“靳三针”针法与认知功能训练辅助经颅直流电刺激对发育迟缓患儿的临床疗效

Clinical efficacy of "Jin's Three-Needle Therapy" combined with cognitive function training-aided transcranial direct current stimulation in children with developmental delay

摘要

目的 观察“靳三针”针法与认知功能训练辅助经颅直流电刺激（tDCS）用于发育迟缓患儿的临床疗效。方法 回顾性分析2021年6月至2025年6月驻马店市第一人民医院收治的发育迟缓患儿84例。根据是否接受“靳三针”针法治疗将84例患儿分为观察组45例和对照组39例。对照组患儿接受认知功能训练和tDCS干预, 观察组在对照组治疗基础上采用“靳三针”针法, 两组均连续干预3个月。干预前后采用Gesell发育量表评估两组患儿智力水平, 采用粗大运动发育量表（GMFM-88）与Peabody精细运动发育量表（PDMS-FM）评估运动功能, 采用酶联免疫吸附试验法检测血清学指标水平, 记录不良反应发生率。结果 干预后观察组智力水平优于对照组, 差异有统计学意义（P<0.05）。干预后两组GMFM-88和PDMS-FM评分、血清脑源性神经营养因子（BDNF）与神经生长因子（NGF）水平较干预前均显著升高, 且干预后观察组各评分高于对照组, 差异均有统计学意义（P<0.05）。两组不良反应发生率比较差异无统计学意义（P>0.05）。结论 “靳三针”针法与认知功能训练, 辅助tDCS用于肝肾亏虚证发育迟缓患儿具有一定疗效, 有助于促进智力发育, 改善运动功能。

Abstract

Objective To observe the clinical efficacy of "Jin's Three-Needle Therapy" combined with cognitive function training-aided transcranial direct current stimulation (tDCS) in children with developmental delay. Methods A retrospective analysis was performed on 84 children with developmental delay admitted to Zhumadian First People's Hospital from June 2021 to June 2025. According to whether they received "Jin's Three-Needle Therapy" or not, the 84 children were divided into observation group ( n=45) and control group (n=39). The children in the control group received cognitive function training and tDCS intervention, while children in the observation group were additionally treated with "Jin's Three-Needle Therapy" on the basis of the control group's regimen; the two groups received continuous intervention for 3 months. The Gesell Developmental Scale was used to assess the intellectual level of children in the two groups before and after intervention, the Gross Motor Function Measure-88 (GMFM-88) and Peabody Developmental Motor Scales-Fine Motor (PDMS-FM) were adopted to evaluate motor function, and the enzyme-linked immunosorbent assay was used to detect the levels of serological indicators. The incidence of adverse reactions was recorded. Results After intervention, the intellectual level in the observation group was superior to that of the control group, and the difference was statistically significant (P<0.05). After intervention, the GMFM-88 and PDMS-FM scores, as well as serum levels of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF), were significantly increased compared with those before intervention in the two groups. Moreover, all scores in the observation group were higher than those in the control group after intervention, with statistically significant differences (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion The "Jin's Three-Needle Therapy" combined with cognitive function training as an adjunct to tDCS yields certain therapeutic effects on children with developmental delay of liver-kidney deficiency syndrome, which helps promote intellectual development and improve motor function.

关键词

发育迟缓 / 肝肾亏虚证 / 靳三针针法 / 认知功能训练 / 经颅直流电刺激

Key words

Developmental delay / Liver-kidney deficiency syndrome / Jin's Three-Needle Therapy / Cognitive function training / Transcranial direct current stimulation

参考文献

[1] 孙艳会, 李杨方. 儿童语言发育迟缓临床特征及诊治研究进展[J]. 中国儿童保健杂志, 2024, 32 (9): 999-1003.

[2] 王苗, 程艳丽, 卜兆丽. 经颅直流电刺激对发育迟缓的疗效观察[J]. 贵州医药, 2023, 47 (2): 192-193.

[3] 张玲, 刘月余, 黄凤舞, 等. 经颅直流电刺激配合听觉统合训练治疗语言发育迟缓的临床研究[J]. 中国医药导报, 2023, 20 (11): 98-101.

[4] DeBaun MR, Jordan LC, King AA, et al. American Society of Hematology 2020 guidelines for sickle cell disease: prevention, diagnosis, and treatment of cerebrovascular disease in children and adults[J]. Blood Adv, 2020, 4 (8): 1554-1588.

[5] 吐鲁娜依·万力, 李金贤, 阿依努尔·努尔买买提. 靳三针联合水中运动对精神发育迟缓患儿脑电活动和认知发育的影响[J]. 临床误诊误治, 2025, 38 (16): 101-105.

[6] 李美晨, 庄礼兴. 靳三针调神针法治疗神志病[J]. 中医杂志, 2022, 63 (24): 2388-2392.

[7] 国家儿童医学中心, 首都医科大学附属北京儿童医院保健中心, 北京市儿科专业质量控制和改进中心, 等. 中国全面发育迟缓诊断指南[J]. 中华实用儿科临床杂志, 2024, 39 (7): 481-489.

