腰部疼痛及表面肌电图的影响。方法 选择2019年9月—2022年4月我院收治的72例慢性腰肌劳损恢复期患者为研究对象,根据随机1∶1数字表法,分为联合组与对照组各36例。对照组给予推拿治疗,联合组在此基础上,给予补肾祛瘀针刺法治疗,2组均治疗并观察4周,评价腰部疼痛及表面肌电图变化情况。结果 治疗后联合组与对照组的总有效率分别为97.2%和75%,联合组高于对照组（P<0.05）;治疗前,2组患者的视觉类比疼痛评分法（VAPS）和下腰痛失能问卷（OPDG）评分比较差异无统计学意义,治疗后,2组患者的VAPS和OPDG评分均降低,且联合组低于对照组（P<0.05）;2组治疗后的腰椎前屈力度都高于治疗前（P<0.05）,且联合组更高（P<0.05）;2组治疗后的表面肌电图神经根振幅和潜伏期均低于治疗前（P<0.05）,且联合组更低（P<0.05）。联合组与对照组治疗后的血清5-HT含量均高于治疗前（P<0.05）,联合组更高（P<0.05）。结论 推拿联合补肾祛瘀针刺法在慢性腰肌劳损恢复期患者中的应用具有良好的安全性,有效改善患者的腰椎功能,缓解患者疼痛,提高整体治疗效果,也能改善患者的表面肌电图状况,促进血清5-HT的释放。

Objective To explore and analyze the effects of massage combined with kidney tonifying and blood stasis removing acupuncture on lumbar pain and surface electromyography in patients with chronic lumbar muscle strain in the recovery period．Methods From September 2019 to April 2022, 72 cases of patients in the recovery period of chronic lumbar muscle strain treated in our hospital were selected as the research objects, and were divided into the combined group and the control group with 36 cases in each group by the random 1∶1 number table method．The control group were given massage therapy, and the combination group were given kidney tonifying and stasis removing acupuncture additionally．Results After treatment, the total effective rates of combined group and control group were 97.2% and 75%, respectively, and the combined group was significantly higher than the control group（P<0.05）．Before treatment, there was no significant difference in the visual analogue pain scale（VAPS）and Oswestry low pain & disability questionnaire（OPDG）scores between the two groups, but after treatment, the scores of the two groups were significantly decreased, and the combined group was significantly lower than the control group（P<0.05）．The lumbar flexion intensity after treatment was significantly higher in both groups than before treatment（P<0.05）, and higher in combination group（P<0.05）．The amplitude and latency of surface electromyogram nerve roots after treatment were significantly lower in both groups than before treatment（P<0.05）, and even lower in combination group（P<0.05）．The serum 5-HT content in combination group and control group after treatment was significantly higher than that before treatment（P<0.05）, and that in combination group was higher（P<0.05）．Conclusions The application of massage combined with kidney tonifying and blood stasis removing acupuncture in patients recovering from chronic lumbar muscle strain has good safety, which can improve the lumbar function of patients, relieve the pain of patients, improve the overall therapeutic effect, improve the surface electromyography of patients and promote the release of serum 5-HT．

目的 比较单纯康复训练和在此基础上结合苍龟探穴针法对脑卒中后肩手综合征I期的临床疗效差异。方法 选择响水县人民医院疼痛康复科收治的卒中后出现肩手综合征I期患者60例,按随机数字表法分为治疗组（n=30）和对照组（n=30）。治疗组患者行与苍龟探穴中医针法结合康复训练,先由具备针灸专业主治资格的临床医师对所选取的部分穴位使用苍龟探穴中医传统针法实施治疗后,再由具有5年以上工作经历的康复治疗师实施治疗,而其他患者则单纯接受康复训练,并观察2组患者在治疗前和治疗后的视觉模拟评分（VAS）、肿胀程度、简式上肢运动功能（Fugl-Meyer）评估以及临床疗效。结果 本次研究临床治疗进程中,2组无不良反应情况出现,因疫情和不能配合治疗而出现5例脱落病例（治疗组2例,对照组3例）。①治疗后,2组患者的VAS和肿胀程度评分低于治疗前（P<0.01）,治疗组患者2项评分高于治疗前（P<0.05）;②治疗后,2组患者的Fugl-Meyer评分高于治疗前（P<0.01）,治疗组患者评分高于对照组（P<0.01）;③治疗组的有效率高于对照组,组间比较差异有统计学意义（P<0.05）。结论 苍龟探穴中医传统针法结合康复训练可减少患者水肿和酸痛情况,明显改善患者上肢运动能力,有良好的临床效果。

