CP sample TX

[Guest guest]

(This seems a reasonable Ac TX approach, any other comments from

group who I am sure have helped those w this condition, would be

greatly appreciated. As my patient is not an infant or adolescent,

more time will be needed, and I definitely agree with daily or every

two day treatments.)

 

Penetration Needling for Child Cerebral Palsy

by Wei Yuxiang, Lu Shenglu and Wang Xingwu

 

Abstract This study is designed to observe the therapeutic effect of

penetrating needling Sishencong (EX-HN 1) through to Baihui (GV 20),

etc.. A total of 100 cases of infantile cerebral palsy were divided

into acupuncture group (n = 50) and control group (n = 50, oral

administration of cerebrolysin). After 3-4 courses of treatment,

results showed that the total effective rates of acupuncture group

and control group were 84.0% and 48.0 % respectively. Comparison

between two groups in the effective rate showed a significant

difference (P< 0.05), suggesting that the therapeutic effect of

acupuncture stimulation is superior to that of western medicine in

treatment of child cerebral palsy.

Key Words Child cerebral palsy Acupuncture therapy Sishencong through

to Baihui

 

Child cerebral palsy (CCP) is a non-progressive cerebral injury-

induced syndrome occurring within a month from pre-birth to

postbirth, manifested mainly by central neurogenic dyskinesia and

abnormal posture, disturbance of vision, audition, speech and

intelligence, and epileptic attack. It seriously endangers children's

mental and physical health and often results in permanent disability.

Up to now, there have not yet been any special therapeutic

approaches. In recent years, the authors adopted penetration needling

and moxibustion to treat CCP and achieved satisfactory results.

 

(* in TCM mother's exposure to funerals(death) or overly celebrating,

may shock fetus -'red and black'?- in 3rd month and later. also,

child abuse is so common worldwide, an estimated up to 80% of adult

population in some areas, that it may be a major factor in many

diseases, esp in developmental afflictions as K qi and essence is

obstructed. marrow and pre and post heaven qi, yuan qi and )

(additional causes: The causes of cerebral palsy include illness

during pregnancy, premature delivery, or lack of oxygen supply to the

baby; or it may occur early in life as a result of an accident, lead

poisoning, viral infection, child abuse, or other factors. Chief

among the causes is an insufficient amount of oxygen or poor flow of

blood reaching the fetal or newborn brain. This can be caused by

premature separation of the placenta, an awkward birth position,

labor that goes on too long or is too abrupt, or interference with

the umbilical cord. Other causes may be associated with premature

birth, RH or A-B-O blood type incompatibility between parents,

infection of the mother with German measles or other viral diseases

in early pregnancy, and micro-organisms that attack the newborn's

central nervous system. Lack of good prenatal care may also be a

factor. A less common type is acquired cerebral palsy: head injury is

the most frequent cause, usually the result of motor vehicle

accidents, falls, or child abuse.)

 

General Data

1. All 100 cases of CCP corresponded with the Standards for Diagnosis

and Typing formulated by the National Conference of Cerebral Palsy in

July of 1987. Among them, 56 were male and 44 female, ranging in age

from 6 months to 14 years. The longest duration of disease was 14

years and the shortest 6 months. The longest duration of treatment

was 10 months and the shortest 3 months. CT examination displayed

that 26 cases had not any marked abnormal changes and 74 cases had

clear pathologic changes including 17 cases of cerebral white matter

malacia, 19 cases of cerebral atrophy, 21 cases of enlargement of the

brain ventricle, 2 cases of disturbance of myelinogeny, 10 cases of

porencephaly and defect of trabs, 4 cases of hydrocephalus and 1 case

of cerebral hemorrhage.

2. Typing of Cerebral Palsy.

If the limbs were limited in movement, with the motor ability being

50-59 points (I.e., the myodynamia was below IV grades), it was

considered as mild palsy; if the motor ability was 36-49 points (the

myodynamia was III), it was considered as moderate palsy; when the

motor ability was 20-35 points (myodynamiawas I-II+), it was

considered as severe palsy: and when the motor ability was 0-19

points (the myodynamia was 0-I), it was considered as extremely

severe palsy.