[8] 汪受传, 虞坚尔. 中医儿科学[M]. 北京： 中国中医药出版社, 2021： 156-160.

[9] 梁静, 王朝晖. S—S语言发育迟缓评价法与Gesell发育评估量表在幼儿语言评定应用中的对比[J]. 中国儿童保健杂志, 2017, 25 (5): 514-516.

[10] 史惟, 朱默, 翟淳, 等. 基于ICF—CY的脑瘫粗大运动功能测试量表内容效度分析[J]. 中国康复理论与实践, 2013, 19 (1): 13-18.

[11] 王军, 陈静, 朱登纳, 等. 中文版上肢技巧质量量表在脑性瘫痪患儿上肢功能评定中的信度和效度[J]. 中国康复医学杂志, 2016, 31 (1): 41-44.

[12] Metzler M, Vesoulis ZA, Wambach JA. Profiling the developmental signatures of genetic global developmental delay[J]. Pediatr Res, 2025, 98 (5): 1625-1626.

[13] Sabeh P, Dumas SA, Maios C, et al. Heterozygous UBR5 variants result in a neurodevelopmental syndrome with developmental delay, autism, and intellectual disability[J]. Am J Hum Genet, 2025, 112 (1): 75-86.

[14] 贾蓉, 岳玲, 崔玲玉, 等. 全面性发育迟缓患儿中胼胝体发育不良的临床特征分析[J]. 河北医科大学学报, 2025, 46 (11): 1348-1353.

[15] 王娟, 张倩. 感觉统合训练联合言语—认知功能训练治疗儿童语言发育迟缓效果观察[J]. 中华养生保健, 2025, 43 (3): 152-155.

[16] 张茜, 代欣, 贺媛, 等. 经颅直流电刺激对儿童语言发育迟缓的应用研究[J]. 河北医药, 2020, 42 (3): 437-440.

[17] 朱景维, 刘鹏民, 贾倩芳, 等. 经颅直流电刺激联合针灸治疗儿童语言发育迟缓的效果[J]. 临床研究, 2025, 33 (5): 111-114.

[18] 李园, 王婧, 张梦洁, 等. 基于变蒸学说探析儿童神经发育障碍性疾病因机证治[J]. 江苏中医药, 2026, 58 (5): 50-53.

[19] 刘诗贤, 朱美俊, 李云. 靳三针结合低频重复经颅磁刺激对痉挛型脑性瘫痪患儿睡眠障碍及脑电活动的影响[J]. 中国针灸, 2024, 44 (11): 1267-1272.

[20] 胡怡佳, 黄任秀, 张靖, 等. 靳三针联合应用行为分析对改善低功能孤独症儿童整体发育水平的影响[J]. 上海针灸杂志, 2022, 41 (8): 807-811.

[21] 王毓婷, 李美晨, 李柯谊, 等. 规范化靳三针治疗脑卒中:随机对照试验[J]. 中国针灸, 2023, 43 (1): 9-13.

[22] 周海荣, 吴文英, 李锦嫦, 等. 靳三针联合重复经颅磁刺激对精神发育迟缓患者认知发育及脑电活动的影响[J]. 上海针灸杂志, 2020, 39 (10): 1274-1279.

[23] 张萌芮, 梁超, 张燕珍, 等. 靳三针对卒中后遗症患者中医证候积分及脑血管阻力、颈动脉IMT值的影响[J]. 中华中医药学刊, 2023, 41 (2): 93-96.

[24] 邵宪花, 孙刚, 鲍利利. 靳三针结合鼠神经生长因子治疗全面性发育迟缓的临床研究[J]. 菏泽医学专科学校学报, 2022, 34 (1): 60-62.

[25] 周陶成, 童光磊, 梁栋, 等. 靳三针联合“通督调神”针刺治疗儿童智力障碍临床及机制研究[J]. 中国针灸, 2021, 41 (7): 751-755.

[26] 张霞丽, 郭建新, 王娴, 等. 针刺联合语言训练对脑瘫患儿语言功能与运动功能的影响[J]. 中国听力语言康复科学杂志, 2025, 23 (6): 649-653.

[27] 冯艳静, 黄爽, 程艳, 等. 以头针为主治疗语言发育迟缓的选穴规律探析[J]. 中国民族民间医药, 2022, 31 (23): 92-97.

[28] 王文杰. “靳三针”配合康复训练治疗小儿精神发育迟缓的临床价值[J]. 包头医学, 2020, 44 (1): 50-52.

[29] 张媛, 陈立峰, 陈薇, 等. 集体语言训练联合经颅直流电刺激对语言发育迟缓患儿发育水平、言语功能及神经中枢营养因子水平的影响[J]. 现代生物医学进展, 2024, 24 (6): 1166-1170.

[30] 杨苗, 白朔. 醒脑开窍针联合语言训练治疗脑瘫伴语言发育迟缓患儿的效果[J]. 中国民康医学, 2023, 35 (14): 69-71.