Objective To compare the clinical efficacy of rehabilitation training alone and the combination of Cangguitanxue acupuncture on post-stroke stage I shoulder-hand syndrome．Methods A total of 60 patients from the Department of Rehabilitation Medicine of Xiangshui County People's Hospital who met the diagnosis（stroke followed by stage I shoulder-hand syndrome）were selected, and they were randomly divided into treatment group（n=30）and control group（n=30）according to the random number table method．Patients in the treatment group underwent a combination of rehabilitation training with the Cangguitanxue acupuncture Chinese medicine acupuncture method, and were first treated by a clinician qualified in acupuncture using the Cangguitanxue acupuncture Chinese medicine traditional acupuncture method on selected acupoints, and then by a rehabilitation therapist with more than five years of experience, while other patients received rehabilitation treatment alone．Results In the clinical treatment process of this study, there were no adverse reactions in the two groups, but there were five cases of dropout due to the epidemic and the inability to cooperate with the treatment（two cases in the treatment group and three cases in the control group）．After treatment, the visual analogue scale（VAS）and swelling degree scores of the two groups were significantly lower than those before treatment（P<0.01）, and the performance of the patients in the treatment group was better than that before treatment（P<0.05）．After treatment, the score of simplified upper limb motor control function（Fugl-Meyer）score in the two groups was significantly higher than that before treatment（P<0.01）, and the score of patients in the treatment group was higher than that of the control group（P<0.01）．The effective rate of the control group was inferior to that of the treatment group, and the difference was statistically significant（P<0.05）．Conclusions The traditional acupuncture method combined with rehabilitation training can significantly reduce edema and soreness in patients, significantly improve upper limb motor ability, and have good clinical effects．

目的 探索整体针联合运动处方应用于伴骨质疏松症（OP）的膝骨关节炎（KOA）患者全膝关节置换术（TKA）术前预康复的可行性、有效性及其对Wnt/β-catenin通路的影响。方法 2021年5月—2022年4月在广州市第一人民医院南沙医院骨科住院治疗的伴OP的KOA患者随机入组,分3组：A组予常规术前宣教和准备;B组在A组基础上,术前应用标准化运动处方3周;C组在A组基础上,术前联合应用整体针和运动处方3周。比较术前3周、术前1天、术后8周视觉模拟疼痛评分（VAS）、关节活动度（ROM）、膝关节功能评分（HSS）的组间差异,并比较术中关节液β连环蛋白（β-catenin）、基质金属蛋白酶-13（MMP-13）、重组人Dickkopf相关蛋白-1（DKK-1）含量的组间差异。结果 共纳入50例受试者,A组15例,B组18例,C组17例。术前1天组间方差分析显示：B、C组VAS均低于A组（P<0.05）,C组VAS低于B组（P<0.05）;B、C组ROM均高于A组（P<0.05）,B、C组ROM比较差异无统计学意义（P>0.05）;B、C组HSS均高于A组（P<0.05）,C组HSS高于B组（P<0.05）。术后8周组间方差分析显示：B、C组VAS均低于A组（P<0.05）,C组VAS低于B组（P<0.05）;B、C组ROM均高于A组（P<0.05）,B、C组ROM比较差异无统计学意义（P>0.05）;B、C组HSS均高于A组（P<0.05）,C组HSS高于B组（P<0.05）。术中关节液标志物含量组间方差分析显示：B、C组β-catenin、MMP-13含量均低于A组（P<0.05）,C组β-catenin、MMP-13含量均低于B组（均P<0.05）;B、C组DKK-1含量均高于A组（均P<0.05）,C组DKK-1含量高于B组（P<0.05）。结论 整体针联合运动处方在OP患者TKA术前应用切实可行,可有效缓解疼痛、改善功能。整体针可增强运动处方的正向预康复作用,其作用机制可能与Wnt/β-catenin通路调节有关。

