目的:基于Logistic回归建立脑性瘫痪(cerebral palsy,CP)肝肾亏损证证候诊断模型.方法:选择郑州大学第三附属医院儿童康复科诊治的 CP 儿童 464 例作为研究对象,按照《中医儿科常见病诊疗指南》关于肝肾亏损证的中医辨证标准自制 CP 肝肾亏损证四诊信息采集表并判定肝肾亏损证是否成立,采用 Logistic回归分析四诊信息并建立肝肾亏损证证候诊断模型,通过 ROC 曲线进行诊断模型效能判定.结果:生齿落后、肢体僵硬、筋脉拘挛、关节屈伸不利、目无神采、舌质淡、脉沉细无力、指纹淡红 8 个证候是脑性瘫痪肝肾亏损证成立的相关因素.基于 Lo-gistic回归分析结果,构建 CP 肝肾亏损证诊断模型,预测函数模型 ROC 曲线下面积为 0.902,P＜0.001.该诊断模型的约登指数为 0.704,灵敏度为 87.6%,特异性为 82.8%.同样本验证的一致率为 84.6%.结论:基于Logistic回归建立的 CP 肝肾亏损证证候诊断模型具有良好的诊断效能和参考价值.

目的:探究低频重复经颅磁刺激联合智力训练对脑瘫伴智力障碍患儿智力发育水平、运动功能的影响.方法:选取2018年1月～2020年7月收治的107例脑瘫伴智力障碍患儿,根据随机数字表法分为对照组53例和观察组54例.对照组给予常规康复联合智力训练,观察组增加低频重复经颅磁刺激治疗,对比两组疗效.结果:观察组发育商、运动粗分、运动发育指数、总有效率均高于对照组,运动诱发电位潜伏期短于对照组,差异有统计学意义(P<0.05).结论:低频重复经颅磁刺激联合智力训练对脑瘫伴智力障碍患儿干预,可有效提升患儿智力水平、运动功能,提高大脑皮质运动区兴奋性,临床疗效较好.

Objective:To study the clinical effect of ketogenic diet (KD) for children with intellectual developmental disorder (IDD).Methods:One hundred and one children who met the research criteria and were treated at our hospital from January, 2018 to December, 2019 were enrolled into a control group ( n=48) and a treatment group ( n=53) with parental consent. Both groups took comprehensive rehabilitation training, and the treatment group took KD. Before and 3 and 6 months after the treatment, the clinical efficacies were evaluated by Wechsler Intelligence Scale for Children (C-WISC), Baby and Junior High School Students' Social Life Ability Scale (S-M scale), Height for Age Z Score (HAZ), and Weight for Age Z Score (WAZ). And the adverse reactions were recorded. Results:Six months after the treatment, the scores of language quotient (VIQ) and operation quotient (PIQ) of C-WISC in the treatment group were better than those in the control group [(44.75±13.68) vs. (44.45±13.56) and (54.05±12.66) vs. (52.43±13.89); both P＜0.05]; the total intelligence quotient (FIQ) score was improved 6 months after the treatment, but there was no statistical difference between the treatment and the control group [(50.16±14.87) vs. (50.21±15.24); P＞0.05]. The score of S-M scale was better in the treatment group than in the control group 6 months after the treatment [7 (6, 9) vs. 7 (6, 8); P＜0.05]. There were no statistical differences in the scores of HAZ and WAZ between the two groups [(－0.22±0.92) vs. (－0.08±0.89) and (－0.41±1.23) vs. (－0.29±1.20); both P＞0.05]. The incidence of KD adverse reactions was 20.75% (11/53) in the treatment group, but the adverse reactions gradually disappeared. Conclusions:KD can improve neurobehavioral development and living ability of IDD children and does not affect their growth and development.

目的:探讨针灸辅助语言训练对脑瘫语言障碍患儿适应性及语言评分的影响.方法:选取2017年1月～2018年6月收治的80例脑瘫语言障碍患儿作为研究对象,采用摸球法分为对照组和观察组,各40例.对照组进行语言训练,观察组进行针灸辅助语言训练,比较两组患儿的适应性及语言能力.结果:观察组总有效率为82.5％,高于对照组的62.5％,差异有统计学意义,P=0.045＜0.05;干预后,观察组的语言发育商评分和适应行为评分均高于对照组,差异有统计学意义,P＜0.05.结论:针灸辅助语言训练可提高脑瘫语言障碍患儿的适应性,并改善其语言功能.

Aim:To observe the effect of whole body vibration training on lower limb motor function in children aged 1~3 years with spastic cerebral palsy .Methods:Seventy-five children aged 1~3 years with spastic cerebral palsy were selected and randomly divided into the whole body vibration training group ( n=38 ) and conventional training group ( n=37 ) .The conventional training group received conventional physical therapy , paraffin therapy and neuromuscular electrical stimulation for twelve weeks .The whole body vibration training group received whole body vibration training on the basis of the conventional training for twelve weeks .The modified tardieu scale ( MTS) , the values in the passive state measured by surface electromyography ( sEMG) were used to evaluate the degree of spasticity in children before and after treatment .The 88-item version of the gross motor function measure (GMFM-88) and Berg balance scale(BBS) were respectively used to e-valuate the gross motor function and balance function before and after treatment .Results:Before treatment , there were no significant differences in MTS score , ankle joint angles R1 and R2 in MTS, the values in the passive state measured by sEMG, GMFM-88 score, BBS score between the two groups (P>0.05).After treatment, all the indexes were significantly improved in the whole body vibration training group compared with the conventional training group (P<0.05).Conclu-sion:Whole body vibration training can effectively relieve spasticity of lower limbs ,and improve gross motor and balance function in children aged 1~3 years with spastic cerebral palsy .