Effect of acupuncture combined with repetitive transcranial magnetic stimulation on motor function and cerebral hemodynamics in children with spastic cerebral palsy with spleen-kidney deficiency / 针刺研究

ABSTRACT

OBJECTIVE: To investigate the clinical effect of acupuncture combined with repetitive transcranial magnetic stimulation in the treatment of children with spastic cerebral palsy with spleen-kidney deficiency, as well as its effect in improving cerebral hemodynamics. METHODS: A total of 220 children with spastic cerebral palsy were divided into observation group and control group using a random number table, with 110 children in each group. The children in the control group were given rehabilitation training and repetitive transcranial magnetic stimulation, and those in the observation group were given acupuncture in addition to the treatment in the control group. Acupuncture was performed at Zusanli (ST36), Xuanzhong (GB39), Sanyinjiao (SP6), Pishu (BL20), Shenshu (BL23), Qihai (CV6), Quchi (LI11), Neiguan (PC6), Hegu (LI4) and Tianshu (ST25) once every other day, three times a week for 3 consecutive months. The two groups were compared in terms of Gross Motor Function Measure (GMFM), Fine Motor Function Measure (FMFM), comprehensive function score for children with cerebral palsy, clinical outcome, and related cerebral hemodynamic parameters (mean blood flow velocity [Vm], systolic peak velocity [Vs], and resistance index [RI] of the cerebral artery). RESULTS: After treatment, both groups had significant increases in the scores of GMFM, FMFM and comprehensive function (cognitive function, speech function, motor ability, self-care, and social adaptability,P<0.01), and the observation group had significantly better improvements in the scores of GMFM (domains A, B and C), FMFM (domains B, C, D and E), and comprehensive function than those of the control group (P<0.01). The therapeutic effect of the observation group (93/110, 84.55%)was superior to that of the control group (80/110, 72.73%, P<0.05). The observation group had significantly higher Vs and Vm and a significantly lower RI than the control group (P<0.01). CONCLUSION: In the treatment of children with spasmodic cerebral palsy with spleen-kidney deficiency, acupuncture combined with repeated transcranial magnetic stimulation can significantly improve their motor function, comprehensive function, and clinical outcome, which may be associated with the regulation of cerebral hemodynamics.