Objective To explore the feasibility,effectiveness and impact on the Wnt/β-catenin pathway of combined holistic acupuncture and exercise prescription for preoperative rehabilitation in knee osteoarthritis（KOA）patients with osteoporosis（OP）undergoing total knee arthroplasty（TKA）．Methods KOA patients with OP were divided into three groups randomly：Group A received conventional preoperative education and preparation,Group B received standardized exercise prescription for three weeks additionally,Group C received combined holistic acupuncture and exercise prescription for three weeks additionally．Between-group differences in visual analogue scale（VAS）pain scores,range of motion（ROM）and knee joint function scores（HSS）were compared at 3 weeks preoperatively,1 day preoperatively and 8 weeks postoperatively．Differences in intraoperative joint fluid levels of β-catenin,MMP-13 and DKK-1 were also compared．Results A total of 50 participants were included,with 15 in Group A,18 in Group B and 17 in Group C．Baseline conditions were comparable among the three groups．One-day preoperative analysis showed that VAS scores were lower in both Groups B and C compared to Group A（P<0.05）,and VAS score was lower in Group C compared to Group B（P<0.05）．ROM was higher in Groups B and C compared to Group A（P<0.05）,with no statistically significant between-group difference between Groups B and C．HSS scores were higher in Groups B and C compared to Group A（P<0.05）,and HSS score was higher in Group C compared to Group B（P<0.05）．Eight-week postoperative analysis revealed that VAS scores were lower in both Groups B and C compared to Group A（P<0.05）,and VAS score was lower in Group C compared to Group B（P<0.05）．ROM were higher in Groups B and C compared to Group A（P<0.05）,with no statistically significant between-group difference between Group B and C．HSS scores were higher in Groups B and C compared to Group A（P<0.05）,and HSS score was higher in Group C compared to Group B（P<0.05）．Intraoperative joint fluid biomarker analysis showed that β-catenin and MMP-13 levels were lower in Groups B and C compared to Group A（P<0.05）,and β-catenin and MMP-13 levels were lower in Group C compared to Group B（P<0.05）．DKK-1 levels were higher in Groups B and C compared to Group A（P<0.05）,and DKK-1 level was higher in Group C compared to Group B（P<0.05）．Conclusions Combined holistic acupuncture and exercise prescription is feasible and effective for preoperative rehabilitation in TKA for KOA patients with OP．Holistic acupuncture enhances the positive pre-rehabilitation effect of exercise prescription,and its mechanism may be related to the regulation of the Wnt/β-catenin pathway．

目的 观察龙氏正骨手法配合浮针临床上治疗颈源性头痛的疗效。方法 将本院80例颈源性头痛患者按1:1随机分为观察组和对照组,观察组采用龙氏正骨手法配合浮针治疗,对照组采用龙氏正骨手法治疗,于1疗程后比较2组临床疗效、疼痛视觉模拟评分(VAS)和颈椎活动度评分(ROM)情况。结果 治疗后两组VAS较治疗前均有改善(P<0.05),观察组较对照组明显(P<0.05)。2组ROM较治疗前均有改善(P<0.05),组间差异无统计学意义(P>0.05)。治疗组的愈显率高于对照组(P<0.05)。结论 龙氏正骨手法配合浮针治疗颈源性头痛能更好地减轻疼痛程度,方便高效。

