Objective: To observe the effect of acupuncture combined with rehabilitation training on cognitive function and amino acid metabolism in children with cerebral palsy.
Methods: Twenty children with cerebral palsy (cerebral palsy group) were randomly divided into an acupuncture and rehabilitation group (11 cases) and a rehabilitation group (9 cases), and 10 healthy children were included as the normal group. The rehabilitation group was treated with rehabilitation training, 30 min each time; on the basis of rehabilitation training, the acupuncture and rehabilitation group was treated with acupuncture at Sishenzhen, Zhisanzhen, Naosanzhen, Niesanzhen, Dazhui (GV 14), Shenzhu (GV 12), Mingmen (GV 4), etc. The Sishenzhen (left and right points) and the ipsilateral Niesanzhen were respectively connected with a group of electrodes, intermittent wave, frequency of 2 Hz for 30 min. Both groups were treated once every other day, three times a week, totaling for 3 months. The Gesell developmental diagnostic scale (GESELL) was used to evaluate the developmental quotient (DQ) scores before and after treatment, and the blood samples of children with cerebral palsy before and after treatment and normal children were collected for amino acid metabolomics.
Results: Compared before treatment, the DQ scores of adaptation, fine motor and social in the acupuncture and rehabilitation group was increased after treatment (P<0.05), and the DQ score of fine motor in the rehabilitation group was increased after treatment (P<0.05). Compared with the normal group, the serum L-glutamate, L-ornithine, L-tyrosine, L-methionine and L-arginine in the cerebral palsy group were down-regulated, and L-histidine, L-citrulline, 5-hydroxylysine and L-glutamine were up-regulated before treatment. The functional pathways mapped by different metabolites between the cerebral palsy group and the normal group included arginine biosynthesis, arginine and proline metabolism, etc. Compared with the cerebral palsy group, the serum L-histidine was decreased, and L-citrulline showed decreasing trend in the acupuncture and rehabilitation group after treatment.
Conclusion: Acupuncture combined with rehabilitation training could improve cognitive function in children with cerebral palsy, and the effect may be related to the down-regulation of L-histidine and L-citrulline metabolism.
目的：观察针刺联合康复训练对脑瘫患儿认知功能和氨基酸代谢的影响。方法：将20例脑瘫患儿（脑瘫组）随机分为针刺康复组（11例）和康复组（9例），并纳入10例健康儿童作为正常组。康复组采用康复训练，每次训练30 min；针刺康复组在康复训练的基础上采用针刺治疗，穴取四神针、智三针、脑三针、颞三针、大椎、身柱、命门等，其中四神针（左右两穴）和同侧颞三针各连接一组电极，断续波，频率2 Hz，留针30 min，两组均隔日治疗1次，每周治疗3次，共治疗3个月。分别于治疗前后采用格塞尔发育诊断量表（GESELL）评估两组脑瘫患儿发育商（DQ）评分，并采集两组脑瘫患儿治疗前后及正常组儿童入组时血液样本进行氨基酸代谢组学检测。结果：与治疗前比较，针刺康复组患儿治疗后适应性、精细动作、个人社交DQ评分升高（P<0.05），康复组患儿治疗后精细动作DQ评分升高（P<0.05）。与正常组比较，脑瘫组患儿治疗前血清L-谷氨酸、L-鸟氨酸、L-酪氨酸、L-蛋氨酸和L-精氨酸下调，L-组氨酸、L-瓜氨酸、5-羟赖氨酸、L-谷氨酰胺上调，脑瘫组与正常组差异代谢物所映射的功能通路包括精氨酸生物合成、精氨酸和脯氨酸代谢等。与脑瘫组比较，针刺康复组患儿治疗后血清L-组氨酸下调，且L-瓜氨酸有下调趋势。结论：针刺联合康复训练可改善脑瘫患儿认知功能，其效应可能与下调L-组氨酸、L-瓜氨酸代谢有关。.
Keywords: acupuncture; amino acid metabolism; cerebral palsy; rehabilitation training.