針灸處置腦性麻痺患者之療效評估之研究

The Evaluation Of Acupuncture Therapy Toward Cerebral Palsy

林新杰(Hsin-Chieh Lin)

指導教授 ： 蔡金川

義守大學/醫學院/學士後中醫學系/碩士(2018年)

摘要

腦性麻痺，主要指腦部的動作控制區域，曾經在懷孕時、出生後、或生產時受到傷害，屬於非進行性的腦病變。患者因此造成運動功能障礙，症狀隨著年齡持續惡化。腦性麻痺患者會有感官之發展及平衡力不佳、智能、認知能力與語言能力及學習能力等缺損。中醫典籍所記載「五遲」、「五軟」、「五硬」等描述，屬於腦性麻痺的範疇。針灸的治療思維與經絡系統中肝、脾、腎經密切相關。中醫針灸臨床常用於腦性麻痺患者之治療，並可以改善患者的日常生活活動能力。 本研究結果，腦性麻痺患者介入針灸後，尿液中之神經滋養因子(brain-derived neurotrophic factor)BDNF濃度有顯著提升。並以「粗動作功能評估量表」( Gross Motor Function Measure-GMFM)做為治療前後之評估工具，藉以評估針灸治療腦性麻痺的療效差異。依據評估結果，尿液中BDNF濃度越高，患者粗動作功能進展越佳。建議針灸治療後為介入復健的黃金時期，應立即進行復健。配合肢體的復健、強化肌群，開啟一連串的肢體學習進而建構各種能力。此研究除了能對腦性麻痺患者未來發展有所幫助，進而能有效提高醫療資源利用及減輕照顧者之負擔。

關鍵字

腦性麻痺 ； 中醫 ； 針灸 ； 神經滋養因子

並列摘要

Cerebral palsy (CP), a kind of non-progressive encephalopathy, mainly refers to brain damage in the motor control region of a fetal during pregnancy or perinatal period. The affected patient has motor function disability and the symptoms aggravate with age. Patients with CP will have disturbances in sensory development and balance state, and impairment in intellect, cognition , verbal and learning abilities. The terms such as “five delay”, “five flaccidity” and “five stiffness” recorded in the ancient books of traditional Chinese medicine are attributed to disorders of CP.
The concept of acupuncture treatment on CP is highly associated with liver, spleen and kidney in the meridian system. Acupuncture is a clinical treatment applied in patients with CP and it can promote their motor function in daily life.
The investigation suggest that acupuncture significantly up-regulated BDNF levels in urine. According to the results, it is recommended that after the acupuncture treatment, rehabilitation should be carried out immediately. Cooperate with the rehabilitation of the limbs, strengthen the muscles, and start a series of limb learning to construct various abilities. In addition to helping the future development of patients with cerebral palsy, this study can effectively improve the utilization of medical resources and reduce the burden on caregivers.

並列關鍵字

Cerebral Palsy ； Traditional Chinese Medicine(TCM) ； Acupuncture ； Brain-Derived Neurotrophic Factor (BDNF)

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