Objective To observe the clinical effect of Long's bone-setting manipulation combined with floating acupuncture therapy on cervicogenic headache. Methods A total of 80 patients with cervicogenic headache in our hospital were randomly divided into observation group and control group evenly. The observation group was treated with Long's bone-setting manipulation combined with floating acupuncture therapy, and the control group was treated with Long's bone-setting manipulation only. After one course of treatment, the clinical efficacy,pain visual analogue score (VAS) and cervical joint range of motion (ROM) in the two groups were compared. Results After treatment, the VAS of the two groups was improved compared with that before treatment (P<0.05), and the VAS of the observation group was significantly higher than that of the control group (P<0.05). ROM in the two groups was improved compared with that before treatment (P<0.05), and there was no significant difference between the two groups (P>0.05). The effective rate of the treatment group was higher than that of the control group (P<0.05). Conclusions Long's bone-setting manipulation combined with floating acupuncture therapy in the treatment of cervicogenic headache can better reduce the degree of pain, which is convenient and efficient.

目的 探索在全膝关节置换(TKA)围手术期中实施以中医透药+整体针疗法为特色的中西医结合加速康复方案的可行性,考察中医、西医加速康复措施在单独应用和联合应用时的促康复效能。方法 以在我院行首次单侧全膝关节置换术的患者为研究对象。根据围手术期干预差异分为四组:A组12例,根据指南采取传统常规的围手术期处理;B组12例,在A组基础上,采取了西医加速康复措施;C组14例,在A组基础上,采取了中医透药+整体针疗法;D组15例,兼采用西医加速康复措施和中医透药+整体针疗法。统计所有患者术后24小时、术后3天视觉模拟疼痛评分(VAS)和术前、术后2周膝关节功能评分(HSS)。并作以上数据的组间比较。结果 四组患者术后24 h VAS组间差异无统计学意义,术后3 d VAS组间总体差异有统计学意义:组间两两比较,B、C、D组均低于A组(P<0.05),B、C、D组间差异则无统计学意义。四组患者术前HSS组间差异无统计学意义,术后2周HSS组间总体差异有统计学意义:组间两两比较,B、C、D组均高于A组(P<0.05),A、B、C组均低于D组(P<0.05),B、C组间差异无统计学意义。结论 中医透药+整体针疗法在TKA围术期应用切实可行,与加速康复理念有机结合可有效缓解患者围术期疼痛,改善术后膝关节功能。

Objective To explore the feasibility of implementing the accelerated rehabilitation program of integrated traditional Chinese and western medicine featuring TCM and holistic acupuncture in the perioperative period of total knee arthroplasty (TKA),and investigate the effectiveness of accelerated rehabilitation under concept of recovery after surgery ERAS of traditional Chinese medicine and western medicine in single application and joint application. Methods The patients who underwent the first unilateral total knee arthroplasty in our hospital were studied. According to the interventions during the perioperative period, they were divided into 4 groups: 12 cases in group A, which were treated according to the guidelines and traditional perioperative treatment; 12 cases in group B, on the basis of group A, western medicine accelerated rehabilitation measures were taken; for the 14 case in group C, on the basis of group A, TCM penetration combinate with holistic acupuncture therapy was adopted; in group D, the combination of western medicine accelerated rehabilitation measures and the TCM therapy above were implemented in 15 cases. The visual analogue score (VAS)of all patients at 24 hours and 3 days after surgery were counted, and their knee function scores in hospital for special surgery (HSS scores) were recorded before and 2 weeks after the surgery. Comparisons of the data above between different groups were carried out. Results There was no statistically significant difference between the 4 groups in the VAS at 24 h after the operation, but statistically significant difference was found in the comparison of VAS at the 3rd day after the operation;In pairwise comparison, the 3rd day's VAS of group B, C and D were all lower than that of group A (P<0.05). There was no statistically significant difference between the 4 groups in the HSS score before the operation, but statistically significant difference was found in the comparison of HSS score at the 2nd week after the operation;In pairwise comparison, the 2nd week's HSSscore of group B, C and D were all higher than group A (P<0.05),and that of group A,B and C were all lower than that of group D (P<0.05). Conclusion The application of TCM penetration medicine combinated with holistic acupuncture in perioperative period of TKA is practical and feasible. The combination of western medicine accelerated rehabilitation measures and the TCM therapy can effectively relieve patients' perioperative pain and improve postoperative knee function.