3. Typing of Hypophrenia

If being 50 -- 59 points in the intelligence, it was considered as

mild palsy, if being 36 –49 points, it was considered as moderate

palsy and if being 20-35 points, it was considered as serious palsy.

 

Methods

1. Acupuncture Group

According to the different state of disease, chose different needling

depth and stimulating strength. In treatment palsy children with

hypophrenia and salivation, a filiform needle was inserted into front

Shencong with the needle tip being toward the face part, and those

inserted in other three Shencong with the needles penetrated from

Shencong to Baihui (GV 20). For palsy of the lower limbs, 4 needles

were inserted into Sishencong (EX-HN 1) respectively, with the needle

tips toward the back part of the head and about 1 cun in depth. For

strabismus, the needles were inserted into the four acupoints to a

depth of about 0.5-1.0 cun, generally 1.0 cun, and manipulated with

uniform reducing and reinforcing method.

Adjunct acupoints: 1). Guangming (GB 37) was supplemented for

strabismus; Chengjiang (CV 24) added for salivation; and Yamen (GV15)

added for slurred speech; 2). For serious dyskinesia of the upper

limbs, flexion of the forearms with disturbance of supine movement,

adduction of the thumb and other four chick-claw-like fingers with

dysfunction in adduction and stretching, Quchi ((LI 11), Shousanli

(LI10), Houxi (SI 3), Hegu (LI 4) and Neiguan (PC 6) were taken

respectively along the axillary nerve, musculo-cutaneous nerve,

median nerve, ulnar nerve, radial nerve and according to Large

Intestine Meridian of Hand Yangming, Small Intestine Meridian of Hand

Taiyang and Sanjiao Meridian of Hand Shaoyang ; 3). For adductor

spasm of the lower limb, disturbance of the knee in flexion and

stretching, scissors-like legs with the toes touching down the

ground, Yanglingquan (GB 34), Zusanli (ST 36 ), Juegu (GB 39 ),

Zhongfeng (LR 4), Taixi (KI 3) and Taichong (LR 3) were taken along

the femoral nerve, obturator nerve, sciatic nerve, common peroneal

nerve, and tibial nerve, and according to Liver Meridian of Foot-

Jueyin, Spleen Meridian of Foot Taiyin, Kidney Meridian of Foot

Shaoyin, Stomach Meridian of Foot Yangming and Gallbladder Meridian

of Foot Shaoyang. These acupoints were needled, once every day, with

the needles being retained generally for 30 min and in combination

with moxibustion of Qihai (CV 6), Yaoyangguan(GV 3 ), Shenshu' (BL

23 ) and Shenzhu (GV12). Thirty days formed a therapeutic course and

the interval between two courses was 10 days. Generally, these

patients were treated continuously for 4 courses.

2. Control Group

The control group was made up of 50 cases. They were treated with

intravenous drip of normal saline, with Cerebrolysin 5-0 ml, 10 days

being a therapeutic course. 3-4 courses were conducted continuously.

 

Standards for Evaluating the Therapeutic Effect

 

Cured: Clinical symptoms and signs disappeared basically, and the

patients could take care of themselves in daily life. Markedly

effective: Clinical symptoms and signs improved strikingly, the

patient could hold something with hands, stood and walk. Effective:

Clinical symptoms and signs improved but myodynamia of the four limbs

had no significant improvement and the patient could not walk.

Ineffective: After 3 – 4 courses of treatment, clinical symptoms had

no any significant changes.

 

Results

 

Table 1. Typing of Cerebral Palsy and the Therapeutic Effect of the

Acupuncture Group

 

Typing Cases Cured Markedly effective Effective Ineffective Total

effective rate

 

Spasm 19 3 9 7 0 100

Mixture 14 2 5 3 4 71.4

Athetosis 10 0 5 3 2 80.0

Athelen-cephalia 7 0 3 2 2 71.4

Total 50 5 22 15 8 84.0

 

 

 

Table 2. Typing and the Therapeutic Effect of the Control Group

 

Typing Cases Cured Markedly effective Effective Ineffective Total

effective rate

 

