正交设计优化体外冲击波治疗脑瘫痉挛的效果

IF 3.1 4区医学 Q2 CLINICAL NEUROLOGY Journal of Neurorestoratology Pub Date : 2022-06-01 DOI:10.1016/j.jnrt.2022.100004

Chuntao Zhang, Jixiang Cheng, Wenjian Zhao, Zhenhuan Liu, Xuguang Qian, Yong Zhao, Bingxu Jin, Yuan Zhou

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引用次数: 0

摘要

目的采用正交设计法研究体外冲击波不同治疗参数对脑瘫患儿痉挛的影响及其量效关系，筛选出临床疗效最佳的参数方案。方法于2020年3月~ 12月将80例痉挛性脑瘫患儿随机分为8组，每组10例。各组患者接受不同波强度(A)、波频率(B)、冲击次数(C)和治疗频率(D)的ESW，采用4因素2水平正交设计确定。在研究前后分别对改良Ashworth量表(MAS)和GMFM进行评分，计算研究期间的差异，评价各组的表现。结果ΔMAS的r值为RA >RD祝辞RC祝辞RB和ΔGMFM分别为RA >RC祝辞RD祝辞RB。两个层次对各因子的影响分别为A1 >A2, B2 >B1, C2 >C1, D2 >D1。经方差分析，因子A、C、D差异有统计学意义(P <0.05)。ESW治疗脑瘫痉挛的最佳组合参数为1.5 bar, 10 Hz, 2000次，每周2次。结论电休克是治疗痉挛性脑瘫的有效方法，值得临床推广应用。

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Optimizing extracorporeal shock wave with the orthogonal array design in the treatment of the spasticity of cerebral palsy

Objective

To study the dose-response relationship between different treatment parameters of extracorporeal shock wave (ESW) and their effects on spasticity in children with cerebral palsy by the orthogonal design and to select the best parameter scheme for clinical efficacy.

Methods

From March 2020 to December 2020, 80 children with spastic cerebral palsy were randomly divided into eight groups of 10 cases. Patients in each group received ESW with varying wave intensities (A), wave frequencies (B), number of shocks (C), and treatment frequencies (D), which were determined by a 4-factor-2-level orthogonal array design. Modified Ashworth Scale (MAS) and GMFM were scored before and after the study, and the difference during the study was calculated to evaluate the performance of each group.

Results

The R-value of ΔMAS was RA > RD > RC > RB and that of ΔGMFM was RA > RC > RD > RB. The influence of the two levels for each factor was A1 > A2, B2 > B1, C2 > C1, D2 > D1. By the analysis of variance, the differences in factors A, C, and D were statistically significant (P < 0.05). The optimal combination of ESW treatment parameters for the spasticity of cerebral palsy was 1.5 bar, 10 Hz, 2000 times, and twice a week.