目的 研究电针治疗对重性抑郁障碍患者的抑郁状态的影响。方法 本研究共分为3组,药物组、和药物+电针组及对照组(每组各50 例),药物组给予艾司西酞普兰抗抑郁治疗连续6周,药物+电针组在给予艾司西酞普兰抗抑郁治疗的基础上,进行电针治疗6周。比较治疗前后三组的HAMD 24 项评分,并对三组的HAMD 24 项评分与血清细胞炎症因子IL-1β、IL-2、IL-6、TNF-α水平进行相关性分析。采用多元逐步回归法,分析影响基线药物组和药物+电针组HAMD 24 项评分的主要因素。结果 与治疗前比较,药物组和药物+电针组患者治疗后HAMD 24 项评分均降低,差异有统计学意义(P＜0.05或P＜0.01),与药物组比较,治疗后药物+电针组HAMD 24 项评分较低,差异有统计学意义(P＜0.05或P＜0.01)。药物组HAMD 24 项评分与血清细胞炎症因子IL-6(r=0.335,P<0.001)、TNF-α(r=0.269,P<0.001)、IL-2(r=0.257,P=0.001)和IL-1β(r=0.205,P=0.021)呈正相关。药物+电针组HAMD24 项评分与血清细胞炎症因子IL-6(r=0.338,P<0.001)、TNF-α(r=0.271,P<0.001)、IL-2(r=0.255,P=0.015)和IL-1β呈正相关(r=0.208,P=0.026)。影响药物组HAMD24 项评分的主要因素有:血清细胞炎症因子IL-6、TNF-α、IL-1β、IL-2、婚姻(已婚)、文化程度(受教育年限少),标准化回归系数分别为0.585、0.516、0.452、0.318、-0.290、0.262(P＜0.05或P＜0.01)。影响药物+电针组HAMD24 项评分的主要因素有:血清细胞炎症因子IL-6、TNF-α、IL-2、IL-1β、婚姻(已婚)、文化程度(受教育年限少),标准化回归系数分别为0.592、0.521、0.448、0.323、-0.295、0.271(P＜0.05或P＜0.01)。结论 药物联合电针治疗能有效改善重性抑郁障碍患者的抑郁状态,细胞炎症因子与HAMD24 项评分相关,可影响重性抑郁障碍患者的抑郁状态。

Objective To explore the effect of electroacupuncture on patients with severe depression. Methods Patients was divided into three groups, acupuncture group, drug group and the control group. Each group had 50 patients. The drug group was treated with escitalopram for 6 weeks.The acupuncture group were treated with escitalopram and electroacupuncture for 6 weeks. We compared the HAMD24 among 3 groups before or after treatment. The correlation of the levels of IL-1 β, IL- 2, IL- 6, TNF-α and the total HAMD24 score among 3 groups were taken by the correlation analysis. And the main factors influencing the total HAMD24 score before the study were analyzed by the multiple inear step regression method. Results Compared with the pre-treatment group, the HAMD score of the drug group and the acupuncture group decreased after treatment, the difference was statistically significant (P<0.05 or P<0.01). Compared with the drug group, the HAMD score of the acupuncture group was lower after treatment; the difference was statistically significant (P<0.05 or P<0.01). The drug group, HAMD scores were positively correlated with IL- 6, TNF-α, IL- 2 and IL-1 β (r=0.335, 0.269, 0.257 and 0.205, respectively, P<0.05 or P<0.01). The acupuncture group HAMD scores were positively correlated with IL- 6, TNF-α, IL- 2 and IL-1 β(r=0.338, 0.271, 0.255 and 0.208, respectively, P<0.05 or P<0.01). The main factors influencing the HAMD score before the study included: serum cytokines IL- 6, TNF-α, IL β, IL- 2, marriage and education. The standardized regression coefficients were 0.585,- 0.516, 0.452, 0.318, 0.290, 0.262, respectively (P<0.05 or P<0.01). The main factors influencing the HAMD score of the drug group before the study included: serum cytokines IL- 6, TNF-α, IL β, IL- 2, marriage and education. The standardized regression coefficients were 0.585,- 0.516, 0.452, 0.318, 0.290, 0.262, respectively (P<0.05 or P<0.01). The main factors of the acupuncture group influencing the HAMD score before the study included: serum cytokines IL- 6, TNF-α, IL β, IL- 2, marriage and education. The standardized regression coefficients were 0.592,0.521,0.448,0.323,- 0.295,0.271(P＜0.05 or P＜0.01). Conclusion Escitalopram combination with electroacupuncture may improve the the depressive state. Inflammatory cytokines were associated with HAMD24 scores and it affects the depressive state of patients with major depressive disorder.

