| ObjectiveTo observe the effect of selective spinal tuina on swallowing disorders in children with spastic cerebral palsy,and to explore its possible mechanism,so as to provide reference for the further optimization of rehabilitation programs of traditional Chinese medicine for swallowing disorders in children with spastic cerebral palsy.MethodsFifty-six children with spastic cerebral palsy dysphagia who met the inclusion criteria were randomly divided into test group(n = 28)and control group(n = 28).During the trial,due to personal reasons of the parents of the children,2 cases in each group were dropped out,so 52 cases were actually included,26 cases in the test group and 26 cases in the control group.Both groups were treated with the same feeding guidance,nursing methods and routine rehabilitation treatment.The control group was treated with swallowing training,and the experimental group was treated with selective spinal tuina therapy on the basis of the control group.The basic swallowing training was the same in the two groups,basic swallowing training once a day,30-40 minutes each time,5 times a week,tuina once every other day,30 minutes each time,3 times a week,a total of 12 weeks of treatment.The children in the two groups were evaluated before treatment and after treatment respectively on the first day of their height and weight is measured by the professional assessment of physicians,and swallowing function was evaluated by dysphagia disorder survey(DDS),gross motor function was evaluated by gross motor function measure(GMFM-88),TCM syndrome was evaluated by TCM syndrome score of spastic cerebral palsy,using Fotric226 s medical infrared thermal imager to collect the children mouth-face region,submandibular infrared thermal imaging figure,Analyz IR software was used to analyze the infrared temperature of Jiache,Chengjing and Lianquan acupoints in the collected infrared thermogram,Excel software was used to record the original data,and IBMSPSS 26.0 software was used for statistical analysis of the data.Result1.Comparison of general conditionsThere were no statistically significant differences in gender,age,weight and height between the treatment group and the control group before treatment(P>0.05),indicating comparability.After the treatment,the average body weight of the trial group was(12.36±2.24)kg compared with that before therapy(11.88±2.20)kg,and the average body weight of the control group was(12.25±2.50)kg compared with that before therapy(11.90±2.47)kg,with statistically differences(P<0.05).The average height of the treatment group was(88.63±7.49)cm compared with that before therapy(88.09±7.48)cm,and the average height of the control group was(89.70±8.18)cm compared with that before therapy(89.15±8.20)cm,with statistical difference(P<0.05).Comparing weight and height increase between the trial group and the control group,there was no statistically significant difference(P>0.05).2.Comparison of swallowing functionsThere was no statistically significant differences in the total score of DDS,oral stage score and pharyngeal stage score between the test group and the control group before treatment(P>0.05),indicating comparability.After the treatment,the total score of DDS in experimental group was(5.26±2.82)compared with that before therapy(10.30±3.64),and the oral stage score of experimental group was(4.61±2.19)compared with that before treatment(9.19±2.53),and the pharyngeal score of experimental group was(0.65±0.89)compared with that before therapy(1.11±1.30),with statistical difference(P<0.05).The total score of DDS in the control group was(7.76±3.62)compared with that before therapy(10.42±3.98),and the oral stage score of the control group was(6.80±2.74)compared with that before treatment(9.26±3.01),and the pharyngeal score of the control group was(0.96±1.21)compared with that before treatment(1.11±1.42),with statistical difference(P<0.05).Compared with the control group,the total score of DDS and oral stage score in the experimental group were significantly lower than those in the control group,with significant differences(P<0.05).There was no statistically significant difference in pharyngeal score between the two groups(P>0.05).3.Comparison of gross motor functionThere was no statistical difference in GMFM-88 score between the trial group and the control group before treatment(P>0.05),indicating comparability.End of the treatment,the score of the experimental group was(91.15±52.61)compared with that before treatment(83.15±53.12),and the score of control group was(86.19±48.94)compared with that before treatment(81.92±47.84),with statistically differences(P<0.05).There was no statistically significant difference in GMFM-88 scores between the two groups(P>0.05).4.Comparison of TCM syndromesThere was no statistical difference when compared with TCM syndrome scores between the trial group and the control group before treatment(P>0.05),indicating comparability.After treatment,the score of the trial group was(40.34±4.07)compared with that before treatment(37.23±4.76),and the score of the control group was(37.03±4.61)compared with that before treatment(35.11±3.94),with statistically differences(P<0.05).The comparison of TCM syndromes scores between the two groups showed that the improvement of TCM syndromes in the experimental group was better than that in the control group,with a statistically significant difference(P<0.05).5.Comparison of acupoints area infrared temperatureBefore treatment,there was no statistical difference in infrared temperature of the Jiache,Chengjing and Lianquan acupoints between the two groups(P>0.05).After the course of treatment,there were statistical differences in the temperature of the Jiache,Chengjing and Lianquan acupoints in the experimental group before treatment(P<0.05).In the control group,there were statistical differences in the temperature of Jiache and Lianquan acupoints before treatment(P<0.05),while there were no statistical differences in the temperature of Chengjing acupoints before treatment(P>0.05).The temperature rise of each acupoint area in the test group was better than that in the control group,and the difference was statistically significant(P<0.05).Conclusion1.Selective spinal tuina and basic swallowing training can improve the swallowing function of children and the overall condition of TCM syndromes and further improve the overall disease resistance and rehabilitation ability of children.2.Selective spinal tuina and basic swallowing training can both improve the gross motor function of children,but selective spinal tuina group has more obvious advantage in improving gross motor function.3.The mechanism of selective spinal tuina in improving swallowing disorders in children with spastic cerebral palsy may be related to the temperature increase of Jiache,Chengjing and Lianquan acupoints,but the correlation between the two relevance needs to be further studied. |
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