Spasm 19 0 4 5 10 47.4

Mixture 15 0 3 4 8 46.7

Athetosis 10 0 2 3 5 50.0

Athelen-cephalia 6 o 2 1 3 50.0

Total 50 0 11 13 26 48.0

 

 

From Table 1, it can be seen that, the therapeutic effect of

acupuncture for spasm type of cerebral palsy is the best while that

for atelencephalia is poorer and the total effective rate is 84%; in

control group, the therapeutic effect for spasm type and mixture type

is poorer and the total effective rate is 48%. Comparison between two

groups in the therapeutic effect showed X2 = 14. 44, P < 0. 05,

meaning that the effect of acupuncture is significantly superior to

that of cerebrolysin in treatment of cerebral palsy.

 

A Typical Case

 

Xue, a boy of two and a half years old, visited our hospital on May

21st, 1996. His mother complained that when she gave birth to her

child, due to difficult labor, this child experienced severe asphyxia

for 10 min. Through emergency treatment, he was out of danger. When

he was six months old his parents found their baby being abnormal in

behavior, and it was diagnosed as cerebral palsy. Examination showed

that the baby had a poor reaction, slurred speech (only could speak a

single word),salivation, inability to sit, his head being unable to

control, severe dyskinesia of the left arm, his upper arm being

unable to lift externally and horizontally, his forearm being unable

to make flexion and supine movement, his wrist presenting flexion and

abduction, adduction of the thumb and the other fingers being chick-

claw-like; his left arm being grade 11 and right arm being grade IV

in myodynamia, weak waist and his pelvis being poor in stability.

When he stood up with help, his legs were scissors-like with the tips

of toes touching down the floor. The myodynamia of his two legs was

grade II, the Babinski's reflex was positive with a hyper-reflex of

the knee, CT examination showed cerebral atrophy and enlargement of

the brain ventricle. It was disgnosed as spasmodic cerebral palsy.

Differentiation of syndromes of TCM: Yin-deficiency of both liver and

kidney and malnutrition of the brain. Therapeutic principles:

tonifying the kidney, strengthening the brain and promoting

production of brain marrow. He was treated by using penetration

needling from Sishencong (EX-HN 1) through Baihui (GV 20), Yamen (GV

15), Chengjiang (CV 24), Taixi (KI 3, stimulated with reinforcing

manipulation), Taicong (LR 3, stimulated with reducing manipulation),

in combination with moxibustion at Qihai (CV 6), Quchi (LI 11 ),

Houxi (SI 3),Yaoyangguan (GV 3), Shenshu (BL 23 ) and Shenzhu (GV

12). After two courses of treatment, his symptoms bettered obviously,

including improvement of head control and restricted movement of the

left upper limb and cease of salivation, he could hold things on his

own initiative. After 4 courses of treatment, his scissors-like legs

ameliorated and after 6 courses of treatment, he could get down from

bed and walk forward more than 10 steps. Cerebral CT examination had

not any positive signs.

 

Discussion

 

1) Sishencong (EX-HN 1) belongs to extra-ordinary acupoints located

at the central crossing points of the vertex, the front and the back

points are located on the track of Dumai (Du meridian) and the left

and right points are near the track of Bladder Meridian. Combination

of Baihui (GV20) and other acupoints of the three Yang meridians of

the foot can function in dredging and regulating all Yang-Qi of the

body.

2). CCP is attributed to the category of flaccidity syndrome in

traditional Chinese medicine. It often results from congenital

defect, or deficiency of the liver, spleen and kidney and blockage of

blood stasis in the interior of the body. The focus is located in the

brain. In the light of the theory of traditional Chinese medicine,

the brain is the convergence place of Qi and blood of Zang and Fu

organs and meridians which are closely interrelated in physiological

activities and affected each other in pathological changes. In this

study, penetration needling of Sishencon (EX-HN 1) through Baihui (GV

20) was used for replenishing essence and brain marrow, nourishing

the kidney and liver, dredging meridians, promoting circulation of Qi

and blood, improving blood supply of the cerebral tissue, thus,

clinical symptoms and signs were ameliorated clearly.