目的 观察电针联合重复经颅磁刺激(rTMS)治疗对卒中后抑郁伴失眠患者的疗效并探讨这种联合治疗的机制。方法 对83例PSD患者随机分为rTMS组28例、电针联合rTMS治疗组25例及药物治疗组30例。电针联合rTMS组在对患者进行rTMS治疗基础上予电针治疗2周,并常规给予选择性五羟色胺重摄取抑制剂(SSRI)草酸艾司西酞普兰抗抑郁药物治疗;rTMS组仅采用重复经颅磁刺激治疗2周;药物组给予同种抗抑郁剂治疗。三组于治疗前及治疗2周后接受17项汉密尔顿抑郁量表(HAMD)和匹茨堡睡眠量表(PSQI)评估及多导睡眠监测(PSG)。结果 三组的HAMD评分、PSQI评分及睡眠参数在治疗基线水平均无明显差异。2周后不同治疗组间HAMD计分降低值总体差异有统计学意义(P<0.001)。药物治疗组HAMD计分降低值小于rTMS组和电针联合rTMS组(P<0.05),电针联合rTMS组HAMD计分降低值大于药物组及rTMS组(P<0.05);组间PSQI计分降低值总体差异有统计学意义 (P<0.05)。电针联合rTMS组PSQI计分降低值大于药物组及rTMS组(P<0.05),而药物组及rTMS组之间的PSQI计分降低值无统计学差异(P<0.05);组间PSG中总睡眠时间(F=16.735,P<0.001)及睡眠效率(F=87.548,P<0.001)治疗前后差值总体差异有统计学意义。电针联合rTMS组总睡眠时间的改善优于药物组及rTMS组(P<0.01),而药物组及rTMS组之间总睡眠时间的改善无统计学差异(P<0.05);电针联合rTMS组睡眠效率的提高优于药物组及rTMS组(P<0.001),而药物组及rTMS组之间的睡眠效率的提高无统计学差异(P>0.05)。结论 电针联合rTMS治疗可显著改善PSD的抑郁情绪、睡眠质量及改善总睡眠时间及睡眠效率,效果优于药物治疗组及rTMS组,体现了电针联合rTMS对PSD治疗的增效作用。

Objective To investigate the effect of electric acupuncture combined with Repetitive Transcranial Magnetic Stimulation (rTMS) treatment of poststroke depression with insomnia and analyze the therapeutic mechanism of this method. Methods 83 patients with PSD were randomly divided into the group of electric acupuncture combined with rTMS (n=32), rTMS group (n=32) and drug treatment group (n=32). The patients in the group of electric acupuncture combined with rTMS were given with the electric acupuncture treatment for 2 weeks on the basis of rTMS treatment, and also were regularly and continuously administrated with antidepressant drug (escitalopram citalopram). The rTMS group were only given with rTMS for 2 weeks, and the patients of the drug treatment group were administrated with the same antidepressant. At the baseline and 2th week, the 17-item Hamilton depression scale (17-HAMD), Pittsburgh Sleep Quality Index (PSQI) and polysomnography (PSG) were evaluated. Results The sleep parameters, PSQI scores and HAMD scores among three groups had no significant difference at baseline. After 2 weeks, the overall difference of HAMD score reduction between different treatment groups was statistically significant (P<0.001). The HAMD score reduction in the drug treatment group was less than that in the rTMS group and the electric acupuncture combined rTMS group (P<0.05), and the HAMD score reduction in the electric acupuncture combined rTMS group was greater than that in the drug group and the rTMS group (P<0.05). The overall difference of PSQI score reduction between groups was significant (P<0.05). The PSQI score reduction value of electric acupuncture combined with rTMS group was greater than that of the drug group and the rTMS group (P<0.05), while there was no significant difference in the PSQI score reduction value between the drug group and the rTMS group (P<0.05). The overall difference of total sleep duration (F=16.735,P<0.001) and sleep efficiency(F=87.548,P<0.001) evalted by PSG among groups was significant. The changes of both the total sleep duration and sleep efficiency of electric acupuncture combined with rTMS group was greater than that of the drug group and the rTMS group (P<0.001), while there was no significant difference neither in the changes of total sleep duration nor sleep efficiency between the drug group and the rTMS group before and after treatment among the groups (P>0.05). Conclusion Electroacupuncture combined with rTMS treatment may improve the efficacy of depression, sleep quality, the total sleep duration and sleep efficiency of PSD, and the effect is better than that of the drug treatment group and the rTMS group, which reflects the synergic effect of electroacupuncture combined with rTMS on PSD treatment.

目的 初步探究针刺数量对小儿脑瘫肌张力及粗大运动功能的影响。方法 选取我院2017年1月—2019年11月接收的脑瘫患儿78例,以随机数表法分组,常规针刺组39例,采用一般治疗加常规针刺穴位;增穴针刺组39例,在常规针刺组治疗基础上增加13个穴位治疗。对比2组患儿三个疗程后的肌张力及粗大运动功能。结果 治疗三个疗程后,常规针刺组肌张力评分稍低于增穴针刺组,粗大运动功能量表(GMFM-88)评分稍低于增穴针刺组,但差异没有统计学意义(P＞0.05)。结论 针刺疗法可以有效辅助脑瘫患儿治疗,但是增多穴位不一定能明显改善患儿肌张力和粗大运动功能。

Objective To explore the effect of acupuncture quantity on muscle tension and gross motor function in children with cerebral palsy. Methods From January 2017 to November 2019, 78 children with cerebral palsy who were treated in our hospital were collected. 78 children with cerebral palsy were randomly divided into two groups. The conventional acupuncture group (39 cases) were treated with general treatment and conventional acupuncture points. And the more-needle acupuncture group (39 cases) were treated with adding another 13 more acupuncture points. Muscle tension and gross motor function were compared between the two groups after three courses of treatment. Results After three courses of treatment, the muscle tension score of the conventional acupuncture group was slightly lower than that of the more-needle acupuncture group, and the gross motor function scale (GMFM-88) score was slightly lower than that of the more-needle acupuncture group, but the difference was not statistically significant (P>0.05). Conclusion Acupuncture therapy can effectively assist the treatment of children with cerebral palsy, but increasing acupoints may not improve the muscle tension and gross motor function of children with cerebral palsy.

目的 分析基于中医针灸的康复训练对小儿脑瘫的临床疗效。方法 选择我院2016年2月—2017年3月接受治疗的脑瘫患儿88例,根据患儿入院接受疗法不同分为研究组(n=45)和对照组(n=43)。对照组给予康复训练治疗,研究组给予康复训练联合中医针灸治疗。比较两组患者治疗3个月后的临床效果,以及治疗前后粗大运动功能、生活质量评分变化。结果 治疗3个月后,研究组总有效率95.56 %明显高于对照组69.76 %(P<0.05);两组患儿粗大运动功能、生活质量、认知功能及自理动作评分均有提高,但研究组以上指标评分明显高于对照组(P<0.05)。结论 基于康复训练联合针灸干预脑瘫患儿可改善患儿粗大运动功能,提高患儿生活质量,效果显著。